www.mhcc.vic.gov.au

Damien – Medication and public mental health services

Complaint story about medication in a Victorian public mental health service.

Please note: this complaint story includes trauma related to public mental health services (choice and autonomy).

What Damien told us

Damien told the MHCC he was receiving compulsory mental health treatment, including medication by injection. He was experiencing unpleasant physical side effects from this, including nausea and headaches.

Damien said he didn’t want to be a compulsory patient anymore, and would prefer another medication option. He also felt his views and preferences about treatment were not being heard.

Damien’s rights

Victoria’s Mental Health Act 2014 and its principles protect the rights of people like Damien who are receiving mental health treatment from a public mental health service. 

Principles relevant to Damien are:

a) Persons receiving mental health services should be provided assessment and treatment in the least restrictive way possible, with voluntary assessment and treatment preferred.

b) Persons receiving mental health services should be supported to make, or participate, in decisions about their assessment, treatment and recovery and their views and preferences should be respected.

The Act presumes that all people receiving compulsory mental health treatment have the capacity to make decisions about their treatment. A person has capacity to give informed consent to a decision if they can understand, remember and consider the information, and communicate their decision.

Damien, therefore, should be presumed to have capacity. He has the right to have his concerns about his medication respected, and to make and participate in decisions about his treatment. His treating team should discuss medication options with him as there may be a less restrictive alternative treatment that he would agree to.

What we did

The MHCC cannot change compulsory treatment or clinical decisions. However, we could support Damien to exercise his rights, including his right to access an advocate, and to ensure his views and preferences are heard.

Damien told us he would prefer to take his medication in tablet form rather than by injection. Therefore, with Damien’s consent, we spoke with the service, who met with him.  A staff member also arranged for an advocate to support him in a clinical review of his medication.

Leading up to the review we contacted Damien, who told us he was still experiencing difficult side effects from his medication. We encouraged him to take notes of the things he had raised with us. We also coached him on how he could communicate his views and preferences at the clinical review.

Outcomes

Following the review, Damien told the MHCC he had now been prescribed medication in tablet form rather than by injection. He was happy with this outcome, and we closed his complaint. Damien’s experience shows how important it is for mental health services to uphold the principles of supported decision making and least restrictive treatment. It also shows the complaints process can help promote people’s voices, choices and recovery.

Please note: names and some details in this complaint story have been omitted to protect the identity of those involved.

Reviewed 21 April 2021

Mental Health Complaints Commissioner (MHCC)

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