Mental Health: Legal and Ethical Frameworks, Models, and Programs

This report provides a comprehensive overview of legal and ethical considerations in mental health, focusing on the Australian context. It delves into codes of practice, discrimination, dignity of risk, duty of care, human rights, informed consent, mandatory reporting, and practice standards. The report also explores policy frameworks, records management, and the rights and responsibilities of workers, employers, and individuals accessing mental health services. Furthermore, it examines specific mental health legislation and its impact on individual workers, work role boundaries, and work health and safety. The report highlights the values and principles of the mental health sector, including recovery-oriented practice, health promotion, holistic approaches, empowerment, access and equity, and early intervention. It also covers historical, current, and emerging models of understanding mental illness, available programs, services, and support systems, along with strength-based approaches and the role of reflective practice. This analysis offers valuable insights into the multifaceted aspects of mental health care and service delivery.

Running head: MENTAL HEALTH
Establish self – directed recovery relationships
Name of the Student
Name of the University
Author Note

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MENTAL HEALTH
Legal and ethical considerations (international, national, state/territory and local) for
mental health work, and how these are applied in organisations and individual practice:
o Codes of practice
The National Practice Standards for the Mental Health Workforce (2013) deals with several
ethical and legal considerations like rights, responsibility, safety and privacy of mental health
consumers. This law is applicable in all organizations and is exerted via working in unison
with people, families and carers in the recovery model. In individual practice, the nursing
professionals are concerned with meeting the diverse needs of the people while marinating an
individual planning format1.
o Discrimination
Mental health practitioner must deliver quality care to the mental health patients irrespective
of class, ethnicity and religion. This concept is applied in all nursing organizations. For
examples the mental health professionals must work with aboriginal and Torres Strait
Islander people, families and communities via reducing their barriers to access the mental
health facilities. On individual level, they must work in culturally competent manner and via
improving social and emotional wellbeing1.
o Dignity of risk
The organization is required to respect the service user’s dignity of risk as long as it not
negatively harming the organizations’ duty of care obligation. At individual level, dignity of
risk includes physical, psychological and financial harm.
1 National Practice Standards For The Mental Health Workforce. 2013. Ebook. Melbourne: National Mental
Health Strategy.
https://www.health.gov.au/internet/main/publishing.nsf/Content/5D7909E82304E6D2CA257C430004E877/$Fil
e/wkstd13.pdf

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o Duty of care
There are several aspects of duty of care like legal, professional, organizational, community
and personal. At organizational level, organization must anticipate the risk of its employees
and then subsequently take care to prevent those risks from harming them. At personal level,
duty of care suggests individual’s own beliefs and values2.
o Human rights
At organization level, human right in relation to mental health in Australia and overseas is
focused on carers’ and consumers’ rights and thereby promoting equity, social justice and
compassionate society. At individual level, the person who is mental health consumers must
be aware of his or her right of availing comprehensive mental health and it is the right of the
caregiver not to discriminate patients on basis or ethnicity (Australian aboriginal or Torres
Strait Islander)3.
o Informed consent
It is the legal rights of all adult individuals to give consent or to refuse medical treatment and
same thing applies for the mental health service. All the organizations are compelled to take
signed consent from the patient before initiating the treatment. When the person is unable to
provide consent (not in normal state of mind), the organization is supposed take consent from
the family members4.
o Mandatory reporting
2 Department Of Health | 6.1 Duty Of Care Issues". 2004. Health.Gov.Au.
http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front11-wk-toc~drugtreat-
pubs-front11-wk-secb~drugtreat-pubs-front11-wk-secb-6~drugtreat-pubs-front11-wk-secb-6-1.
3 Human Rights". 2015. Mental Health Australia. https://mhaustralia.org/tags/human-rights.
4 Informed Consent To Medical Treatment | ALRC". 2015. Alrc.Gov.Au.
https://www.alrc.gov.au/publications/10-review-state-and-territory-legislation/informed-consent-medical-
treatment.

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MENTAL HEALTH
The mandatory requirement before proceeding on the mental health programs includes
patient confidentiality, proper focus on the past conducts and lack of national consistency.5
o Practice standards
National Practice Standards for Mental Health Service, Australia deals with knowledge, skills
and attitudes that are expected for the professionals those who work to deliver quality mental
health service. It also deals with the setting in which the mental health has been provided1.
Practise Standards for Mental Health Australia 2013
Source: National Practice Standards For The Mental Health Workforce. 2013
o Privacy, confidentiality and disclosure
According to the Nursing and Midwifery Board of Australia, nurses must treat the personal
information of the patients obtained during professional capacity as private and confidential.
At organisational level the registered nurse is required to sign consent from in this regards
before resuming the theory. Any bridging of this ethical regulation might lead to termination
of service6.
5 Mandatory Reporting Under The Health Practitioner Regulation National Law".
2017. Http://Www.Health.Nsw.Gov.Au. http://Mandatory reporting under the Health Practitioner Regulation
National Law
6 Nursing And Midwifery Board Of Australia - Home". 2017. Nursingmidwiferyboard.Gov.Au.
http://www.nursingmidwiferyboard.gov.au/.

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o Policy frameworks
Mental Health Policy Framework deals with the legal norms, best practise evidence, reporting
and process requirement that all the health service providers are required to comply. This
helps in ensuring consistent and effective provision for mental health service7.
o Records management
The process of record management deals with preparation of checklist to keep the medical
records8.
o Rights and responsibilities of workers, employers and individuals accessing the
service
The right of the workers is to equal care to all the patients while keeping respect to culture,
dignity and values. The individuals who are accessing the service must trust the service
providers and perform their instructions accordingly1
o Specific mental health legislation and its impact on individual workers
According to the Mental Health Legislation New South Whales, “An authorized medical
officer may refuse to admit a person to a mental health facility as a voluntary patient if the
officer is not satisfied that the person is likely to benefit from care or treatment as a voluntary
7 Mental Health Policy Framework". 2018. Health.Wa.Gov.Au.
http://www.health.wa.gov.au/circularsnew/frameworks/Mental_Health.pdf.
8 Department Of Health | Administrative Record Keeping Guidelines For Health Professionals".
2016. Health.Gov.Au. http://www.health.gov.au/internet/main/publishing.nsf/content/admin-record-keeping-
guide.

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patient”- It creates confusion among the workers and this act is subjective and dependent on
the understanding and comparative evaluation of a particular health care professional9.
o Work role boundaries – responsibilities and limitations
There lies professional boundary of relationship between patient and nurse. Thus the urse
becomes confused regarding to what extent they will involve with the patients and the
limitation is the boundary of the involvement is not strict or defined. However, within the
zone of helpfulness, nurses are required to provide optimised care10.
Figure: The concept of professional boundary
Source: Nursing and Midwifery Board of Australia Codes-and-Guidelines, 2010
9NSW Legislation". 2008. Legislation.Nsw.Gov.Au.
https://www.legislation.nsw.gov.au/#/view/act/2007/8/chap2/sec5.
10 A Nurse’S Guide To Professional Boundaries. 2010. Ebook. Melbourne: Nursing and Midwifery Board of
Australia.

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Figure: Responsibility of professional Boundary
Source: Nursing and Midwifery Board of Australia Codes-and-Guidelines, 2010
o Work health and safety
Under work health and safety, mental health care professional are required to work in a
culturally competent manner10.
Values and principles of the mental health sector, including:
o Recovery
According to the Australian Government, Department of Health, “recovery is not
synonymous with cure”. Recovery in case of mental health deals with retaining or gaining of
hope while understanding one’s disabilities and abilities. It also deals with the internal
conditions of a person like hope, social identity, engagement in active form of life, personal
autonomy11.
o Recovery oriented practice
11 Department Of Health | Principles Of Recovery Oriented Mental Health Practice". 2017. Health.Gov.Au.
http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongov-toc~mental-pubs-
i-nongov-pri.

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The recovery oriented practise of Australian Government Department of Health always try to
ensure that the health services related to mental health must be delivered in such a way that it
supports the recovery mode of the consumers of mental health. The principles of recovery
oriented practice are dependent on uniqueness of the individuals, the real choices, attitudes,
rights, dignity, respect, partnership and communication of the consumers of mental health.
The model also promotes continuous evaluation process of the applied therapy11.
o Health promotion and prevention
Health promotion and prevention falls under the standard 12 of the national practise standard
for the mental health workforce (2013) of Australian Government Department of Health.
According to this standard, mental health promotion is regarded as an integral pillar of all
work related to mental health. Here the practitioners of mental health need to apply primary
prevention principles along with the use of mental health promotion in order to provide
quality care. The mental health practitioner must also value the establishment of resilience in
groups, communities and individuals in order to reduce the negative impact of mental
illness12.
o Holistic approach
According to the Australian Government Department of Health, a holistic approach along
with person-centred treatment and care is recommended to provide rehabilitation,
psychological and recovery support to the mental health consumers. The core principles of
holistic care deal with acknowledging people preferences along with centrality of the people
with lived experience in order to support their own recovery model. This model also
12 Department Of Health | Standard 12: Health Promotion And Prevention". 2013. Health.Gov.Au.
http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-wkstd13-toc~mental-
pubs-n-wkstd13-3~mental-pubs-n-wkstd13-3-12.

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acknowledges several elements that modulate the well-being of an individual like cultural
background, personal beliefs, education, employment, housing and physical health13.
o Empowerment/disempowerment
Australian Government, Department of Health promotes empowering of the consumers of the
mental health and their families through active participation and partnerships. It is a part of
their recovery model designed in order to prevent further episodes of mental illness or
monograph. It values the right of information of a person with mental illness and provide
necessary in information so that he or she can participate in informed decision making14.
o Access and equity
The concept of accept and equity is extremely significant in case of providing quality mental
health care to the Australian aboriginals and Torres Strait Islander. According to the
Australian Human Rights Commission, human right based approach is required to be
undertaken via the access and equity strategy while acknowledging the importance of non-
discrimination, participation, equality and inclusion. Such that the accessibility of the issues
experienced by the aboriginals and Torres Strait Islander peoples while availing
comprehensive mental health care must be taken into consideration15.
o Early intervention
13 Department Of Health | Capability 2A: Holistic And Person-Centred Treatment, Care, Rehabilitation And
Psychosocial And Other Recovery Support". 2018. Health.Gov.Au.
http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-recovgde-toc~mental-
pubs-n-recovgde-app~mental-pubs-n-recovgde-app-2~mental-pubs-n-recovgde-app-2-a.
14 Department Of Health | Empowering Consumers And Their Families And Carers Through Participation And
Partnerships". 2006. Health.Gov.Au. http://health.gov.au/internet/publications/publishing.nsf/Content/mental-
pubs-p-mono-toc~mental-pubs-p-mono-inc~mental-pubs-p-mono-inc-emp.
15 Access And Equity: Inquiry Into The Responsiveness Of Australian Government Services To Australia’S
Culturally And Linguistically Diverse Population | Australian Human Rights Commission".
2018. Humanrights.Gov.Au. https://www.humanrights.gov.au/access-and-equity-inquiry-responsiveness-
australian-government-services-australia-s-culturally-and.

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The early intervention and prevention of mental health complications have been stringently
framed by the Australian Government, Department of Health for young people and children
because as per the national mental health reform (2011-12), childhood is the best time to
prevent the susceptibility of mental disorders. The main values of the early interventions is to
generate awareness among the school and the early childhood services in order to remove the
burden of the suicide case among young Australians arising (especially men) due to untreated
mental illness16.
o Rights
The mental health statement of rights and responsibilities tries to make sure that the carers,
consumers, service providers and the members of the community are aware of the of the
existing and relevant rights of responsibilities framed by the Australian Government under
the domain of mental health. Such awareness will help make them confident in exercising
their own rights. According to the mental health right, all the Australians are expected to
receive high-quality and safe health-care in a timely manner. Moreover, the mental health
consumers deserve the right of individualised care planning, support and treatment17.
o Social justice and inclusion
People with mental illness should be able to enjoy same economical, social and educational
opportunities just like anyone else. Australian Government, Department of Health has
highlighted education, housing, transport, employment, income and health care are the main
social determinants of health18.
16 Department Of Health | Early Intervention And Prevention, And Mental Health Services For Children And
Youngpeople". 2011. Health.Gov.Au. http://www.health.gov.au/internet/publications/publishing.nsf/Content/
nmhr11-12~nmhr11-12-challenges~earlyintervention.
17 Mental Health Statement of rights and responsibilities. 2012. Health.Gov.Au.
http://www.health.gov.au/internet/main/publishing.nsf/Content/E39137B3C170F93ECA257CBC007CFC8C/
$File/rights2.pdf
18 Department Of Health | Capability 5A: Supporting Social Inclusion And Advocacy On Social Determinants".
2013. Health.Gov.Au. http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-
recovgde-toc~mental-pubs-n-recovgde-app~mental-pubs-n-recovgde-app-5~mental-pubs-n-recovgde-app-5-a.

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o Citizenship
Citizenship is defined to highlight a person’s strong connection with the 5 Rs (rights), roles,
responsibilities, resources, rights and relationships. However, according to the latest report
published in The Guardian, people may be denied Australian citizenship or may have their
citizenship revoked over drug abuse and mental illness19.
Historical, current and emerging models of understanding mental illness in Australia and
internationally
Evidence base for recovery including research and personal recovery experience
Government of South Australia has initiated research on evidence-based recovery of
mental health problems. Such research mostly centers ON the individuals unique and
personal journey towards the mental wellness program20. According to the National Health
and Medical Research Council (NHMRC), evidence is important however, nor adequate in
framing recommendations for the treatment. Examining the evidence on the basis of criteria
of quality, level, relevance and strength and then moving it into clinically significant
recommendations is inclined on the experience and judgment of the expert clinicians whose
role is to design treatment guidelines21.
19 Medhora, Shalailah. 2014. "Mental Illness May Be Used To Deny Australian Citizenship Under New
Bill". The Guardian. https://www.theguardian.com/australia-news/2014/nov/25/mental-health-may-be-used-to-
deny-australian-citizenship-under-new-bill.
20The Framework For Recovery-Oriented Rehabilitation In Mental Health Care, Mental Health & Substance
Abuse Division. 2018. Ebook. 1st ed. Adelaide: Government of South Australia.
http://www.sahealth.sa.gov.au/wps/wcm/connect/c17e5f804eb00bcaac5aeee39488de5b/
Rehab+Recovery+Framework-mental+health-20130108.pdf?
MOD=AJPERES&CACHEID=ROOTWORKSPACE-c17e5f804eb00bcaac5aeee39488de5b-lITywZA.
21 Evidence-Based Psychological Interventions In The Treatment Of Mental Disorders: A Literature Review.
2017. Ebook. 3rd ed. The Australian Psychological Society. http://Evidence-based Psychological Interventions
in the Treatment of Mental Disorders: A Literature Review.

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Programs, services and supports available to people with mental illness
There are several mental health programs designed by the Department of Health,
Australia two of the notable ones among them are Australian Child and Adolescent Trauma
and Grief Network and Better Success to Psychiatrists, Psychologists and General
Practitioners through the Medicare Benefits Schedule22.
The mental health services in Australia offers several services to the people who are
suffering from mental complications like: Mental Health Support Services, Psychiatric
Disability Support Services, specialist Homelessness Services, Specialist Homelessness
Services, Personal Helpers and Mentors and Access to Allied Psychological Services23.
Mental Health Australia, the registered charity under government of Australia
provides numerous supports to the people who are suffering from mental health
complications. They helpline numbers in order to increase the mental health awareness
among people like depression, reduction in stigma and anxiety24.
Strength based approaches
Strength-based approach on mental help enables the health care professionals to
acknowledge that every person has unique mode of strength and abilities so that she or he and
depend on it to overcome the problem. These kinds of approaches encourage individual to
cultivate their identity, interests while building their own strengths in order to pursue their
goals25.
22 Department Of Health | Mental Health Programs". 2015. Health.Gov.Au.
http://www.health.gov.au/internet/main/publishing.nsf/content/mental-progs.
23 Mental Health Support Services". 2016. Mhsa.Aihw.Gov.Au. https://mhsa.aihw.gov.au/support/.
24 "Need Help?". 2017. Mental Health Australia. https://mhaustralia.org/need-help.
25 Xie, Huiting. "Strengths-based approach for mental health recovery." Iranian journal of psychiatry and
behavioral sciences 7, no. 2 (2013): 5.