Office of the Public Advocate Community Visitors Annual Report 2007 MENTAL HEALTH OFFICE OF THE PUBLIC ADVOCATE AN INDEPENDENT STATUTORY OFFICE ACCOUNTABLE TO THE VICTORIAN PARLIAMENT ISSN 1833-9387 Community Visitors Annual Report 2007 Mental Health Act 1986 Produced by the Office of the Public Advocate 5th floor, 436 Lonsdale Street Melbourne 3000 Victoria Telephone: 1300 309 337 (for the cost of a local call) 2 www.publicadvocate.vic.gov.au Contents 1 EXECUTIVE SUMMARY 3 2 RECOMMENDATIONS 4 3 MESSAGE FROM THE CHAIRPERSON 5 4 INTRODUCING THE BOARD 6 5 MESSAGE FROM THE PROGRAM MANAGER 7 6 INTRODUCING THE STAFF 8 7 INTRODUCING COMMUNITY VISITORS 9 8 GOALS, OBJECTIVES AND GUIDELINES OF THE BOARD 2006-07 10 9 THE FINDINGS, 2006-07 10 10 COMMUNITY VISITORS MENTAL HEALTH STREAM 10 The Community Visitors Program is a program of the Offi ce of the Public Advocate and its aims are incorporated within the mission of the Offi ce. The mission is to provide a responsive and accessible service that informs and engages with Victorians to promote and protect the rights and dignity of people with a disability, and reduce exploitation, abuse and neglect. ISSN 1833-9387 Ordered to be printed VICTORIAN GOVERNMENT PRINTER Dec 2007 No 71 Session 2006-07 MENTAL HEALTH COMMUNITY VISITORS ANNUAL REPORT 2006/07 1 30 October 2007 The Honourable Lisa Neville MP Minister for Mental Health Level 22, 50 Lonsdale Street MELBOURNE VIC 3000 Dear Minister RE: COMMUNITY VISITORS (MENTAL HEALTH) ANNUAL REPORT In accordance with the Mental Health Act 1986, please find enclosed the 2006-2007 Annual Report of the Community Visitors Mental Health Board. This year, Community Visitors celebrated 20 years of the program. We commend this report to you. Yours sincerely BARBARA CARTER RUTH BAKER OAM KEN LOCKE Acting Public Advocate Board Member Board Member 5th Floor - 436 LONSDALE STREET • MELBOURNE VICTORIA 3000 TELEPHONE: (03) 9603 9500 • VICTORIA: 1300 309 337 FAX: (03) 9603 9501 • TTY: 9603 9529 DX 210293 • E-MAIL: [email protected] www.publicadvocate.vic.gov.au 2 1 Executive Summary The 2007 annual report is an analysis of data collected The Board calls on the Government to increase the number from across the state and examined by the Board. of mental health beds and services in relation to demand and the expanding population growth. This includes The key findings provide the Board with evidence to inform government addressing the ongoing chronic shortage of the Victorian Government with an up-to-date commentary secure extended care beds. on public mental health services, including inpatient and residential services from 1 July 2006 to 30 June 2007. Shortage of professional and allied health staff: The report provides relevant information to demonstrate, • There remain continuing staff shortages with, at times, where, in the assessment of Community Visitors, service significant delays in recruitments to critical key staffing deficits are evident and where improved standards of positions that provide essential rehabilitation and treatment and care have been observed or are required. inpatient services. The Board through the activities of the Community Visitors The current recruitment initiatives undertaken by has continued to monitor services across the state to the government must continue in order to ensure that current 106 mental health facilities providing accommodation and and future positions within mental health services are inpatient mental health services. The Community Visitors maintained and the optimal mental health services are received in excess of 178 referrals from the Office of the delivered. Public Advocate’s Advice Service to respond to enquiries from patients, carers and interested persons in relation to Delays in maintenance and cleaning: various aspects of services and treatment of people with a • Significant delays in maintenance have been a mental illness. disturbing trend reported by the Board in some of the The Board remains concerned that, while there have state’s major metropolitan hospitals providing mental been significant funds announced by the Federal health services. Government in 2006 and encouraging signs towards a Government must increase maintenance funding, ensure much-improved state mental health system, the delays that hospital management is held accountable for the in the implementation impact on the day-to-day lives of provision of maintenance and cleaning services and ensure people with a mental illness. There is continuing need for that the rights of patients to a safe, clean and attractive improvements to address the ongoing demands on the environment are respected. current mental health services system. Shortage of low-cost rental accommodation Some significant key findings of this report are: The Board calls on the Government to address the Shortage of beds: shortage of low-cost rental accommodation in both the • The shortage of acute beds remains a key finding that private and public sector to ensure that options are has been reported by the Board to the Minister since available for patients on discharge. 2003. The Board further calls on the Victorian Government • The shortage of secure extended care beds remains; to continue to implement and invest in the provision of there are no such facilities in Hume and Barwon–South prevention and recovery care accommodation services West regions, with patients being inappropriately which are accessible statewide and to explore and accommodated in adult acute inpatient units waiting research ways of providing care for patients who require for secure extended beds and with some patients individualised secure accommodation that is currently remaining in acute units for more than eight months. unavailable. • There is a shortage of appropriate community accommodation on discharge and a lack of capacity by the state to meet the needs of patients with dual and complex needs. MENTAL HEALTH COMMUNITY VISITORS ANNUAL REPORT 2006/07 3 2 Recommendations The Community Visitors Mental Health Board recommends that the Victorian Government: 1 Increases the number of mental health beds and services in relation to demand and to the expanding population growth areas, such as Barwon-South West Region 2 Urgently addresses the shortage of secure extended care beds to help ease the pressure on adult acute beds 3 Takes action to reduce the common practice of locking acute units by providing additional high dependency beds where needed 4 Increases funding for the Multiple and Complex Needs Initiative and the Integrated Rehabilitation and Recovery Care Program to ensure they are effective and responsive to the requirement of patients with particular needs who are in hospital units 5 Maintains and extends initiatives to increase the number of professional allied health staff and psychiatric nurses 6 Increases maintenance funding and ensures that hospital management is held accountable for the provision of maintenance and cleaning services that are effective, responsive to immediate needs and respect the rights of patients to a safe, clean and attractive environment 7 Takes action to overcome the chronic shortage of low-cost rental accommodation in both the private sector and public sector to ensure accommodation is available on discharge from mental health facilities 8 Further expands the provision of prevention and recovery care accommodation services state-wide 9 Explores and researches ways of providing the care and accommodation needs of patients for whom individualised secure accommodation is required which is currently unavailable. An opportunity may exist to consider such a model of care within the proposed facility to be built at Heidelberg. 4 3 Message from the Public Advocate as Chairperson of the Board For twenty years, Community Visitors have been informing The Board will monitor the impact of the State government about issues affecting the most vulnerable Government’s tobacco reforms relating to restricting members of our community. The Community Visitors are smoking in public places and venues taking effect from the eyes, ears and voice of the community. The Community 1 July 2007. A study quoted by SANE Australia found Visitors also provide a voice for people with a disability who that smoking rates in people with schizophrenia are up may be unable to advocate for themselves. to three times those of the general population. Nicotine withdrawal symptoms usually occur and can be very This annual report is based on the dedicated work of the distressing. It will be crucial for Community Visitors in the Community Visitors in the Mental Health stream of the mental health stream to oversee the potential impact of program who conducted 1251 visits to facilities in 2006-07. the reforms and ensure people have access to adequate On behalf of the Mental Health Board, I thank all nicotine replacement management and specialised group Community Visitors for their commitment, time and energy programs, for example SmokeFree programs, while in in promoting the rights of patients and residents in the mental health care and affected by the reforms. facilities. The Community Visitors perform a most valuable I appreciate the support and cooperation provided to role and the production of this report is an important part of Community Visitors by service providers and DHS program the advocacy effort of the Office. staff and rural regional staff. The day-to-day discussion and The Board has welcomed implementation of mental cooperation assists us to protect rights and tackle issues of health initiatives in Victoria announced in the May 2006 patient wellbeing. State Budget. This report details many current shortfalls Julian Gardner, the former Public Advocate, was a member in service provision, in particular, the shortage of beds of the Mental Health Board for all but two months of the features as it has for several years. The findings of the year. The Board, Community Visitors and staff thank Julian Community Visitors are largely about the impact of bed for his vision, inspiration and support. I also thank the shortages on the whole system of care.