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Legal Systems and Mental Health in NSW Australia

This is essay is for Masters level course.

Please read the below instructions carefully.

You will need to read the below article and then answer all the questions in an academic essay.

1-The paper should be in academic essay style with sub-headings permitted.
2.The essay should be 3,000 words +/– 10%. Please use 12 point font and 1.5 line spacing.
3.The aim of the essay is to dentify and critically analyse key social work theoretical and ethical perspectives as they interact with the legal system.
4.You need to have undertaken additional reading and research in relation to the topic. A minimum of 10 references is recommended.
5.Read the article and then address the questions about mental health services, rights and responsibilities and the law in NSW. You must address all parts of the question in your essay.

You need to ensure that the essay meets the following criteria:

1-Demonstrated ability to critically evaluate the Australian legal system in relation to social work practice with regard to the impact of laws and the legal system on vulnerable populations through exceptional and insightful critique of the issues and presentation of a well reasoned argument for the position taken.

2-Demonstrated ability to identify the specific legal responsibilities for social workers in relation to the particular issue(s) examined
through exceptional capacity to identify social workers’ legal responsibilities in relation to particular issues examined.

3-Demonstrated ability to utilise and critique use of specific social work interventions within the legal system through exceptional and insightful critique of interventions within the legal system and high number of relevant and up to date references

4-Explain and critique personal values and professional ethical issues in relation to social work practice within the legal system through exceptional and insightful critique of personal values and professional ethical issues in relation to social work practice within the legal system.

5-Presentation including clarity of written communication, organisation of the material (typed with 1.5 spacing, clear margins, with headings and sub-headings) and accuracy of APA referencing style through exceptional/outstanding work of a publishable standard, meticulous referencing.

ESSAY QUESTIONS FOR LEGAL SYSTEM AND MENTAL HEALTH

Consider the article by Jonathan Harms of ARAFMI Reviewing the implementation of primary carers rights under the Mental Health Act 2007 September 30, 2011

Identify legislation which is relevant to the main issues raised in the article. Discuss the impact of this legislation and how it is implemented through mental health services on individuals with mental illness and their families and/or carers.

Discuss the social work ethics that would be relevant in the area of mental health services and how this would intersect with the law.

Reflecting on mental health services, at which level of government should these types of issues be managed for the wellbeing of individuals and why?

Students are encouraged to read widely on the subject to build knowledge and understanding of the role of social workers in mental health services and the impact of law on their work.

Reviewing the Implementation of Primary Carers Rights under the Mental Health Act 2007
In 2009 ARAFMI conducted a survey of carers to understand how the primary carer changes had been implemented across NSW and now would like to repeat the survey to gauge progress since that time.

Article | September 30, 2011 | By Jonathan Harms
The new Mental Health Act introduced in 2007 for the first time explicitly recognised the role of carers in mental health care.
Section 68: (j) the role of carers for people with a mental illness or mental disorder and their rights to be kept informed should be given effect.
Further than this it sought to address specific long-standing issues for carers in the mental health area, particularly around the exclusion of carers from information about their loved one’s treatment by the creation of the ‘primary carer’ role.
This exclusion can occur because unlike most other illnesses, in mental illness people can be strongly resistant to treatment and can seek to frustrate it by any means, including by preventing carers from knowing any details about their treatment (even if they are in fact providing the bulk of support to them). Sometimes they can also become suspicious of their carers and this can also cause them to seek to exclude them from information.
ARAFMI has already written in more detail about the reasons carers can sometimes be excluded and the general legal rationale behind the recognition of Primary Carers in the Mental Health Act 2007 in this article:
http://www.arafmi.org/article/primary-carers-mental-health-act-2007
However, there were strong reasons for making these changes to the Act in 2007 and perhaps some of the most important were the findings of NSW Mental Health Sentinel Events Committee’s four reports, which were finally tabled as one in the NSW Legislative Council in September 2009 called “Tracking Tragedy – a systematic look at homicide and non-fatal serious injury by mental health patients and suicide deaths of mental health inpatients” (the ‘Tracking Tragedy Report’).
This Report reviewed cases in which people who were under the care of public mental health services had killed or seriously harmed themselves or others.
With regard to suicide while on authorised leave from a mental health facility for example, this Report found that of the 22 consumers who had done this; 11 were normally living with their families when not in hospital. However, five of their files did not document any communication with the family about leave from the facility or the risk of suicide before the consumers were released by the facility and killed themselves (page 13, ‘Key Findings Communication’). While these numbers represent a tiny proportion of people receiving assistance from health services in NSW, the findings were instructive.
The Report found that several deaths could have been prevented by better communication and contingency planning with the family (pages 13 and 33) and that while suicide in in-patient settings or whilst on unauthorised leave was declining, suicide on authorised leave was actually increasing at the time of the Report (page 19).
The Report noted that ‘the issues around communication with families are symptomatic of broader issues within the mental health system. The balance on issues such as confidentiality is often not achieved due to staff skills, experience, attitudes and workload’.
However, this is not to discount the difficulty of managing these issues for NSW Health staff. The treating team must develop a relationship with the consumer in order to be able to assist them. If they adamantly do not want their families or carers involved or advised about their treatment this naturally presents a very real dilemma.
Added to this are technical legal issues around confidentiality of medical information and decision making capacity which trained lawyers can disagree about, let alone doctors and nurses and carers. Balancing issues of trust and legal rights while still allowing carers to have enough information to support their caring role, particularly when a consumer is discharged from inpatient care, can be very difficult.
However, the authors of the Tracking Tragedy Report welcomed the changes to the Mental Health Act which sought to address these concerns by creating the role of Primary Carer. Provisions in the Act were meant to address some of the confusion around appropriate access to information by family and carers and to facilitate their inclusion in a consumer’s mental health treatment when their attitude to carer involvement fluctuated due to their illness.
A primary carer nomination allows the consumer to nominate a person to be given special access to their information and this nomination can remain in place if its removal is beyond the consumer’s capacity when they become unwell or would place them or others at risk if it were removed. If they are too unwell to make a nomination it can be made on their behalf from potential nominees listed in section 71 (1)(d) of the Act. ARAFMI also welcomed the changes which still stand as being the most sophisticated attempt to deal with this issue legally so far in Australia.
Primary Carer Implementation Survey
In 2009 ARAFMI conducted a survey of carers to understand how the primary carer changes had been implemented across NSW and how beneficial they had been.
Now, two more years later ARAFMI would like to repeat this survey to better understand how the situation has changed since that time, and what further improvements could be made. This is especially important given that the Mental Health Act is to be reviewed in 2012 and could possibly be further refined in a number of areas as a result, including with regard to carer rights generally and primary carer rights in particular.
If you would like to undertake this survey to inform ARAFMI, please click on the link below:
http://www.surveymonkey.com/s/FFP63WD
ARAFMI will publish results of this survey along with a comparison with the previous results in the next ‘Mind Reader’. They will also be considered along with the results of further consultations by ARAFMI when providing input to the future review of the Mental Health Act 2007 in 2012.
About the Author
Jonathan Harms
Manager Policy, Promotion and Member Services

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