organisations in draft version 2 of the NSQHS Standards) and Standard 2: Partnering with Consumers (Standard 2: Partnering with consumers in draft version 2 of the NSQHS Standards). Workforce development A suitably skilled and qualified healthcare workforce is integral to a health service organisation providing an appropriate response to deterioration in a person’s mental state. Health service organisations use recruitment processes to ensure that the healthcare workforce has the appropriate skill mix to deliver safe, effective and culturally competent care. Where appropriate, this may include recruitment of peer workers and Aboriginal mental health workers. Members of the healthcare workforce benefit from ongoing professional development, accessed within the health service organisation, or through external training programs, in order to augment their skills. Dealing with deterioration in mental state can be challenging for members of the multidisciplinary team, and for other staff members such as ward clerks, porters and cleaners. It can add considerably to workplace stress. Chronic, unmanaged stress can erode empathy and potentially contribute to poorer experiences for people accessing health care. Members of the healthcare workforce should have access to peer support, mentoring and appropriate clinical supervision. Standardised processes to support high quality care Many health services have escalation protocols to respond to specific aspects of deterioration in a person’s mental state, including: a process for review by specialist mental health staff support for people who have thoughts of self-harm, or who have harmed themselves support for people who have suicidal thoughts management of delirium drug and alcohol intoxication or withdrawal management of aggression or violence discharge against medical advice, including an assessment of competency. Technological systems such as MyHealthRecord may also provide benefits to people, for example, by contributing to improved communication with external care providers and improved continuity and coordination of care as people are transferred in and out of acute health services. Evaluation and feedback Ongoing monitoring and evaluation of processes and systems for recognising and responding to deterioration in mental state is essential to establish their efficacy, track performance over time and determine priorities for improvement. Evaluation should address the quality and safety of responses to deterioration in mental state, not just the potential preventability of adverse outcomes.
Ms Janne McMahon OAM* Independent Chair Private Mental Health Consumer and Carer Network (SA) Ms Karen Burns* Chair Mental Health Coordinating Council (NSW) Dr Kim Mullaley+ Emergency department consultant Joondalup Health Campus Ms Lily Wu Consumer representative National Mental Health Consumer and Carer Register Mr Malcolm Green+ Program Lead, Between the Flags Clinical Excellence Commission (NSW) Dr Marc Broadbent* Senior Lecturer, School of Nursing and Midwifery University of the Sunshine Coast, (QLD) Associate Professor Morton Rawlin* Chair, General Practitioner General Practice Mental Health Standards Collaboration (RACGP) (VIC) Dr Nathan Gibson* Chief Psychiatrist, WA Safety and Quality Partnership Advisory Committee (SQPSC) Dr Nick Kowalenko Chair, Faculty of Child and Adolescent Psychiatry Royal Australian and New Zealand College of Psychiatrists Dr Peter Jenkins* Director, Child and Youth Mental Health, Eastern Health Royal Australian and New Zealand College of Psychiatrists Associate Professor Richard Newton Medical Director, Mental Health Austin Health Professor Tracey Bucknall+ Associate Head of School, Faculty of Health Deakin University Ms Wei Ting Ho Clinical Nurse Consultant, Physical Health Sydney Local Health District MHS * member of ACSQHC Mental Health Advisory Group + member of ACSQHC Recognising and responding to clinical deterioration Advisory Committee