Communication is often used as a broad term. Here I will be focussing specifically on communication in the mental health hospital and community settings. After working for two Melbourne hospitals in their inpatient wards and community locations, I’ve noticed a gap with communication between treating teams and consumers and carers. I’m not the only one.
Recently I conducted a project with the carer consultant for a large metropolitan hospital. We found dissatisfaction with consumers and carers in regards to communication with treating teams. There are many factors that play into this, but I believe all of us can do better when it comes down to something that can seem as basic as communication.
The lived experience workforce (primarily peer support workers) at this hospital usually get great feedback when it comes to communication from consumers and carers. This is largely because building rapport with consumers is in their job description, and they are allocated time to do so. The treating team (clinicians and psychiatrists) on the other hand are under time and bed pressure to get answers from consumers and carers. They need to treat consumers as fast and effectively as possible under a bio-medical model.
For the consumer, the side effects of medication can be the biggest factor affecting communication between them and the treating team. This is when carers can advocate and ask as many questions as possible toward the treating team on their behalf. This is what my parents did and I am forever grateful as I was too sedated by medication to assert myself in a years long process.
Understanding rights and a basic knowledge of the Mental Health and Wellbeing Act 2022 and assertive communication are great ways for consumers and families/carers to give themselves agency. And, no question is a dumb question under consultation circumstances.
The five essential rights that every consumer and carer should be aware of are:
1. Advance Statement
2. Nominated Persons
3. IMHA opt out
4. Capacity and Informed consent
5. Second Psychiatric Opinion
When working on the inpatient unit I carried a self-made booklet in my pocket with summarising these rights, so I could talk to consumers and carers about them.
There are a few key and easy things that clinicians and psychiatrists can do to improve communication also.
Treating teams can:
· Hand out or read the statement of rights in consultations
· Inform families/carers and consumers about the five rights
· Practice active listening, and normalising (where possible)
· Create small talk, seek common ground to build rapport– It’s not all about ticking boxes
· Connect and engage with the lived experience workforce[';
Any mental health service will have a statement of rights and information on the five rights which one can get their hands on. Many also have consumer and carer peer support workers that share their lived experience, build rapport and carry a wealth of knowledge to connect and engage with consumers and carers. Holding this information and knowing who to connect with is essential for any consumer or carer, and will help with feeling overwhelmed when entering the mental health system.
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