MHIMA - FRAMEWORK FOR MENTAL HEALTH IN MULTICULTURAL AUSTRALIA: TOWARDS CULTURALLY INCLUSIVE SERVICE DELIVERY

WORKERS - IMPLEMENTATION GUIDE - Safety & quality

Safety and quality practices underpin all activities undertaken by mental health services. They exist to provide clear, evidence-based pathways for staff to follow to ensure the best quality of care for all consumers. Governance for safety and quality provide mechanisms for safeguarding high standards of health care through continual improvement. Governance  for safety and quality provide mechanisms to safeguard high standards of health care trough continual improvement.

Governance frameworks include processes to ensure:

• High standards of clinical performance and clinical audits
• High standards of risk management
• Ongoing professional development
• Well developed procedures to manage adverse events.

All health services, including mental health services, are guided by standards such as the National Safety and Quality Health Service (NSQHS) Standards (2012) which was developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC). These standards are routinely assessed through accreditation cycles. Mental health services are, in addition, guided by the National Standards for Mental Health Services (NSMHS) 2010. These are also designed to be assessed along with the NSQHS Standards through regular accreditation cycles.

Standard 4 of the NSMHS (2010) focuses specifically on 'Diversity Responsiveness', however, the Framework considers all safety and quality governance mechanisms to be applicable to all of Australia's multicultural population. Mental health services, for example, should be equally accessible to all members of the Australian community, including those from CALD backgrounds. The safety and quality of these services should be of the same high standard for everyone. To ensure this, services must be culturally and linguistically responsive to the population at all levels of service provision.

• Transcultural specialist services for primary and secondary consultation, utilising bi-cultural specialists and cultural consultants
• A culturally responsive workforce that is equipped with the knowledge and skills to work across languages with the assistance of skilled mental health interpreters.

Sound safety and quality controls, such as the NSQHS (2012) and the NSMHS (2010):

• Enable consumers to participate meaningfully in the provision of their own care, and also at the service delivery level
• Provide a clear understanding of a consumer's rights and ways to express their concerns, complaints or grievances
• Allow for availability of translated information, as well as verbal explanations, in a way that is understood by the consumer, family and carers.

The Framework advocates that in multicultural Australia, safety and quality practices should be culturally inclusive for all population groups, and that cultural responsiveness should be integrated rather than be seen as an add-on. The challenges of sound safety and quality practices are whether they can be applied equally to all Australians irrespective of language or cultural backgrounds.

KEY OUTCOME AREA 2: SAFETY AND QUALITY

Improved outcomes in access, coordination across the continuum of care, quality and safety for CALD mental health consumers, carers and their families.

• Outcome Indicator 2.1 Improved access to culturally appropriate mental health services

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I have increased awareness about demographic data analysis about CALD communities and their needs in the catchment area.		NSMHS: 10.2
  Developing	I am informed about CALD consumer needs and am able to more effectively work with CALD consumers.
  Advanced	I participate in improved strategies to minimise access barriers for CALD consumers and carers.

• Outcome Indicator 2.2 Improved access to professional interpreters.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I have increased awareness of the identified needs of diverse CALD client groups in regards to access to professional interpreters.		NSMHS: 10.2.1
  Developing	I facilitate the implementation of the Language Services Policy and provide access to professional interpreters when required.
  Advanced	I contribute to and use these improved strategies to provide language services to CALD consumers and carers.

• Outcome Indicator 2.3 Improved access to multilingual mental health rights and responsibilities

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need to provide CALD mental health consumers and carers with a written statement of their rights and responsibilities in an understandable language and format.		NSMHS: 1.4 NSQHSS: 1.17
  Developing	I provide written information about rights and responsibilities in a language consumers and carers can understand.
  Advanced	I routinely provide multilingual resources to CALD consumers and carers on a needs basis and evaluate and improve these based on client feedback.

• Outcome Indicator 2.4 Improved CALD data collection.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need for CALD data collection to inform service provision and planning and evaluation.		NSMHS: 4.1, 4.2, 4.3 NSQHSS: 2.1
  Developing	I participate in CALD data collection as part of 2.1 standard data input processes.
  Advanced	I routinely collect relevant CALD relevant data variables as part of service delivery and contribute to reviews and improvements.

• Outcome Indicator 2.5 Improved CALD relevant research development.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need for and benefits of CALD specific research.
  Developing	Developing I contribute to CALD specific research when needed.
  Advanced	I utilise CALD specific research outcomes to inform evidence based best practice whenever possible.

• Outcome Indicator 2.6 Improved CALD consumer safety

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the specific needs of CALD consumers to ensure their safety.		NSMHS: 2
  Developing	I adhere to safety plans addressing the diverse needs of CALD consumers and carers as part of their care and treatment planning.
  Advanced	I contribute to regular evaluations and reviews to improve the safety of CALD consumers and carers and implement the outcomes.

• Outcome Indicator 2.7 Improved culturally appropriate mental health assessments.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need to consult with specialist services or cultural informants to ensure culturally appropriate assessments.		NSMHS: 10.4
  Developing	I utilise processes in place to ensure culturally appropriate mental health assessments.
  Advanced	I implement these improvements to processes to ensure culturally appropriate mental health assessments and contribute to these.

• Outcome Indicator 2.8 Culturally appropriate discharge planning.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need and benefits of culturally appropriate discharge planning.		NSMHS: 10.6
  Developing	I make use of the processes the mental health service has in place to ensure CALD consumers and carers are discharged with appropriate cultural support.
  Advanced	I contribute to routine evaluations and implement improvements to processes of culturally appropriate discharge planning.

• Outcome Indicator 2.9 Improved access to professional interpreters for CALD mental health consumers & carers.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need to adhere to the Language Services Policy and use of accredited and competent interpreters trained in mental health interpreting.
  Developing	I adhere to a Language Services Policy and participate in training and professional development opportunities to improve effective use of interpreters.
  Advanced	I am aware of and regularly contribute to these evaluations and implement the improvements to work more effectively with interpreters and improve access for CALD consumers and carers.

• Outcome Indicator 2.10 Increased development and access to multilingual resources for CALD mental health consumers & carers.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need for improved access to and development of multilingual resources for CALD consumers and carers.
  Developing	I provide CALD consumers and carers with resources in their preferred language as part of their intake, assessment, treatment and care planning.
  Advanced	I contribute to these routine evaluations and implement the improvements on a regular basis.

• Outcome Indicator 2.11 Enhanced culturally inclusive strategic planning.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the importance of including CALD consumers and carers and in the development of the strategic plan.
  Developing	I am aware of the processes in place to include CALD consumers and carers in the development and reviews of the strategic plan and support this process whenever possible.
  Advanced	I support CALD consumers and carers to participate in routine service reviews.

• Outcome Indicator 2.12 Enhanced culturally inclusive mental health education and training

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need to participate in cultural competency/ responsiveness training and am able to access this training when required.
  Developing	I am able to access cultural competency/ responsiveness training when required.
  Advanced	I routinely participate in training and professional development in cultural competency/ responsiveness and contribute to reviews and improvements.

• Outcome Indicator 2.13 Increased use of culturally appropriate assessment

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the importance of culturally appropriate mental health assessments for CALD consumers and carers.		NSMHS: 10.4
  Developing	I utilise these processes to ensure incorporation and use of culturally appropriate assessment in my work with CALD consumers and carers.
  Advanced	I routinely use and review culturally appropriate assessment tools.

• Outcome Indicator 2.14 Ensuring non-discriminatory practices.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the need to prevent and address issues associated with prejudice, bias and discrimination occurring within the team.
  Developing	I follow processes in place to address issues associated with prejudice, bias and discrimination between staff.
  Advanced	I contribute to regular evaluations and improvements to ensure non-discriminatory practices and equitable access and support the inclusion of CALD consumers and advocates.

• Outcome Indicator 2.15 Integration and coordination of services with multicultural sector support services.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the importance of integration and coordination of services with multicultural sector support services to CALD consumers and carers.		NSMHS: 9
  Developing	I ensure integration and coordination with all mental health staff and multicultural support services when working with CALD consumers and carers.
  Advanced	I contribute to regular reviews and implement improvements to ensure improved integration and coordination of services provided to CALD mental health consumers and carers.

• Outcome Indicator 2.16 Improved use of information and communication technology in CALD specific initiatives.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the importance of the use of information and communication technology in improving access for CALD consumers and carers when appropriate.
  Developing	I participate in the use of information and communication technology to enhance mental health service delivery for CALD consumers and carers.
  Advanced	I routinely contribute to regular reviews and improvements in information and communication technology and utilise these in my work with CALD consumers and carers.

• Outcome Indicator 2.17 Improved person-centred care.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the importance of culturally responsive and person-centred approaches in my work with CALD mental health consumers and carers.
  Developing	I use a culturally responsive and person-centred approach in my mental health care planning and treatment plans with CALD consumers and carers.
  Advanced	I routinely contribute to regular reviews and improvements of methods and strategies to deliver culturally responsive and person-centered mental health care and use these in work with CALD consumers and carers.

• Outcome Indicator 2.18 Enhanced cultural approaches to recovery-oriented mental health care

  Level	Strategy	Good Practice Examples	Referencing
  Entry	I accept and respect the importance of using a recovery-oriented approach within a cultural context when working with CALD consumers and carers.
  Developing	I utilise a recovery-oriented approach within a cultural context in my care planning and treatment plans for CALD consumers and carers.
  Advanced	I regularly contribute to improving recovery-oriented care within a cultural context in my work with CALD consumers and carers oriented care.