Whose goals are they?
Your treatment plan (sometimes called individualised service plan, or ISP) is an important part of your direction for recovery. Your case manager or other provider helps you determine and document goals, usually on an agency form, but this is your roadmap. It is done for your benefit, not theirs.
Some tips for active participation:
- Ask that you be told in advance of treatment planning so that you have an opportunity to think about your goals.
- Insist that your goals, your life, your future are reflected. You don't have to sign off on anything you don't agree with.
- Ask for a copy of your treatment plan. You can't work on goals if you don't know what they are.
Treatment planning is a dynamic process. As goals are achieved, new goals are set. You can expect to review you treatment plan every three months. Your treatment plan should address mental health and physical health, social needs and economic needs. How is your connection with the agency going to help further these goals? What can you do to further these goals?
* Some information on this page has come from the booklet "Patients' Rights - A Self-Help Guide To The Victorian Mental Health Act" produced by the Mental Health Legal Centre.
Definition of Treatment
Treatment is defined as things done with professional skill to remedy the illness or disorder or to lessen its ill effects or the pain and suffering it causes. Treatment includes things like medication, counseling, psychotherapy and monitoring, support, assessment and case management.
Consent to Treatment
If you have been given sufficient information about a treatment and you agree that the treatment can go ahead, you are giving your consent to the treatment.
You must be given information about why the treatment is thought necessary, the nature of the proposed treatment, possible side effects and what to do if they occur, and alternative treatments. The information must be explained to you in a way that you can understand. If the staff are explaining it in a way you don't understand they may say you are unable to consent and should be made involuntary. You are not expected to understand the treatment as well as they do but you must demonstrate some understanding of its benefits and risks. Always ask for simpler language to be used or an interpreter if you need it.
It cannot be assumed that you consent to treatment simply because you do not object to it.
Case Management and Individual Service Plans (ISPs)
If you are in the public mental health system, Department if Human Services policy requires you to have a case manager appointed and an individual plan for your treatment. This is known as an Individual Service Plan (ISP). This plan is a written summary listing your aims and ways to achieve them. This should be created by you and your case manager in consultation with you psychiatrist. ISP's are different from treatment plans and more detailed and have to be made for both involuntary and voluntary patients.
If you are using a non-government organization, which provides rehabilitation and support services, they may develop a similar plan known as an Individual Program Plan (IPP). You should be consulted about what you want in your plan. It should be reviewed regularly with you.
Treatment Plans
If you are an involuntary patient, in hospital or on a CTO, you have the right to a treatment plan. Treatment plans are new in the Act. They are an opportunity to put your wishes to the treating team and the Board for them to consider. Plans should be prepared, reviewed and revised on a regular basis as required. A treatment plan should be a brief clear statement of the treatment to be provided by the Area Mental Health Service and who is responsible for providing it.
In preparing you treatment plan your doctor must take into account: -
- your wishes; and
- the wishes of a guardian, family member or carer involved in your ongoing care or support unless you object; and
- whether the treatment is only to promote or maintain your health or wellbeing; and
- any beneficial alternative treatments available; and
- the nature and degree of any significant risks associated with the treatment or any alternative treatments.
For both inpatients and CTO's the plan must contain an outline of the treatment you are to receive and may contain anything else the authorized psychiatrist thinks appropriate.
If you are on a CTO it must also state: -
- which doctor will monitor your treatment; and
- which doctor will supervise your treatment; and
- the name of your case manager; and where you are to receive the treatment; and
- what time you are required to attend for treatment; and
- intervals at which the supervising doctor must submit a report to the monitoring psychiatrist.
You must be given a copy of the treatment plan and have it explained. If the plan changes you should have a copy of the changes.
Your treating team should ask you what your wishes are, and you should make them very clear, when the plan is first made and each time it is due to be reviewed. Think carefully about issues such as the treatment you would prifer. If you don't want the service to consider the wishes of you guardian, family member or primary carer, you should make that very clear to your treating team. If you don't object they have to consider the wishes of those people if they are giving you ongoing care or support.
Changing Your Treatment Plan
You should ask the treating team to vary the treatment plan if you believe it should be changed, including if there are issues that should be added. The treatment in the plan should only be for the purpose of your health or wellbeing. You can also challenge the plan if your psychiatrist failed to consider you wishes, alternative treatments or the risks of the treatment or alternatives. Your treating team should update the treatment plan regularly. It can only be changed by an authorized psychiatrist. An authorized psychiatrist must review treatment plans regularly.
If you are not happy with your treatment plan you can also appeal against your ITO or CTO to the Board. If the service has not complied with the Act in making the plan such as not considering your wishes, alternatives or risks, using it for something other than your health and well being, or because the plan can't be implemented, the Board can order the authorized psychiatrist to revise it.
You can also ask the Office of the Chief Psychiatrist to intervene or seek legal advice if you want your treatment plan changed, or you want to challenge the way it was developed.
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