Designated carer and principal care provider rights

NSW Mental Health Act 2015

The Mental Health Act 2007 (the Act) was changed in 2015 after a major review. These changes help to promote the consumers views and wishes about their treatment. The Act strengthens the role of carers and the importance of involving carers in treatment and recovery.

This page describes some of these changes related to being a Designated Carer or Principal Care Provider. 

Designated Carer

A Designated Carer is a person who knows the consumer well, and is an ongoing support but does not necessarily provide day to day support. 

A consumer can nominate up to two designated carers unless they are under the age of 15 or under the Guardianship Act 1987, then the Act makes their designated carer their parent or Guardian. If the health care team believes the nomination will put the carer or consumer at risk, they can withdraw the nomination and must tell the consumer and carer why. 

Principal Care Provider

A Principal Care Provider is a person primarily responsible for providing day to day support or care to the consumer, but not as a paid position. A principal care provider can be nominated by the consumers health care team, but not if the consumer has excluded that person from being given information. 

Role of carers

As a Designated Carer or Principal Care Provider you have the right to: 

• be consulted about discharge planning and leave
• be informed of Mental Health Review Tribunal hearings
• be given information about the consumer’s care and treatment
• provide your views about the consumer to the treating team, and have this information considered in decisions about care.

As a Designated Carer or Principal Care Provider you should be notified if the person you care for: 

• is absent without permission or has not returned from leave
• is to be transferred to another mental health facility or unit
• is reclassified as a voluntary patient
• is detained or admitted as a voluntary patient. 

As a Designated Carer or Principal Care Provider you can request that: 

• the consumer be discharged into your care
• the consumer be placed under a Community Treatment Order
• the consumer be admitted into a mental health facility
• you receive information about medication being administered
• an Official Visitor visits. 

As a Designated Carer you should be notified when: 

• a Community Treatment Order is being considered and an application is made to the Mental Health Review Tribunal
• the consumer has been on a Community Treatment Order and the order is being varied, revoked or no longer sought
• electro convulsive therapy is being considered and an application has been made to the Mental Health Review Tribunal
• an application is made for consent for a surgical operation or a special medical treatment. 

What does being an excluded carer mean? 

A consumer can nominate a Designated Carer. A consumer can also nominate persons who are to be excluded from being provided with information or consulted about their care. 

If you are an excluded carer you can still provide information to the healthcare team, and you can still receive general healthcare information. General healthcare information refers to factual information that increases your understanding of mental health problems and treatment that is not specific to the person you care for. 

There are limits to being excluded as a carer. These limits include if the exclusion puts a consumer or carer at risk, or that the consumer lacks capacity to make a decision to exclude someone at the time. In these situations the exclusion can be put on hold and reviewed when circumstances change.

Where can I get more support and information? 

If you are unsure about what information can be shared with you, please ask your clinician.

It can be very distressing to be excluded as a carer. Please talk to the team about your concerns if this happens and ask about accessing support from the Family Team or from One Door Mental Health. 

One Door Mental Health delivers the Family and Carer Mental Health Support Service in Sydney Local Health District. One Door provides individual and group support, information and advocacy. You can call them on 02 9708 2670, go to onedoor.org.au or ask your clinician to contact them on your behalf. 

Information for families and kinship groups

Caring for someone with a mental illness or distress can be a new experience. Most people experiencing mental illness recover, and families play an important role in supporting recovery. Families can help hold the hope for the people they care for.

Sometimes supporting a family member can be stressful or difficult.

What happens?

When the person you care for enters the Mental Health Service they will be assessed by the treating team. If you are not offered an opportunity to discuss your experience, please ask for one.

You might be asked some questions more than once. It’s important to remember to let the team know:

• if you need an interpreter
• if there are children or older people living with the family
• if you are worried about your safety or others safety
• if you have any questions

You will be provided with information about the Mental Health Service. In both the Community and Hospital, staff will introduce themselves and help you understand how the mental health system works. If the person you care for has given consent for you to be a part of their care, you can be given information about their treatment and progress and be involved in their care planning. You can still receive general information if the person you care for has declined to allow you to be part of their care or nominated you as an excluded carer.

If the person you care for is being treated under the Mental Health Act, and you are nominated as a Designated Carer or Principal Care Provider, you have rights to access information about admissions, treatment and discharge. The Designated Carer and Principal Care Provider information sheet has more information, including on being an excluded carer.

Discharge

If the person you care for consents to your involvement you will be involved in discharge planning from hospital and community mental health. During planning both you and the person you care for will be given information on the care provided, follow up services and emergency contacts.

You or the person you care for should receive a follow-up phone call within a couple of days of discharge from hospital.

Personal support and information

One Door Mental Health supports Carers individually and in groups, provides advocacy, and works closely with the Mental Health Service. You can call them on 02 9708 2670 or ask your clinician to contact them on your behalf.

The Transcultural Mental Health Centre runs support groups in different languages for families. Contact them on 02 8838 2120.

Our Sydney Local Health District Mental Health Service provides support to families. Please speak with your clinician about support options, and ask about family education and support groups.

The Head to Health website has a range of mental health resources including online programs, fact sheets, audio and video, and online forums about mental health.

SANE Australia has information on diagnosis, care and Carer online forums, which are safe, anonymous and moderated 24/7 by mental health professionals. Call 1800 187 263.

How can I support the children in our family?

Firstly, talk to your clinician and let them know your concerns. Our Mental Health Service offers information, support and groups for children who live with someone with a mental illness, your clinician can provide information. You can find out more information at Children of Parents with a Mental Illness. 

Who do I contact if I am worried about the person I care for?

Your first contact should be with the clinician who the person you care for has the most contact, this might be a care coordinator, or GP for example. If you are still concerned you can escalate your worries to the Team Leader, Doctor or Nursing Unit Manager.

At any time you can call the REACH number for hospital 0472 802 944 or community 02 9767 9000, which will escalate your concerns to a senior member of staff.

The NSW Mental Health Line 1800 011 511 is a 24-hour seven days a week call line that puts you in touch with your local mental health service. You can call this number at any time, including after hours and weekends.

If you require urgent medical attention, if a person has caused serious physical harm to themselves or you have safety concerns call Triple Zero (000) immediately.