/ CHHS17/054

Canberra Hospital and Health Services

OperationalProcedure

Approval ofExternal Counselling Sessions

(Mental Health Justice Health Alcohol and Drug Services (MHJHADS))

Contents

Contents

Purpose

Alerts

Scope

Section 1 – Background

Section 2 – Procedure for Approval of Bereavement Counselling Sessions for People Affected by Suicide

Section 3 – Procedure for Approval of Counselling Sessions for Disaster Affected Persons Requiring Further Support

Implementation

Related Policies, Procedures, Guidelines and Legislation

References

Definition of Terms

Search Terms

Appendices

Appendix A: Letter of Condolence

Appendix B: Minimum Credentials Required for Approved Mental Health Professionals

Appendix C: Conditions for Approved Mental Health Professionals

Purpose

The purpose of this procedure is to provide information on the provision of bereavement counselling and support to families and carers affected by the suicide of a person accessing Mental Health, Justice Health and Alcohol and Drug Services (MHJHADS), and/or to those affected by an emergency or disaster in the ACT who have been provided with initial psychosocial support by MHJHADS staff under the Disaster Recovery Counselling Committee: Psychosocial Response Operational Plan.

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This Standard Operating Procedure (SOP) describes for staff the process to

Scope

Alerts

Bereavement by Suicide

This procedure should be read in conjunction with the MHJHADS Significant Incidents Reporting Operational Procedure.

Emergency and Disaster Recovery

Under the ACT Community Recovery Sub Plan, MHJHADS Division of ACT Health has the responsibility in the ACT to provide timely psychosocial response, assessment, intervention and support to the people of the ACT in the aftermath of a disaster or emergency.This procedure should be read in conjunction with the ACT Community Recovery Sub Plan (available via the Community Services Directorate website) and the Disaster Recovery Counselling Committee: Psychosocial Response Operational Plan.

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Scope

This procedure applies to all staff within the ACT Health, MHJHADS Division.

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Section 1 –Background

Bereavement by Suicide

Families and carers affected by a death by suicide often face unique challenges that differ from those bereaved by another type of death. This may include higher rates of stigma and complicated grief reactions when compared with other causes of death. Furthermore, the risk of death by suicide can increase in families where a suicide has previously occurred.

Emergency and Disaster Recovery

A small portion of disaster affected persons will continue to experience elevated levels of distress and require support beyond psychological first aid. Difficulties are often related to the hardships encountered during disaster recovery rather than the event itself. These individuals may have pre-existing vulnerabilities, such as mental health conditions or past traumas.

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Section 2 – Procedure for Approval of Bereavement Counselling Sessions for People Affected by Suicide

Following a significant incident:

  1. By the next business day, the Manager is to advise the Discipline Principal of Social Work, or their delegate, of the death and provide details of any contact (if made) with the family member(s)/carer(s)/nominated persons(s), and the circumstances of the death.
  2. Within seven (7) days, the Discipline Principal of Social Work will send a letter of condolence (refer to Appendix A: Letter of Condolence) and offer of support or counselling to the family member(s)/carer(s)/nominated person(s), in consultation with the program area. The letter will also contain appropriate information on bereavement and related issues
  3. All arrangements for external mental health counselling and support will be made through the Discipline Principal of Social Work, with the Director of Allied Health maintaining the financial delegation.Up to six (6) counselling sessions are available for each affected person.
  4. Counselling, if requested, or other forms of support will be provided by appropriately qualified and approved external mental health professionals.
  5. Appendix B: Minimum Credentials Required for Approved Mental Health Professionals lists the required credentials for professionals to be considered appropriately qualified to provide counselling.
  6. A list of approved external mental health professionals will be kept and maintained by the Discipline Principal of Social Work. The list of approved external mental health professionals will include, where possible, professionals with expertise in providing counselling to specialist groups, such as children and young people, Aboriginal and Torres Strait Islander people, people from culturally and linguistically diverse backgrounds, and people who identify as Lesbian, Gay, Bisexual, Transgender, Intersex (LGBTI).
  7. To be a MHJHADSapproved external mental health professional, an EOI will be advertised every three years (or as required) and will be decided on the credentials listed in Appendix B: Minimum Credentials Required for Approved Mental Health Professionals. Previously approved mental health professionals will need to reapply every three years to remain on the list, and provide proof of their ongoing continuing professional development in the area. A contract will be signed with the approved mental health professionals outlining payment conditions (refer to Appendix C: Conditions for Approved Mental Health Professionals).
  8. If the need for further sessions is identified, the Discipline Principal of Social Work will request further sessions, providing a background and rationale as to their need, to the Director of Allied Health, who will authorise the additional sessions if appropriate. This authorisation is required prior to further sessions being booked. Sessions undertaken without authorisation will not be paid for by MHJHADS and will remain the responsibility of the individual and the mental health professional.
  9. All communication in relation to offers of counselling and support to family and carers are to be documented in the deceased person’s electronic clinical record.

Note:

All additions to the deceased person’s electronic clinical record are to be approved by the Executive Director of MHJHADS prior to being made.

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Section 3 – Procedure for Approval of Counselling Sessions for Disaster Affected Persons Requiring Further Support

Where it has been identified that a disaster affected person is in need of psychological support beyond psychological first aid offered as part of the Disaster Recovery psychosocial response (refer to DRCC Operational Plan within the MHJHADS Disaster Recovery: Coordination of Psychosocial Response Operational Procedure), the following is required:

  1. The On Site Disaster Recovery Team Leader (appointed upon activation of the Disaster Recovery Counselling Committee: Psychosocial Response Operational Plan)is to advise the Discipline Principal of Social Work or their delegate of the need and provide details of contact made to date, including background and rationale for sessions.
  2. Steps 3 to 7 are followed as per Section 2.
  3. All communication in relation to offers of counselling and support are to be documented in the person’s Disaster Recovery Counselling Committee (DRCC) counselling file, kept in the DRCC Administrative Centre (1 Moore Street, Canberra).

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Implementation

Staff will be advised of this procedure via their Operational Directors and Managers.

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Related Policies, Procedures, Guidelines and Legislation

Policies

  • ACT Health Consumer and Carer Participation Framework
  • MHJHADS Assessment and Intervention with Persons Vulnerable to Suicide
  • ACT Health Significant Incidents Reporting
  • ACT Health Incident Management Policy
  • ACT Health Open Disclosure Procedure

Procedures

  • CHHS Healthcare Associated Infections Clinical Procedure
  • CHHS Patient Identification and Procedure Matching Policy

Legislation

  • ACT Human Rights Act 2004
  • Carers Recognition Act 2010
  • Emergencies Act 2004
  • Health Records (Privacy and Access) Act 1997
  • Mental Health Act 2015
  • Work Health and Safety Act 2011

Guidelines

  • National Standards for Mental Health Services 2010
  • National Safety and Quality Health Services Standards 2012
  • Standards of Practice for ACT Health Allied Health Professionals 2016
  • The ACT Charter of Rights for People who experience Mental Health Issues
  • Mental Health Statement of Rights and Responsibilities 2012
  • Australian Charter of Healthcare Rights 2008

Emergency Plans

  • ACT Community Recovery Sub Plan
  • ACT Recovery Plan
  • ACT Health Emergency Plan
  • Disaster Recovery Counselling Committee: Psychosocial Response Operational Plan
  • MHJHADS Business Continuity Management Plans

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References

  1. Hutton, D. (2001). Psychosocial aspects of disaster recovery: Integrating communities into disaster planning and policy making. Institute for Catastrophic Loss Reduction.
  2. Tal Young, I., Iglewicz, A., Glorioso, D., Lanouette, N., Seay, K., Ilapakurti, M., & Zisook, S. (2012). Suicide bereavement and complicated grief. Dialogues in Clinical Neuroscience, 14(2), 177-186.

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Definition of Terms

Death in Custody – death in the care of a custodial officer as defined in Section 3C Death Coroners Act 1997 e.g. Police, Corrections and Mental Health Officers accompanying people subject to an order under the Mental Health Act 2015. It includes, but is not limited to, deaths that arise while being taken into or detained in custody. This incorporates deaths that occur in hospital or in the community where a person is subject to a Mental Health Order.

Open Disclosure – a process of communication with patients/consumers/people following an adverse event and is not a legal process. Apologising and disclosing an adverse event to a patient/consumer/person is not the same as admitting fault, rather it is an expression of regret and statements of fact. The standard outlines a clear and consistent process which includes:

  • an apology
  • an invitation for the consumer to relay their perspective on the event
  • a factual explanation of what occurred, including actual and potential consequences, and
  • the steps being taken to manage the event and prevent its recurrence

Refer to the Open Disclosure Procedure for more information.

Postvention – an intervention conducted after a suicide, largely taking the form of support for the bereaved (family, friends, professionals and peers).

Riskman – an online web based system used to report incidents.

Sad News – a term used by Torres Strait Islander people in Australia to describe a set of unique cultural practices and protocols associated with a death in the community during the time following the death.

Significant Incidents – an incident with an Extreme or Major outcome occurring in relation to ACT Health services and care, requiring immediate notification to the Director General/Deputy Director General. Significant Incidents include Sentinel events and Notifiable Incidents.

Sorry Business – a term used by Aboriginal people in Australia to describe a set of unique cultural practices and protocols associated with a death in the community during the time following the death.

Work Injury – an injury or illness contracted as a result of duties performedduring the course or work activities.

DRCC Specific Terms

DRCC: Disaster Recovery Counselling Committee.

Community Recovery Coordinator: the Deputy Director of the Community Services Directorate. They are responsible for initiating contact with the Chair of the DRCC and activating the response under the Community Recovery Sub-Plan.

Counselling Sites: a location or site where staff of member agencies of the DRCC are deployed to provide psychosocial response and support.

Counsellors: qualified professionals from a range of government and non-government member agencies whose role it is to provide psychological first aid and counselling to affected persons.

Disaster Recovery Counselling Committee: the members of the Disaster Recovery Counselling Psychosocial Response and Support Committee.

Personal Support Workers: people nominated to provide personal support in emergency or evacuation centres or in the community, to people affected by the emergency. This can include staff from any participating member agency identified as being able to provide that support.

Emergency Management Terms

Emergency/Affected Person:a person who is in need or distressed or whose property is lost or damaged as a result of an emergency.

Emergency:an event such as fire, flood, storm, earthquake, explosion, accident, act of terrorism, biochemical event, epidemic or animal disease, actual or imminent, which requires a significant and coordinated response. An emergency includes those events deemed by Emergency Services Authority as disasters or natural disasters.

Emergency Management: the establishment of formal plans, structures and arrangements so as to coordinate the resources of agencies, and agencies and other persons in a comprehensive approach to facilitate prevention, preparedness, response and recovery in relation to emergencies or emergency risks.

Emergency Recovery: the coordinated process of supporting emergency/ affected individuals and communities in the reconstruction of the physical infrastructure and the restoration of emotional, social, economic, physical and spiritual wellbeing.

Evacuation Centre Manager: a member of the Community Recovery Network, Community Services Directorate, that is responsible for the management and coordination of information between stakeholders at an Evacuation Centre.

Incident: a localised event, either accidental or deliberate, which may result in death, injury or damage to property, which requires a normal response from an agency/s. An incident becomes an emergency when the resources of the agency are insufficient to deal with the incident and outside resources are desirable or required. Those resources then require coordination.

Territory Controller:Under the ACT Emergencies Act 2004, in respect of a declared emergency: “The controller shall manage the response to, and the recovery from, the emergency by ensuring agencies, agencies and other persons committed to dealing with the emergency are appropriately deployed.”

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Search Terms

Bereavement; bereavement by suicide; death by suicide; counselling; approved mental health professional; disaster recovery; mental health; MHJHADS.

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Appendices

Appendix A – Letter of condolence

Appendix B – Minimum credentials required for approved mental health professionals

Appendix C –Conditions for approved mental health professionals

Disclaimer: This document has been developed by ACT Health, Canberra Hospital and Health Service specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.

Date Amended / Section Amended / Approved By

Appendix A: Letter of Condolence

Insert Date

Insert Name

Insert Address

Dear

On behalf of Mental Health, Justice Health and Alcohol & Drug Services (MHJHADS), I would like to extend to you and your family sincere condolences on your recent loss.

We realise that this is a difficult time for you and your family and that everyone reacts differently to the death of a loved one. Some people find solace with family and friends or supportive networks, while others find it helpful to speak with a professional counsellor about their loss.

If you feel that speaking with a professional counsellor may assist you and/or your family members, MHJHADS will fund up to six (6) sessions with acounsellor. Please seek out a Mental Health Care Plan from your GP for each of the family members requiring professional support and then contact the Discipline Principal of Social Work for MHJHADS on 6205 xxxx or via email on to make the appropriate arrangements for reimbursement.

The following professional counsellors have identified as working with bereavement, though you are welcome to see a counsellor of your choice:

  1. <refer to counsellors list. Identify counsellors appropriate for client group, example counsellors specialising in working with children, or older adults, etc>

Support can also be obtained by the Support Link Standby Response Service who provide free support to people who have lost a loved one by suicide. They can be contacted on 0421 725 180, 24 hours a day, 7 days a week. Lifeline also provide a range of support services and can be contacted for support on 13 11 14, 24 hours a day, 7 days a week.

I have enclosed information on suicide bereavement and communicating with children affected by a death by suicide.

Please contact me if I can assist you and your family in any way.

Yours sincerely,

Name

Title

Business Area

Mental Health, Justice Health and Alcohol & Drug Services

GPO Box 825 Canberra ACT 2601

Appendix B: Minimum Credentials Required for Approved Mental Health Professionals

A list of approved mental health professionals for the provision of counselling services to family member(s)/carer(s)/nominated person(s) affected by the unexpected death or suicide of a consumer will be kept and maintained by the Discipline Principal of Social Work.

The list of approved mental health professionals will include and identify, where possible, professionals with expertise in providing counselling to specialist groups, such as children and young people, Aboriginal and Torres Strait Islander people, people from culturally and linguistically diverse backgrounds, and people who identify as LGBTI.

To be an approved mental health professional, the following credentials are required:

  • An accredited qualification in counselling, psychology, or social work and registration with AHPRA (if relevant).
  • A minimum of 10 years post-graduate experience, particularly in the area of mental health, trauma, bereavement by suicide, and grief.
  • Professional indemnity insurance
  • Ongoing continuing professional development in the area of mental health, trauma, bereavement by suicide, and grief.

Previously approved mental health professionals will need to reapply to remain on the list every three years, providing proof of their ongoing continuing professional development in the area.

Appendix C: Conditions for Approved Mental Health Professionals

The following conditions will form the basis of any contract made with an approved mental health professional that is deemed eligible following the EOI process:

  1. Where eligible, the person will be advised to seek a Mental Health Care Plan from their GP.
  2. MHJHADS will provide payment for up to six (6) sessions.
  3. If further sessions are required, the mental health professional will contact the Discipline Principal of Social Work or delegate providing a background and rationale as to their need.
  4. MHJHADS will not provide payment for sessions beyond the initial six (6) sessions unless approval has been granted by the Director of Allied Health. Sessions undertaken prior to approval will be the responsibility of the individual and the mental health professional.
  5. MHJHADS will not provide payment for ‘failure to attend’. It is expected that the individual will be made aware of and agree to the mental health professionals cancellation policy.
  6. Interventions provided to individuals will be based on best practice and will focus on supporting the individual through the bereavement process. If other treatment needs are identified, the individual and the mental health professional may choose to continue treatment beyond that for bereavement, however, this will not be funded by MHJHADS.