National safety priorities in mental health: a national plan for reducing harm

Purpose and rationale

Page last updated: October 2005

The purpose of this Plan is to provide national direction in identifying, avoiding and reducing harm across all environments in which care of people with mental health disorders is provided. Primarily it aims to provide guidance for achieving safer mental health services. The Plan also identifies the importance of an underlying information infrastructure critical to safety and quality improvement.

This Plan aims to enhance the patient safety improvement initiatives led by the Australian Council for Safety and Quality in Health Care for the acute health care sector. Integral to this approach is improving the systems of delivering care and adopting a transparent culture in which health care providers can report safety incidents without fear of inappropriate blame. This Plan emphasises that information generated from adverse events can be used to enhance safety in mental health service delivery for all people involved. The focus of the Plan includes the safety of mental health consumers, carers, families, the community and the workforce. It recognises that understanding and addressing the safety concerns of all stakeholders is critical to improving safety in the mental health sector.

The Plan identifies priority areas agreed by the National Mental Health Working Group as key areas for galvanising safety improvement action nationally, while acknowledging that local priorities will also need to be developed. The roles and responsibilities for progressing activity under the Plan will be guided by those outlined in the National Mental Health Plan 2003-2008. While the primary focus will be public specialised mental health services, the Plan also aims to influence activities in the acute care sector outside mental health, private sector mental health services (especially private hospital services) and broadly influence other sectors such as primary care services and support services that deliver care to people experiencing mental disorders. It is acknowledged that the strategies identified will have differing applicability in different settings and sectors, and many strategies will need to be progressed in partnership with stakeholders outside public specialised mental health services.

It is important to acknowledge that mental health service delivery, while it shares much in common with health care delivery generally, can also present quite different challenges from most other areas of health care. This is primarily because of the responsibilities related to administering legislative powers for mandatory treatment. It is critical that a balance is achieved between individual rights to dignity, respect and privacy and the need to protect the personal safety of consumers, staff and others, including families, other consumers, visitors, and the public. A basic tenet underpinning this plan is that mandatory treatment is to be used only when less restrictive options are not available, and should not be perceived or used by anyone as a punishment or coercion. The existence of powers of mandatory treatment behoves mental health services and professionals to actively identify, prevent and reduce iatrogenic harm.