Implementation guidelines for non-government community services

How the national standards and their supporting principles apply to the non-government community mental health service sector

Page last updated: 2010

This section discusses the principles that underpin the national standards, and the nine performance indicators that are associated with the delivery of care and services. These principles and performance indicators are the same for all parts of the mental health service system.

The National Standards for Mental Health Services
Complying with the national standards
Principles underpinning the national standards
Implementation

The National Standards for Mental Health Services

The national standards focus on recovery and are based on values related to human rights and dignity. They promote the empowerment of consumers of mental health services, their carers and families. They emphasise practices which support continuous improvement in service quality. Although they are presented separately, many of the standards are interrelated. Section 2 Working to the guidelines of this guide includes a table which identifies those interrelationships so that service providers can avoid duplication by cross referencing their implementation of related standards.

Service providers should find no surprises in the national standards. The issues that they address should already be the focus of organisations that are committed to providing quality services.

It is important to note that not all criteria associated with each standard apply to the non-government community mental health sector. This is further discussed in Section 2 Working to the guidelines of this guide.Top of page

Complying with the national standards

All of the national standards that apply to the non-government community mental health sector are equally important. However, there are differences in compliance expectations.

Standard 6 Consumers brings together criteria that are assessable under other standards. They do not have to be assessed again for Standard 6. Gathering them under Standard 6 ensures that all consumer related criteria are examined together, so that the service provider gets a good composite picture of their performance in relation to consumers.

Most standards can be met at different levels. This is what continuous improvement is about, the capacity to do even better once minimum requirements are met. For example, in Standard 3 Consumer and carer participation, Criterion 3.1 a service provider might be able to demonstrate in its year one self assessment that it has opportunities for consumers and carers to be involved in planning, service delivery, evaluation and quality programs. That involvement might be once a year and minimal. The service provider could set a goal that by year 3, there will be at least one opportunity every three months for more comprehensive involvement. In the three-year self assessment, this service provider would be meeting Standard 3 Criterion 3.1 more comprehensively than they were in their year one self assessment.

Some standards and the criteria that support them must always be met in full. Standard 2 Safety is in this category. All service providers must be able to demonstrate that their services are safe. While continuous improvement should still be a goal, safety requirements must be met. There is no scope for service providers to be at a 'minimal' level of achievement and 'working towards' achieving Standard 2. Similarly if standards have criteria that relate to meeting legislative requirements (for example, Standard 8 Governance, leadership and management, Criteria 8.4 and 8.9) service providers must demonstrate from year one that these criteria are met.Top of page

Principles underpinning the national standards

The principles behind the national standards and the nine performance indicators apply equally across all parts of the mental health service system. The principles of recovery oriented mental health practice sit above all of them.

The principles that have been followed in the development of the national standards are:
  • Mental health services should promote an optimal quality of life for people with mental health problems or mental illness.
  • Services should be delivered with the aim of sustained recovery.
  • Consumers should be involved in all decisions regarding their treatment and care, and as far as possible should have the opportunity to choose their treatment and setting.
  • Consumers have the right to have their nominated carers involved in all aspects of their care.
  • The role played by carers, as well as their capacity, needs and requirements should be recognised separately from consumers.
  • Participation by consumers and carers is integral to the development, planning, delivery and evaluation of mental health services.
  • Mental health treatment, care and support should be tailored to meet the specific needs of the individual consumer.
  • Mental health treatment and support should impose the least personal restriction on the rights and choices of consumers, while taking into account their living situation, level of support within the community and the needs of their carers.
The national standards describe care that will be delivered in accordance with each of the nine Key performance indicators for Australian public mental health services (2005):
  • Effectiveness: care, intervention or action achieves desired outcome in an appropriate timeframe.
  • Appropriateness: care, intervention or action provided is applicable to the client's needs and based on established standards.
  • Efficiency: achieving desired results with the most cost effective use of resources.
  • Accessibility: ability of people to obtain health care at the right place and right time irrespective of income, physical location and cultural background.
  • Continuity: ability to provide uninterrupted, coordinated care or service across programs, practitioners, organisations and levels over time.
  • Responsiveness: the service provides respect for all persons and is client orientated. It includes respect for dignity, cultural diversity, confidentiality, participation in choices, promptness, quality of amenities, access to social support networks, and choice of provider.
  • Capability: an individual's or service's capacity to provide a health service based on skills and knowledge.
  • Safety: the avoidance or reduction to acceptable limits of actual or potential harm from health care management or the environment in which health care is delivered.
  • Sustainability: system or organisation's capacity to provide infrastructure such as workforce, facilities, and equipment, and be innovative and respond to emerging needs.Top of page

Implementation

The national standards have an important place in quality service management and service delivery for mental health service providers.

There will be time costs in implementation, but in the longer term the national standards should be seen as a core part of operating practice. Most service providers who are committed to quality service delivery would already be working in a way that would meet the standards. The standards will measure and present their practices in a consistent, cohesive and accountable form.

The implementation process will be different for each state and territory and for each individual service provider. For instance service providers in states that already have their own standards or accreditation will start at a different point than those in other states. Other factors that might determine the starting point for individual service providers will include:
  • the size and organisational complexity of the service provider
  • whether or not the service provider is involved in a voluntary external accreditation program
  • whether or not the service provider is working to an internally developed quality assurance framework
  • the nature of the service and its consumer group
  • the length of time the service has been in operation.
The national standards establish the minimum national expectations of service providers. The implementation process for each service provider will vary, but all should be able to demonstrate that over time they are enhancing the quality of their services by working according to the principles of recovery oriented mental health practice and the national standards.