Looking for advice on how to get a sense of power, mutual respect, and autonomy back

Hi Jlol,

Thank you for sharing your experience with the inpatient staff and the new aftercare program the health authority has initiated.

I am sorry that you were made to feel powerless, like a child, and not in control of your healthcare. That is the total opposite of what health care is supposed to be about.

Nearly all of the hospital workers are not trained in mental health, which becomes alarmingly obvious to those who seek that kind of support from them. The truth is the hospital was never meant to be for mental health, only physical health, because nurse and physician training has one to zero courses on mental health. I could see a potential avenue for advocacy, we should all be writing letters to the big unis to demand they put a whole semester's worth of mental health into nursing and med school. It's not an excuse to be rude or weird, but it does provide a reason why they become that way. They lack the soft skills and the psychiatric crews are burned out.

You received a phone call as part of their aftercare program. As all medical therapies are, it should be totally voluntary - so you should have been asked upon discharge if you wanted to receive follow up. In any case, you can still decline. You have as much of a protected right to not access health care services as you do to access health care services. They got your phone number from your patient chart, which always has your phone number, address, next of kin names and numbers etc.

I recommend, on your next phone call, telling the worker exactly what you've said here. They could use the feedback from patients, and if they were smart they would use this feedback to drive changes and updates to their programming.

You are also more than welcome to report your experience to the Patient Quality team. Every health authority has one, you can try searching "(your health authority) + patient complaint". If need help finding it, I am sure one of us could help you search it up.

I can also understand your disappointment with the help lines, whom are mandated to report to the police when someone mentions the S or H words. It's a mandate made from a good place, but it can and does act like a major deterrant to people calling in for help. No one wants the police on their doorstep. The help line is also supposed to give you a heads up that they made the report or that they are going to because they have to. It's not supposed to be a surprise like that.

I also recommend making use of your communities social workers. With a referral from a physician, social workers are covered under medicare. They have ample information on supports that might possibly assist you with your particular needs. They also are required to have more mental health training as an ally to health care.

I am sorry to hear you were feeling unwell, and I am sending you positive vibes for better days ahead of you.

Thankyou @YourLocalMHGuru

When you said "The help line is also supposed to give you a heads up that they made the report or that they are going to because they have to" are you able give me more info on that? Because they definetly didn't. Do you know if this is documented anywhere?

Many thanks again for your reply. I think I will tell the worker about what I've said in this post. That's a good idea.

You are welcome, @Jlol

When you called, did they go over their "disclosure regarding confidentiality"? Or when you mentioned the S word, did they mention they have an obligation to report? All health professionals have a mandate regarding limits to confidentiality. Child abuse, domestic abuse, suicide, and homicide are all trigger words that the limit of confidentiality has been breached and they have a duty to report. I am not sure if you would find that information online, as it is typically part of an employee's or volunteer's training. If you call them or another help line - ask them about their duty to report to police and they can explain to you where their particular agencies limits are. The duty comes out of fear for someone's safety and best interest to get them some help. The help lines in my home country all lead the conversation with our disclaimer regarding duty to report and, if you didn't hang up, they tell you that they are going to have to make a report. Australia would have the rules on reporting but maybe some are not going through that confidentiality speech before the call when they should be. In Australia, it is called "Duty of Care and Confidentiality". Plug that into your search bar and have a read about what this entails. Your worker must have been really worried for you, so I hope you do not feel deterred to make those calls again when you need to but better armed about their limitations. Talking about a severity level might help them better understand you are not at the level of involving police, but be forewarned they can bypass this if they feel truly concerned.

Thanks @YourLocalMHGuru
No, they didn't go over any disclosures, though I suspect it would be one of those "press 1 to hear our disclosures" things while you wait.

They didn't say anything when I mentioned the 's' word either. In fact I didn't even say the 's' word. I said the phrase "sometimes work makes me feel like I don't want to be here".

I haven't found anything on their site apart from one line saying that they would call emergency services if they thought you were going to harm yourself. However, it didn't say anything about them telling you first.

I rang again afterwards and asked the next person I spoke to if they could give me their policy, but they refused saying "it was too long to read out over the phone". I asked if they could email it to me and they said no.

@Jlol @YourLocalMHGuru

I am doing the cert IV in mental health peer work right now in Western Australia.

We have to inform the client about confidentiality and the exceptions.

Basically everything talked about is confidential between myself, the multi-disciplinary team and the client. Except;

1) If the client is at risk of imminent harm

2) Someone else is at risk of harm

3) If the client gives informed consent (the client is first informed of rights, options and consequences.

4) If the records are subpoenaed by a court of law