Family and Carer Issues
If you have a complaint about the treatment you or a friend or family member are receiving from your local mental health services, please refer to our complaints section for information on what to do.
Q. If a family member is using mental health and/or addiction services, what rights do the family have to be involved in that process?
There is nothing in the Privacy Act to prohibit family members providing information to mental health services regarding a family member, and nothing to prevent services receiving such unsolicited information and taking action based on it. However, services may choose to verify information obtained in this way before taking action.
Additionally, under the Mental Health (Compulsory Assessment and Treatment) Act, there is a legal requirement for families to be consulted. If there are still concerns about the lack or level of treatment received by the person who is at risk, the family member should contact the Clinical Director or Manager of Mental Health Services of at their local DHB and pursue the matter with them.
Some DHBs now have a family liaison worker who may be able to offer support to families, and who may also be able to act as a conduit for advice to the DHB regarding its policies and procedures.
Q. If one or both parents are under the care of mental health services, how can family members obtain support in caring for the children?
In this kind of situation there are two avenues to explore:
- Speak to the mental health services case worker(s) involved in the parent(s)' treatment and ask to speak/meet with a mental health services social worker to discuss what avenues of support may be available.
- Call the local Child Youth and Family Services (CYFS) office and ask to speak to the duty social worker to discuss what options are available for care at home (if appropriate) or elsewhere (what advice is provided will be partly dependent on an assessment of whether the children are at risk). While CYFS may utilise other agencies, such as Barnardos, it may also be possible for people to contact such agencies directly.
Q. If your parent's mental health issues are affecting you and/or your relationship with them, how can you or your parents access help to deal with this?
Supporting Families (SF) [formerly Schizophrenia Fellowship] are contracted to provide support and assistance to families of people with experience of mental illness (not just those who have schizophrenia) and have family advisors who would be able to offer advice and support in this situation. SF has a wide national network and the local branch should be listed in the phone book. Otherwise, contact the SF National Office in Wellington by phoning 04 499 7012 or visit the SF website at www.sfnat.org.nz.
Also, there is a national organisation called Relationship Services who provide counselling for families - if there is a branch in your area it will be listed in the phone book under ‘Relationship Services'.
If the problem is creating mental health issues for you, then you may be able to access the Child and Youth Service of your local DHB. However, if the issue is that of relationship problems, rather than you developing mental health issues, this service may not be able to offer assistance, although they may be able to provide suggestions as to further courses of action.
If you school has a guidance counsellor they may be able to assist or to suggest other local organisations that may be able to provide advice and/or support.
Q. When consulting with families, do DHBs have to adhere to Standard 10? What access do families have to put their case forward and to be involved?
Objective 3.3 of the National Mental Health Strategy is to improve responsiveness of mental health services to families and caregivers. This is supported by Standard 10 of the National Mental
Health Standard, Family, Whānau Participation, which covers the obligations of providers to develop policies and procedures that actively support family, whānau participation in decision making and monitoring of services.
The term "family advisory services and family run initiatives" describes funded peer support, and education and training services, run by family members for family members, as well as advisory services to providers. People are employed to provide such services in some DHBs, but most work in NGOs. The figure below shows the growth in these positions over the last year, and the gap to the Blueprint guideline.
More information on family advisory services and family run initiatives:
2000 / 2001 Family Advisory Positions (Blueprint guidelines and actual contracted full-time positions [FTEs])
All DHBs should by now have implemented Mental Health Standard 10 as this is the nationally recognised standard for DHB services. However, there is currently no external monitoring of standards implementation, and the way in which standards are implemented may vary between DHBs, as will the degree to which family members may be involved in determining policy on a variety of issues. If family members are concerned about either the level of, or lack of, involvement of families, this should be raised, in the first instance, with the mental health services manager at the DHB. This could be done by either a single individual or by a group sharing the concerns. If this does not have a satisfactory outcome, then concerns could be taken to the funding and planning manager or to the CEO of the DHB.
Most DHBs in their current District Annual Plans describe recent service development and future plans for ensuring that they respond better to the needs of families, whānau and caregivers of their service users. This should provide an indication of what initiatives your local DHB has implemented to support family, whānau participation and you should be able to obtain a copy of the current plan from the DHB. Below is a list of ideas from District Annual Plans for 2001/02.
Policy development:
- Development of family/whānau policies
- Expectations for staff regarding implementation of these policies being included in position descriptions
- Linking of policies to performance management
- Development of closer relationships with local family support and representative organisations such as Supporting Families in many parts of the country
Support and information for families:
- Appointment of a kaitakawaenga (family/whānau support and liaison)
- Availability of kaumatua to support family/whānau
- Consumer/family newsletters
- Preparation of information handbooks for service users and families
Involvement of families at the level of the individual service user:
- Involvement of families at the level of the individual service user
- Regular family/whānau ward meetings
- Documentation of family involvement in service user records
- Visiting areas made more suitable for visiting children
- Staff attendance at NGO case conferences with service users and families
Feedback from families:
- Satisfaction studies and feedback forms
- Family forums to obtain feedback and input in service development
Support for the organisation and staff from families:
- Appointment of a family advisor to the DHB
- Family advisor involvement in audit of services
- Family/whānau participation in quality improvement project groups
- Assistance from family/whānau with staff training
Support for staff:
- Family/whānau support modules in orientation and in service training of clinicians
- Ensuring staff have access to the publication of the Royal Australian and New Zealand College of Psychiatrists, Involving Families Guidance Notes
- Research into engagement of families