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Chapter 9 Section A: Carers of people with mental health conditions – Overview

Carers can have a big impact on the wellbeing, treatment and recovery of a person living with a mental health condition.

This chapter of the Manual provides information to anyone who cares for another person who is involved with the mental health system because of their mental health condition. It has information about the rights of carers, as well as information for carers to help them advocate on behalf of those friends or family members they care for in their interactions with the mental health and legal services systems.

In this Manual, the word ‘carer’ is used to describe a person who has responsibility for major aspects of the care of a family member or friend living with a mental health condition. A carer could also be colleagues and/or members of a shared community.

This is different from paid professional carers, who may be health care professionals or support workers who provide treatment, care and/or psychosocial support. For example, paid professional carers may support someone in a hospital, aged care or disability care facility, outpatient facility or in the person’s own home.

Sometimes carers are called ‘persons responsible’. Often responsibility for a person is shared between family members and friends. Sometimes this happens through a formal discussion about the division of tasks and responsibilities.

In some circumstances, a person may be a full-time carer for a person with a mental health condition and share the same residence. In other instances, a person may have little or no daily face-to-face contact with the person.

However, either through prior legal or informal arrangement, or simply through circumstances, they may be the principal decision-maker for a person who experiences some degree of impairment. Sometimes, this Manual refers to a carer who might also be a concerned parent of an adult who is living independently and finds himself or herself interacting with the mental health system.

Carers may be providing care and support for the person because they are motivated by love or care for the person, because they believe they can provide a higher level of care than other options and/or because other services are not available.

It is important to note that, at times a person and their carer may have very similar views about the care and treatment that the person should or would like to receive. Sometimes a person would like to be admitted to hospital and their carer supports them in this, but a hospital refuses to admit them.

In other circumstances, the view of a person with a mental health condition is completely different from that of their carer. A carer might think that their family member or friend should not be in hospital, even though that person is a voluntary patient.

Alternatively, a carer might think their family member or friend should be admitted as an involuntary patient, but that person strongly disagrees to hospitalisation or rejects a diagnosis of mental illness.

This chapter deals with the rights and responsibilities of different people and authorities that a carer might need to know about in all these possible situations.

The Mental Health Act 2007 (NSW) provides for people with mental illness who are “under the Act” to nominate a ‘Designated Carer‘. The law recognises the role of carers for people living with a mental illness or mental disorder and their rights to be kept informed, to be involved, and to have information provided by them considered. A Designated Carer will be informed or consulted about particular aspects of the person’s care and treatment, including decisions to detain in, and discharge them from a public mental health facility.

A Designated Carer can also be a person who is a close relative or friend who has frequent contact and interest in the care of a person living with a mental health condition. The ‘relative’ of a person who is an Aboriginal or Torres Islander includes a person who is part of the extended family or kin of a person according to the indigenous kinship system of the person’s culture.

The Mental Health Act 2007 (NSW) also provides for a category of persons called Principal Care Provider, who are persons entitled to similar information to a Designated Carer.

It is important to remember that all carers, people with mental illness and health care providers have legal rights and responsibilities, both under the Mental Health Act 2007 (NSW) and under the general law.

You will find information in this chapter of the Manual about how you can support your friend or family member by gaining a better understanding of the following issues:

Updated August 21, 2020