CHHS17/219

Canberra Hospital and Health ServicesOperational Procedure Clinician in Police Operations (CiOPs) (MHJHADS)Contents

Contents....................................................................................................................................1

Purpose.....................................................................................................................................2

Scope........................................................................................................................................ 2

Section 1 – Essential Information..............................................................................................3

Security Clearance.................................................................................................................3

Privacy and Consent..............................................................................................................3

Recorded Telephone Lines & Clinical Records......................................................................4

Staff selection:...................................................................................................................... 4

Section 2 – Procedure...............................................................................................................5

Hours / Days of Operation....................................................................................................5

Contact Details......................................................................................................................5

Documentation Requirements..............................................................................................5

CATT Whiteboard..................................................................................................................6

Modes of Intervention..........................................................................................................6

Clinical/Operational Escalation.............................................................................................8

Implementation........................................................................................................................ 8

Related Policies, Procedures, Guidelines and Legislation.........................................................8

Definition of Terms...................................................................................................................9

Search Terms............................................................................................................................ 9

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Purpose

To provide a procedure for MHJHADS clinicians outlining the role, responsibilities, clinical/operational escalation pathways and reporting requirements for undertaking seconded shifts as Clinicians in Operations (CiOPs), from Winchester Police Operations Centre Belconnen ACT (ACTPOps).

Clinicians in Operations are a strategic element of the Mental Health Community Policing Initiative (MHCPI), and are overseen and supported by the MHCPI team and the MHCPI steering committee. The clinical activities of the CiOPs are governed through the MHJHADS Division Adult Community Mental Health Service (ACMHS), Crisis Assessment and Treatment Team.

The broad objectives of embedding a CiOPs in ACTPOps are: To improve confidence and informed decision making of police members/emergency

service personnel as first responders dealing with people experiencing mental health issues.

To improve interagency co-operation response to time critical incidents involving people experiencing mental health issues.

To improve the ability to provide in-situ risk assessment, advice and mobilise follow-up care.

To improve therapeutic outcomes for people experiencing a mental health illness or mental disorder and to provide least restrictive care principles.

The overarching aim of embedding the CiOPs within ACTPOps is to provide timely, coordinated and appropriate guidance for services interacting with persons in psychiatric crisis. The CiOPs has a leadership role in ensuring that every safe avenue of least restrictive care is explored, prior to involuntary action being taken by emergency service personnel.

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Scope

This procedure pertains specifically to clinicians in MHJHADS who undertake rostered or seconded shifts as CiOPs at ACTPOps.

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Section 1 – Essential Information

Security Clearance All CiOPs must have AFP security clearance completed prior to commencing the role. CiOPs are expected to keep secure any information they may incidentally become aware of.. Any significant security oversights will be immediately raised with the CiOPs by the Operations Sergeant. CiOPs must display their AFP security pass at all times and adhere to building security measures including on entry and exit to Winchester Police Centre.

Privacy and ConsentThe handling and exchange of personal information is regulated by privacy legislation at the Federal, State and Territory level by the following legislation: Privacy Act 1988 (Cth) Information Privacy Act 2014(ACT) Health Records (Privacy and Access) Act 1997 (ACT)

Staff undertaking the CiOPs role will comply with their legislative obligations and operate in line with the Confidentiality, Privacy and access to Mental Health and Alcohol and Drug Services clinical records procedure

Under the Health Records (Privacy and Access) Act 1997, personal health information cannot be released to police unless:1. the person has consented to its release and/or, 2. there is a significant risk to the life or physical and mental health of the person or

another person.In addition, the Commonwealth Privacy Act 1988 states that personal information can be released by an entity where: it is unreasonable or impracticable to obtain the individual's consent to the collection,

use or disclosure; and the entity reasonably believes that the collection, use or disclosure is necessary to lessen

or prevent a serious threat to the life, health or safety of any individual, or to public health or safety.

Any correspondence released by the CiOP under this section of the Commonwealth Privacy Act 1988 should be discussed with the Crisis Assessment and Treatment Team (CATT) Manager, Adult Community Mental Health Service (ACMHS Director or Director on Call (after hours) at the time the request is made.

Any information released under this section of Commonwealth Privacy Act (1988) should have a file note completed which includes the following statement: “Information from (person’s name) health record is being lawfully released under provisions of the Commonwealth Privacy Act (1988) (explain rationale).

Any uncertainty regarding information sharing should be discussed initially with the relevant Team Manager or Operational Director. After hours, the Director-on-call can be contacted

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via the Canberra Hospital switchboard, (02) 6244 2222. Any requests for information that do not meet the requirements of the relevant legislation as outlined above should be directed to the MHJHADS Executive Office on 6205 5142 for consideration. This includes requests for information about deceased persons.

Decisions not to disclose information should also be noted in the clinical file. For example “request by X for information in relation to (person’s name), nil time critical risk issues described, X was directed to MHJHADS to discuss information exchange. X has been advised to recontact if time critical risk issues become apparent”.

Recorded Telephone Lines & Clinical RecordsPlease note that all general telephone lines in and out of ACT Police Operations ACTPOps are recorded. These recordings are kept indefinitely by ACT Policing.

To preserve confidentiality there is a telephone line on the CiOPs desk that is unrecorded. This phone should be used for all client related contacts. If a call is transferred to you on a recorded line you MUST advise the person that the call is being recorded and should offer to call back on a non-recorded liner - for example “ My name is ......................... I am an ACT Health clinician, working a shift in the ACT Policing Operations room. For your information, I need to advise you that this call is being recorded because you have been transferred to me on a police line. Would you like me to call you back on a non-recorded line?”

CiOPs should be aware that they may be recorded as part of the background of another call or radio transmission. These recordings can be subpoenaed and played in open court or coronial processes. CiOPs must maintain a high standard of professionalism whether they are communicating directly with patrol, directly to the person, speaking informally with operations staff.

Access to the ACT Health system is provided via a laptop on the CiOPs desk. At any time the CiOPs clinician is away from the desk, the laptop MUST be locked.

There is no facility to print clinical information at ACTPOps. Should there be a requirement to print or fax information; this is coordinated via ACT Mental Health Triage contactable on (02) 6244 2380

Staff selection:Any MHJHADS clinician interested in undertaking the CiOPs role must submit an Expression of Interest (EOI). The clinician must have Team Manager and Operational Director support to undertake the role. Preference is given to Health Professional Officer 3/Registered Nurse Level 3 or above who has significant experience, particularly in clinical risk assessment and crisis management. Successful clinicians must complete orientation training including triage training and undertake at least one shadow shift. CiOPs are required to participate in regular professional supervision.

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Section 2 – Procedure

Hours / Days of Operation CiOPs operate at ACTPOps on a shift basis (one 8 hour shift per day, 7 days a week).

NOTE: Any ACT Police (ACTP Act Ambulance Service (ACTAS) officers/MHJHADS staff who contact Mental Health Triage during these times should be re-directed to contact the CIOP instead.

A name plate is provided for each CiOPs and is to be displayed throughout the shift. Arrival and departure times are to be strictly adhered to and any variations are required

to be reported to the ACTPOps sergeant via 131 444or via email actcommunications@afp.gov.au and CATT Team Manager.

An unpaid 30 Minute meal break is to be taken during the course of the shift. (ACTPOps staff are required to contact triage while the CiOPs is on their scheduled meal break).

Contact DetailsThe CiOPs can be contacted through ACTPOps (131 444) or alternatively, MHJHADS CiOPs contacting via the CiOP mobile (0408 486 781). ACT Mental Health Triage can be contacted on 6205 1065 if the CiOP is unavailable

Documentation RequirementsStaff undertaking the CiOPs role should ensure they follow the MHJHADS Triage Category of Response for Mental Health Services procedure and the Crisis Assessment and Treatment Team Mental Health Services Triage Procedure. Additional documentation requirements are as follows: All contacts (including but not limited to basic enquiries or information checks) made

with the CiOPs are to be well documented in MHJHADS electronic clinical record in the form of an initial assessment document, or where an initial assessment document is not appropriate, a file note is required.

Contact numbers and addresses should be checked and updated to ensure the clinical file is accurate. Any referral to external teams needs to be followed by a MHAGIC message to that team. Where risks are identified follow up by CATT (crisis assessment and triage team) is actioned until referral is accepted into the treating team for ongoing management.

Where the person is not known to mental health services, a new MHAGIC (via ACTPAS if needed) record should be created. In the rare event a file is unable to be created (i.e. no date of birth) a file note should be recorded in the “Anon Male” or “Anon Female” files on MHAGIC. The Anon file notes should include the name of the person in the title and other demographic information (DOB, gender, address etc) in the body of the file note.

All persons are to be registered with the “CATT-ACTP Comms” Team on MHAGIC and should only be de-registered after contact with that person has been completed. This includes entering ALL details (including the outcome of the contact).

MHCPI Register CiOPs must complete the MHCPI Register G:\Access and Specialties\Crisis Assessment

and Treatment Team\MHCPI Folder\MHCPI Register (basic data) – then select the current year whiteboard. All relevant categories are to be completed. CiOPs should

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request that the relevant Promise/Member number or CAD number are obtained from the ACTPOps Sergeant on duty. Please record any additional notes about the response in the comments box.

CiOPs must enable ‘macros’ by clicking the ‘options’ button, THEN select enable macro’s (see below)

CATT WhiteboardIn addition to completing the MHCPI Register CiOPs are required to register any persons responded to by CATT and/or contacts that result in an ED presentation on the CATT whiteboard. G:\Access and Specialties\Crisis Assessment and Treatment Team\CATTWhiteboard and select CATT whiteboard Active (see below)

Alert:Please ensure the CATT whiteboard folder is closed immediately after use and double check all persons have been entered on the whiteboard prior to finishing your CiOPs shift.

Modes of InterventionAlert:Any release of information must meet obligations under Privacy Act as described in Essential Information.

Information request- The CiOP may liaise directly with the ACTAS Staff/ACTP Officers/Staff or ACTP Officers on site. The type and amount of information provided by the CiOP to ACTAS or ACTP will depend on the assessed level of risk; with the threshold for sharing information decreasing as the risk increases (this includes risk to the person and risk to others, such as family, friends or police).

Advice/consultation request - Where ACTP/ACTAS request advice from a mental health clinical perspective, the CiOP will liaise directly with the ACTP Officers/Staff or with the ACTP Officers on site to provide clinically appropriate guidance.

CiOP are expected to play a leadership role in promoting least restrictive options for transport and care; and to invite police to share their decision-making around whether a person should be placed on an Emergency Detention order.

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Direct contact with person experiencing a mental illness or mental disorder - Where possible the CiOP should communicate directly with the person, family or carer contacting ACTPOps or on site with ACTP Officers/ACTAS. Standard triage processes apply with regard to assessing risk and helping stakeholders decide what action to take.

If it is indicated that a face to face assessment by a mental health worker is required, the CiOPs will organise a mental health clinician from the relevant community team, or CATT if it is after hours, to attend on site (where there is a risk of violence or risk to self that cannot be contained, on site attendance is not required).

Referral to MHJHAD services - The CIOPs will refer to other parts of mental health services including CATT/Community Mental Health Teams and Forensic Mental Health Services. Direct contact will be made with referral via MHAGIC messages where appropriate. Please consider whether a referral to CATT is required on weekends. Referrals may include the completion of an ISBAR, Initial Presentation document and/or SVAT as per MHJHADS standard operating procedures.

Reiteration of Management Guidelines - Where a Multi-Agency Response Guideline (MARG) exists for persons with mental illness or a mental disorder, the CiOP will direct and assist the referring agency (ACTP/ACTAS) to implement these plans.

Problem resolution- It is envisaged that the CIOP will assist where communication problems between ACTAS/ACTP & Mental Health services are evident, including providing contextual, information which adds value with respect to service provision (including Requests for Transport etc).

It is preferable that CiOPs provide advice (within their scope of practice*) to responding agencies (police or ACTAS), prior to any final decisions being made about intervention options – but only when it is safe to do so. Any final decision (e.g. decision to transport a person to hospital on an Emergency Action), is ultimately at the discretion of the attending agency (ACTP/ACTAS/MHJHADS) and where any disagreement exists, judgement should always err on the side of caution.

*CiOPs must avoid providing advice on operational/clinical matters outside their scope of practice or professional training. Any confusion or uncertainty about this must be escalated at the time of the inquiry to the relevant Team Manager or the MHJHADS Operational Director on Call.

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Clinical/Operational EscalationCiOPs may escalate any clinical or operational issues to the relevant Team Manager or Operational Director. After hours the Director on Call should be contacted via the Canberra Hospital Switchboard 6244 2222

Any systemic issues can be brought to the attention of the MHCPI Committee by emailing mental-health-initiative@afp.gov

In accordance with Incidents Reportable to the Executive Director and Intervention Following the Death of a Person (MHJHADS) Operational Procedure: If CiOPs is advised of the death of a person currently or previously accessing MHJHADS

services they must phone the CATT Team Leader, or after hours the Director on-call to advise. An ACTPAS Death Notification and Riskman report should also be completed

If the CiOPs is advised of a siege or other critical situation involving a person currently or previously accessing MHJHADS services, they must phone the CATT Team Manager or after hours, contact the Director on Call.

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Implementation

This procedure will be communicated during induction into the CiOP’s role.

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Related Policies, Procedures, Guidelines and Legislation

Policies Confidentiality and Privacy Procedure. Memorandum of understanding between MHJHADS, the ACT Ambulance Service, the

Australian Federal Police, the Canberra Hospital, Calvary Health Care ACT for People Requiring Mental Health Care.

Crisis Assessment and Treatment Team - Mental Health Services Triage Procedure Triage Category of Response for Mental Health Services Incidents Reportable to the Executive Director MHJHADS and Intervention Following

Death.

Guidelines ACT Charter of Rights for People who Experience Mental Health Issues Australian Charter of Healthcare Rights Standards of Practice for ACT Health Allied Health Professionals, 2016 ACT Carers Charter

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Legislation ACT Human Rights Act 2004 ACT Mental Health Act 2015 ACT Information Privacy Act 2014 ACT Health Records (Privacy and Access) Act 1997 Privacy Act 1988 (Cth) Australian Federal Police Act 1979 Carers Recognition Act 2010

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Definition of Terms

ACTAS – ACT Ambulance ServiceAFP - Australian Federal PoliceACT POL – ACT PolicingACTPOps – ACT Police OperationsCiOPS – Clinician in Police Operations GP – General PractitionerMARG – Multiagency Response GuidelineMHCPI – Mental Health Community Policing Initiative

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Search Terms

CiOPs, CATT, Community, Policing, Police Operations, MARP, MARG, AFP, ACTAS, Police

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Disclaimer: This document has been developed by ACT Health, Canberra Hospital and Health Service specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.

Date Amended Section Amended Approved ByEg: 17 August 2014 Section 1 ED/CHHSPC Chair

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register