Question – Mental Health Services during COVID-19
Questions asked by the Hon Meg Webb on 4 June 2020 and answered for the Government by Hon Jeremy Rockliff Minister for Mental Health and Wellbeing on 24 June 2020
With regard to the COVID-19 Disease Emergency:
QUESTION (1) What additional or adapted measures have been implemented for providing health care to, and ensuring the physical and mental wellbeing of, voluntary and involuntary clients in Tasmania’s mental health facilities?
ANSWER (1) All services within Statewide Mental Health Services developed COVID-19 management plans which detailed strategies to avoid or reduce the risks to patients, staff, family members, carers, visitors and the broader Strategies were tailored to individual service types and included measures like:
- Implementing infection control measures, complying with public health recommendations around social distancing, isolation and quarantine where required, and the provision of appropriate PPE based on clinical need to protect both patients and staff;
- Identifying options to manage patients who show symptoms of COVID-19 or contract COVID-19;
- Identifying options for managing vulnerable patients and staff;
- Supporting staff to work from home where possible to minimise potential spread;
- Supporting staff to work from home who identified as vulnerable;
- Reduced face to face contact with patients and increased contact via telephone or telehealth;
- Screening of patients and staff; and
- Reduced access to services, such as visitors.
QUESTION (2) What special measures have been implemented in Tasmania’s mental health facilities to protect vulnerable patients, such as elderly individuals and those with existing health conditions?
ANSWER (2) As part of the COVID-19 plans that were developed, services undertook a review of each site and the patients to determine those who had additional vulnerabilities which placed them at greater Measures were implemented that helped manage the risks specific to individual needs.
Plans were developed on how to provide care to a COVID-19 positive patient.
Inpatient units reviewed their patients with a view of discharging patients where appropriate to support them within the community, which would enable the creation of hot and cold zones in the inpatient units in preparation for any patients who tested positive to COVID-19.
The Roy Fagan Centre (RFC) is a specialised centre to assess and treat older persons with mental illness and dementia. The management plan for the RFC recognises the extreme vulnerabilities of its older patients, and the anticipated complexities of medical and nursing care. The RFC implemented visitor restrictions very early on to protect its patients from the risk of COVID-19.
Visitor restrictions for other service sites were also implemented.
QUESTION (3) What measures have been taken in relation to the administration of Treatment Orders under the Mental Health Act 2013 to:
(a) reduce crowding in Tasmania’s mental health facilities;
(b) ensure physical distancing can be maintained in those facilities; and
(c) safeguard health and wellbeing more generally?
ANSWER (3) As part of the service management plans, a range of decisions were made which was guided by advice from Public Health in relation to measures that should be implemented within health facilities.
3.1 This included the management of visitors, and reducing face to face contact with contact by telephone and telehealth where The Mental Health Tribunal met its requirements under the Mental Health Act 2013 to review persons detailed under the Act via the use of Polycom Healthcare.
Each inpatient unit reviewed all patients to ensure that those who could be cared for appropriately in the community were discharged from hospital.
3.2 All services within Statewide Mental Health Services implemented a range of measures within its facilities to ensure physical distancing occurred. For example, there was a shift to phone consultations where For patients and patients who needed to be seen face to face, staff ensured they followed advice from Public Health Services and utilised PPE when required.
Inpatient units modified their layouts to ensure there were separate hot and cold zones, and that all rooms in the facility were able to meet the physical distancing requirements wherever possible.
3.3 Mental Health Services established the COVID-19 support line to provide assistance to people requesting support relating to COVID-19, such as people who were in This was part of the Mental Health Helpline and was staffed by appropriately qualified mental health clinicians.
QUESTION (4) To what extent are the rights of mental health clients under the Corrections Act 1997 and the Mental Health Act 2013 restricted as a result of COVID-19?
ANSWER (4) To protect patients and staff, the Government made the difficult decision to not allow visitors to all Tasmanian Health Service hospitals as a temporary measure, which included the mental health acute inpatient Additionally, patient leave was ceased temporarily to further reduce the risk of COVID-19 to patients and staff.
This measure meant that patients receiving inpatient mental health treatment were unable to leave the unit and strategies were implemented to ensure patients could remain in contact with families, carers and other support networks. Restrictions have recently been eased and treating teams are now working with their patients in relation to leave options where appropriate.
QUESTION (5) What processes and arrangements have been put in place to ensure people with mental illness have a direct voice to decision-makers about the impact of COVID-19 on:
(a) their mental and physical health and wellbeing; and
(b) the measures being adopted in relation to their treatment and care during the pandemic emergency?
ANSWER (5) Mental Health Services implemented a range of strategies to manage patient’s physical health and Generally, this was undertaken at an individual service unit level where patients are able to discuss any issues, including those arising from COVID-19, with their treating team or the service manager, who would then work with patients to identify and implement a solution.
Information was provided to patients in relation to additional services they could access such as Mental Health Families and Friends Tasmania and Flourish.
QUESTION (6) What impact has COVID-19 had on staff-escorted leave and access to allied health services provided by psychologists and diversional therapists?
ANSWER (6) Where a patient is required to access treatment or a medical appointment that is essential to their health, this has still been facilitated through the period of Staff escorted leave for patients has now been reintroduced with the easing of leave restrictions and where a plan for leave has been developed with the treating team. Referrals continued to be made to ensure health related services were accessible for patients.
Access to Allied Health staff has not been affected by COVID-19, though the delivery of these services may have been via telehealth rather than face to face.
QUESTION (7)(a) How many COVID-19 tests have been carried out in Tasmania’s mental health facilities; and
(b) what have been the results for staff and patients?
ANSWER (7a) Anyone requiring a test has been taken to the testing centres, whenever Some staff have been trained to carry out tests on those people who are unable to attend the testing centres, but the numbers are extremely low.
(7b) All tests conducted returned a negative result.
QUESTION (8)(a) What sanitation and social distancing measures have been implemented in Tasmania’s mental health facilities;
(b) to which facilities do these measures apply?
ANSWER (8) All facilities within Statewide Mental Health Services have implemented the measures recommended by the Public Health Services.
- Staff must complete a staff screening prior to commencing at
- Staff adhere to the requirement to stay home if they are unwell and contact the Public Health Service for
- Staff and visitors must sanitise prior to entering any of our
- Visitors to Inpatient Units are required to complete a screening
- Visitors to community services are required to complete a screening tool at
- Staff and visitors must maintain appropriate social distancing and hand hygiene, and there are posters clearly displayed throughout all
- Cleaning regimes have been reviewed and enhanced utilising government cleaning
- PPE including hand hygiene facilities are available throughout
- Education to staff and patients has occurred and is
QUESTION (9)(a) What measures have been taken to minimise the impact of restrictions on visits to Tasmania’s mental health facilities; and
(b) have opportunities for video communication between patients and their families and friends been provided?
ANSWER (9a) Staff have encouraged and helped patients to remain connected with their support networks via telephone or video communication while the restrictions on visitors were in Mental Health Services have also reviewed and enhanced ward-based activities in consultation with patients. Where services have outdoor areas, patients have been encouraged to utilise these.
(9b) For patients who do not have a mobile phone, staff worked with patients individually to help them to connect with their family and friends. Inpatient Units worked closely with the iVisitors program to implement tablets and mobile phones in areas for patients to use social media platforms to maintain contact during the restriction period.
QUESTION (10) What measures are in place to minimise the physical and psychological harm of any COVID-19 related isolation measures that have been in place?
ANSWER (10) Treating teams are supporting patients, providing education about COVID-19 and responding to their individual needs during this Services have also kept support networks informed and ensured patients have had contact with family and friends.
Peer Carer and Peer Support Workers have also engaged with patients and their families during this time.
QUESTION (11) What has been the impact of the COVID-19 emergency period on the Mental Health Official Visitors Program’s ability to:
(a) check on the treatment of patients in mental health facilities; and
(b) receive complaints from patients?
ANSWER (11) There was a suspension of visits by the Official Visitors to all approved This was a decision that was not made lightly, but essential to safeguard the health and safety of patients, staff and the Official Visitors.
Principal Official Visitor Mr Richard Connock was supportive of this decision and mechanisms were put in place to ensure that patients were still able to contact the Official Visitors program if they wanted support or to raise issues.
The Official Visitors will be recommencing their visits to facilities in the North and North West from 1 July 2020.
