Caring for someone with a mental illness is a new experience for most people. It is usually a role they never expected or imagined they would need to take on. Working out what you need to know and the questions you need to ask is important.
Who should I talk to regarding the illness?
Mental health professionals such as a psychiatrist, psychologist, case manager or general practitioner (GP) can provide you with general information about the disorder being experienced by the person for whom you are caring. Due to confidentiality laws, mental health professionals cannot discuss specific issues affecting your loved one, unless they have received permission to do so in writing from them.
It is recommended that you, as a carer, let the professional know of any concerns you may have about the person. Information and insights into your the situation can assist the mental health professional in their provision of effective care.
Some useful questions to ask are:
- How do I find out more information about my loved one’s mental illness?
- What do I do if there is a crisis?
- What rights are they entitled if in hospital?
- What are my rights as a carer?
- Are there support groups which can help both of us?
- What are the side effects of the medication he/she is taking?
- What can I do if they refuse to take medication?
- What other treatments are available?
- Are there services which can help find accommodation?
- Are there services which can help with social needs?
- Can someone help them find a job?
A new requirement (under Section 9 of the Mental Health Act) for patients who have voluntarily been in a mental health facility for more than 12 months, is to have a Mental Health Tribunal Review Hearing. This determines if they need to stay in the facility based on whether the patient is likely to benefit, or not, from being there.
Making decisions together
In your role as a carer, we may forget to ask the person we’re caring for if they are satisfied with the treatment they are receiving. We may want to make decisions on their behalf and forget to include them in this process.
It can be useful to bring up some of the following points when the person is well and willing to talk:
- Are you happy with your mental health worker, psychiatrist or other professional(s)?
- Would you like a second opinion?
- If it is difficult for you to discuss some things with me, would you like to speak with someone else?
- If you are going through a difficult time, for example experiencing an episode of psychosis, what can I do to help? What can I say which may help? Are there things I should not say?
- How else can I help you?
- Do you know you have the right to know about your mental illness or mental disorder and have the right to be supported throughout?
What do I do if he/she is experiencing a psychotic episode?
If someone is experiencing a psychotic episode:
- Remove any immediate danger such as sharp objects and ensure they are in a safe environment.
- Contact your nearest mental health crisis team if the person is at risk of serious harm to themselves or others.
- If the person is expressing paranoid ideas or responding to internal voices, do not argue with them. The ideas and feelings are very real to the person experiencing them.
Let them know that you understand their viewpoint but it differs from yours. For example, you might say: “You may believe that Fred next door is spying on you and I believe that he is an avid gardener who enjoys spending time in the garden.”
- If there is no immediate danger, speak to their case manager or doctor. They will be able to assess whether a change of medication is required or specialised hospital care is needed.
What do I do if the person is suicidal?
People living with mental illness sometimes think about or talk about suicide. Such thoughts are not uncommon for someone experiencing an acute episode of mental illness. This does not necessarily mean they will harm themselves, however, it is important that these thoughts are discussed with their doctor as soon as possible. All suicide threats should be taken seriously.
Suicide threats require urgent attention, especially when the person has a plan of how they will carry it out. It can be helpful to attend suicide prevention workshops to learn how to identify risk factors and what actions need to be taken to prevent suicide. (See the Mental Health Information Service Fact Sheet entitled “What you should know about suicide”).
Be aware that they may not agree to see a professional, even if they are at risk of harm to themselves or others. Therefore, it will be essential for you to contact 000.
- Due to increased numbers of mental health facilities, there is now access to timely assessment and emergency mental health care. Video link technology is available to facilitate assessments of those people who are remote or distanced from care. These can be accessed (under the Mental Health Act) without undue costs.
- Under Section 27A of the Mental Health Act, where a medical or accredited professional is determining via audio visual link whether a person is mentally ill or disordered, the person must consult a psychiatrist when reasonably practical to do so.
- The NSW Government is working to ensure prompt action to increase the number of declared mental health facilities across NSW – especially rural and regional NSW. The police, ambulance and the Ministry of Health have all collaborated in this regard.
- NSW will continue to maintain concepts of “risk of serious harm” and “no other appropriate care of a less restrictive kind being reasonably available” as the threshold for involuntary treatment within the State.
What should I do in a crisis situation?
- Call your local mental health crisis team (always keep their phone number handy).
- Take the person to the emergency department of your nearest hospital (if they are willing and can be safely transported).
- Call “000” and request help from the emergency services, if necessary.
- All persons in NSW have the right to seek mental health treatment, however, the decision to admit a person for treatment is a clinical judgement made at the time of presentation.
- When deciding if involuntary treatment is needed, the views of consumers, family members, treating community psychiatrist, general practitioners and emergency service providers (where reasonable and practical to do so) is triangulated properly. This means all concerned are included in the consultation.
Talk with someone
We usually cope better with stress by talking to, and sharing our feelings with other people. This may be as simple as talking with your partner or best friend. Sometimes, carers find regular sessions with a counsellor or psychologist a good way of helping them manage the challenges of their caring role. It’s important not to allow misconceptions about your loved one’s mental illness stop you from seeking help.
What is the Family and Carer Mental Health Program?
You may also wish to find out more about the activities of the Family and Mental Health Carer program operating in your area.
This program aims to:
- Improve family/carer wellbeing
- Improve outcomes for consumers
- Increase family/carer knowledge helping carers manage their role effectively
- Promote open communication between services regarding family/carers issues
- The program is run by four non-government organisations (NGOs) across NSW who provide:
- Education and training to build coping skills and resilience
- Individual support, information, advocacy and peer support
What information am I entitled to?
The following points are new inclusions (2014) within the Mental Health Act:
- The term Primary Carer has been replaced with Designated Carer. Consumers can now nominate up to two Designated Carers and specify what access the carers have to personal information.Under Section 72A, there is a new type of carer – the Principal Care Provider. This person is primarily responsible for providing care to the individual and is entitled to receive such information as:
- Admission advice
- Discharge advice
- This extends the principles of the Act which requires carers to remain clearly informed.
- Authorised medical officers will be responsible to make reasonable attempts to identify the Principal Care Provider.
- The person(s) being cared for have the right to know about, and choose, their own care. They are to be supported towards choosing their care as much as is reasonably safe for them to do so.
⬇️ Download this information as a fact sheet
This information is for educational purposes. As neither brochures nor websites can diagnose people it is always important to obtain professional advice and/or help when needed.
This information may be reproduced with an acknowledgement to WayAhead – Mental Health Association.
The Association encourages feedback and welcomes comments about the information provided.