APPENDIX B

GLOSSARY OF TERMS

GLOSSARY OF TERMS

Acute/sub-acute services

Services which provide short-term to medium-term care for mental health consumers with different levels of disability and need. Acute services generally refer to inpatient (or hospital-based) facilities which provide services for consumers in psychiatric crisis. Sub-acute services provide rehabilitative support to people recovering from an acute episode of mental disorder.

Advocates

A person or organisation authorised by a consumers to speak on their behalf, or represent their concerns and interests. Advocates must be directly accountable to the consumer. Examples may include a friend or relative, a legal representative or officer from a government organisation (e.g. from the Office of the Public Advocate).

Affective (mood) disorder

A mental disorder characterised by disabling disturbances in emotion. Includes depression, mania and bi-polar disorder (or manic-depression). In the case of depression, symptoms may include pronounced subjective changes in emotion (e.g. sadness, guilt, irritability) and/or overt changes in behaviour and appearance (e.g. blunted facial expression, slowed movement).

Appropriately qualified and experienced mental health professional

An individual with recognised qualifications and experience which enable them to provide appropriate treatment and support to the consumer and their carers. The degree of formal training and expertise required will be determined by factors such as the degree of specialisation required/available (e.g. staff specialising in child and adolescent mental health), the needs of the defined community (e.g. Aboriginal and Torres Strait Islander mental health staff, ethnic health workers) and the type of services being delivered (acute care, residential support, drop-in, rehabilitation).

Area Mental Health Service

Government-funded, public mental health services that provide a range of specialist services to consumers and carers with immediate and ongoing mental health needs. Services include (but are not limited to): crisis assessment and treatment teams, residential and non-residential rehabilitation services, and acute inpatient services, and psychiatric disability support services.

Assessment

A process which aims to determine a consumer’s mental health status, diagnosis and ongoing needs. In most instances, psychiatric assessments will be conducted face-to-face with the consumer and/or significant others, where available. The assessment forms the basis of an individualised care plan, which is developed in collaboration with the consumer, their family or carers.

Care environment

The environment in which the Area Mental Health Service delivers treatment and support. It could be a living skills centre, a psychiatric inpatient unit, community centre, school or hostel.

Carer

A person whose life is affected by his or her close relationship with a consumer, or who has a role in assisting a consumer with daily living. Carer, in this document, may also refer to the consumer's identified family, including children and parents, or other legal guardians and people significant to the consumer. It is also acknowledged that for some people their carer may be their community.

Case closure

When a consumer no longer requires mental health services and leaves the system. (This should be distinguished from “discharge” which occurs when a consumer exits the hospital or inpatient service.)

Case manager

An identified and accessible Area Mental Health Service staff member who is responsible for co-coordinating the treatment and support provided to an individual consumer and their carers. (Also referred to as case co-coordinator, key worker, case worker.)

Clinical indicator

A measure of the clinical outcome of treatment or care; a method of monitoring care and services, which attempts to “flag” problem areas, evaluate trends and direct attention to issues requiring further review.

Community living

The ability of the consumer to live independently in the community with the best possible quality of life.

Co-morbidity

The co-occurrence of 2 or more disorders. Can refer to mental and physical disorders.

Consumer

A person making use of, or being significantly affected by, a mental health service.

Continuity of care

The co-ordinated, ongoing provision of services to meet individual consumer needs. Services must be co-ordinated and “barrier free” across services settings, whether hospital or community-based and across different types of services, such as treatment, rehabilitation and accommodation support.

Crisis assessment and treatment (CAT) teams

Mental health teams which provide 24-hour mobile support to all persons who are being considered for psychiatric hospital admission. CAT services also provide treatment and support for people whose acute mental illness can be managed in the community.

Defined community

The community to which the mental health service provides treatment and support. (For example, it might be a catchment area population, privately insured population, Statewide population, specific cultural group within the population.)

Disability

A disability is any restriction or lack of ability to perform an activity within the expected range for a human being.

Disability support service

A range of service responses which enable the individual to live as independently as possible and be included in the ordinary life of their community.

Discharge

Occurs when a consumer leaves an inpatient (hospital-based) mental health service.

Dual diagnosis

A mental disorder with a co-existing substance abuse disorder.

Entry process

The process provided by the mental health service which assists the consumer and their carers to make contact with the mental health service and receive appropriate assistance.

Family

The family of the consumer.

High prevalence disorder

A mental disorder with a high rate of occurrence in the community. Anxiety and affective disorders are regarded as “high prevalence” disorders in Australia.

Individual service plan

A documented set of goals developed collaboratively by the consumer and the Area Mental Health Service (usually the case manager). The individual service (or management) plan sets the direction for treatment and support, identifies necessary resources and specifies outcomes for the consumer. It is recorded in the consumer's individual clinical record.

Initial contact

When a consumer (already known to the service or new) makes first contact with a mental health service for assistance or information. Initial contacts are usually made to the Duty or Triage worker, who records the presenting problem(s), assesses risk of harm and the urgency of follow-up response required.

Integrated mental health service

A mental health service which brings together a number of specialised components into a unified system to maximise continuity of care for consumers. These components include a unified management system between inpatient and community services, a case management system, a single point (or process) of entry into the service, multi-disciplinary teams, active involvement of consumers and carers, specialist crisis intervention, assessment, acute care, ongoing care and rehabilitation care across the consumer's lifespan.

Linkages

The formal and informal aspects of the relationship within and between the mental health service and another service providers, agencies or sectors.

Mental disorder

A mental disorder may be defined as a clinically significant behavioural or psychological syndrome or pattern that occurs in an individual, which is associated with distress, disability or with a significantly increased risk of suffering death, pain, disability or a significant loss of freedom.

Mental health

Mental health is the capacity of individuals within the groups and environment to interact with one another in ways that promote subjective well being, optimal development and use of mental abilities (cognitive, affective and relational) and achievement of individual and collective goals consistent with justice.

Mental health problem

A mental health problem is a disruption in the interactions between the individual, the group and the environment producing a diminished state of mental health.

Mood disorder

See Affective (mood) disorder.

Other service provider

An organisation outside the Area Mental Health Services, or individual practitioner who provides a direct health or welfare service to the consumer.

Personality disorder

Maladaptive personality traits and behaviours that are of long-standing and deviate significantly from the expectations of an individual’s culture.

Primary health care providers

Community-based, general health care providers such as general practitioners, alcohol and drug services, and disability support services.

Psychiatric disability support services

Support services in the community for people with severe and disabling mental disorders, designed to assist with independent living.

Psycho-education

The ongoing provision of relevant information to a consumer and/or carer regarding mental disorder, symptoms, treatment options, prognosis etc. The consumer’s age, cultural background and mental state should be considered in the provision of this information.

Psycho-social factors

Social and environmental factors that influence an individual’s psychological state.

Psychosis (or psychotic disorder)

A mental disorder characterised by one or more of the following: delusions, hallucinations, disorganised speech, and grossly disorganised or catatonic behaviour. Schizophrenia, schizo-affective disorder and bipolar disorder are classified as psychoses.

PRISM

Psychiatric Records Information System Manager. An information system for the collection of patient data from inpatient mental health services.

Program

A part or function of the mental health service such as the rehabilitation team, health promotion unit, the crisis team, the living skills centre or inpatient psychiatric unit. (For example, some mental health services have only one team which performs all these functions.)

Psychiatric inpatient unit

A ward, unit, or facility located within a hospital for the assessment and treatment of mental disorders. Inpatient units normally include high dependency units and areas for seclusion or patients.

RAPID

Redevelopment of Acute and Psychiatric Information Directions. An information system for the collection of patient data from inpatient mental health services.

Service evaluation

A systematic evaluation of the performance of the mental health service, in full or in part, using valid and reliable methodology. (For example, could be a description of service activity, consumer satisfaction with the service, monitoring of individual health outcomes for consumers.)

Situational crisis

Any event which evokes a pronounced emotional response requiring intervention by a mental health professional.

Strategic plan

A plan that is organisation-wide, establishes an organisation's overall objectives and seeks to position the organisation in terms of its environment.

Support

Direct services and interventions provided to a person with a mental disorder and/or mental health problem and associated disability aimed at reducing handicap and promoting community tenure (e.g. assistance with cooking and cleaning). Support services do not necessarily have a treatment or rehabilitation focus.

Therapies

The range of treatment approaches which reflect best available evidence and are used in mental health care (excluding medication and other medical technologies). This may include psycho-therapeutic, psycho-educational, rehabilitative, collaborative approaches using individual and/or group methods.

Treatment

Specific physical, psychological and social interventions provided by health professionals aimed at the reduction of impairment and disability and/or the maintenance of current level of functioning.

Triage (also “Duty”)

A system for determining the relative priority of new referrals, typically based on assessments of risk and urgency.