The Mental Health and Wellbeing Act 2022 sets out principles for mental health and wellbeing services (‘services’).
These 13 mental health and wellbeing principles are important for psychiatrists, doctors, nursing, allied health, lived experience and other mental health staff, and services to consider when they make decisions about people's care, support or treatment, or assessment.
There are also five principles that are specific to care or treatment decisions.
The Mental Health Tribunal, police, emergency departments, and others must also consider these principles under mental health laws.
Principles are ideas that guide the way decisions are made, or that people, service providers and organisations need to think about when they do their job.
If you don’t think these principles have been followed you can:
- contact IMHA for assistance
- make a complaint to the service
- make a complaint to the Mental Health and Wellbeing Commission.
Mental health and wellbeing principles
You can read the mental health and wellbeing principles as stated in the Mental Health and Wellbeing Act 2022. These principles are presented in plain language on this page.
The Principles of the Mental Health and Wellbeing Act: plain language fact sheet can be downloaded in IMHA or First Nations design.
1. Dignity and autonomy principle
People living with mental health issues, emotional distress, or a mental illness are to be treated with dignity and respect. Their independence is to be supported and promoted. For example, by being able to make their own decisions.
2. Diversity of care principle
People living with mental health issues, emotional distress, or a mental illness are to have access to different types of care and support. This is to be based on what they want and prefer.
This includes considering their:
- access needs
- relationships
- living situation
- experience of trauma
- education
- finances
- work.
3. Least restrictive principle
Least restrictive means people living with mental health issues, emotional distress, or a mental illness need to be given as much freedom as possible.
Services must aim to support people with the least restrictions on their rights and independence. The goal is to support their recovery and participation in the community.
The person's own wishes must guide their recovery and what it means for them to participate in the community, even if other people disagree. What is restrictive for one person might not be restrictive for someone else.
4. Supported decision making principle
People receiving services should be supported to make their own decisions about their treatment, assessment, care and recovery, even if they are experiencing compulsory treatment. The person’s own views and wishes are to be given priority.
5. Family and carers principle
Families, carers, and supporters of people receiving services are to be supported in their role in decisions about the person’s assessment, treatment and recovery.
6. Lived experience principle
The experiences of people living with mental health issues, emotional distress, or a mental illness and their families are to be recognised and valued when services are being provided.
7. Health needs principle
Medical and other health needs must be identified, and the person living with mental health issues, emotional distress, or a mental illness, supported to address them.
This includes any needs related to drug and alcohol use. How a person’s physical health needs connect and impact their mental health needs must also be considered.
8. Dignity of risk principle
People receiving services have the right to take reasonable (personally suitable) risks when making decisions.
9. Wellbeing of young people principle
The health, wellbeing, and independence of children and young people receiving services are to be promoted and supported in ways that work for them, considering life experiences, age, and other factors.
10. Diversity principle
The diverse needs and experiences of people receiving services are to be considered when providing treatment and care, including:
- gender identity
- sexual orientation
- sex
- ethnicity
- language
- race
- religion, faith or spirituality
- class
- socioeconomic status
- age
- disability
- neurodiversity
- culture
- residency status
- geographic disadvantage.
Services must be given in a way that is responsive to these diverse needs and experiences. This means people can tell services what they need to feel safe.
Services are to be understanding of:
- the diverse needs and experiences of the person
- any experience of trauma
- how needs and experiences are connected and can impact on a person’s mental health.
11. Gender safety principle
People receiving services may have specific safety needs or worries (concerns) because of their gender.
Consideration is to be given to these needs and concerns and services should:
- be safe
- respond to any current or past experience of family violence or trauma
- recognise and respond to the ways gender can affect how services are provided to them, what treatment they receive and their recovery
- recognise and respond to the ways in which gender connects with other types of discrimination and disadvantage.
12. Cultural safety principle
Services must be culturally safe and responsive to individuals from all racial, ethnic, faith-based, and cultural backgrounds.
People living with mental health issues, emotional distress, or a mental illness are to be provided treatment and care that considers and is consistent with their cultural and spiritual beliefs and practices.
The perspectives of the person's family and, when possible and appropriate, the views of significant members of their community are to be considered.
First Nations people must have their unique culture and identity respected. This includes their connection to family, kin, community, Country, and water. The views of First Nations elders, traditional healers, and mental health workers are to be considered and respected in decisions about treatment and care if possible and appropriate.
13. Wellbeing of dependents principle
The children and dependents of people receiving services must have their needs, wellbeing and safety protected.
Decision making principles for treatment and interventions
There are also five principles about decision making. These principles only apply when services are deciding about compulsory treatment or restrictive interventions.
Compulsory treatment means people are not allowed to refuse treatment.
Restrictive interventions that can be used in hospital are:
- Seclusion: when someone is kept by themselves in a room.
- Bodily restraint: when someone is physically prevented from moving all or part of their body.
- Chemical restraint: when someone is given a medication to control their behaviour by stopping them from moving their body. It is not medication for medical or mental health treatment.
You can read the decision-making principles as stated in the Mental Health and Wellbeing Act 2022 . These principles are presented in plain language on this page.
1. Care and transition to less restrictive support principle
The goal of compulsory assessment and treatment is to help the person’s recovery. Services are to be comprehensive, caring, safe and high quality, and move people towards less restrictive forms of treatment, care and support.
Least restrictive means people receiving compulsory assessment or treatment need to be given as much freedom as possible. What is restrictive for one person might not be restrictive for someone else.
2. Consequences of compulsory assessment and treatment and restrictive interventions principle
Compulsory assessment and treatment and restrictive interventions can greatly limit a person's human rights.
These may cause a person serious distress, or harm to their:
- relationships
- living arrangements
- education
- work.
The above should be considered by mental health services and their staff any time compulsory treatment and/or restrictive practices are used.
3. No therapeutic benefit to restrictive interventions principle
Using restrictive interventions does not inherently (necessarily) benefit the person.
4. Balancing of harm principle
Compulsory assessment and treatment, or restrictive interventions, are not to be used if they will cause more harm than they are supposed to prevent.
5. Autonomy principle
A person's views and wishes are to be respected and followed as much as possible in all decisions.
This includes decisions about assessment, treatment, recovery, and support, even if someone is being given compulsory assessment and treatment.
How an advocate can support you
If you are receiving compulsory treatment, you may feel you need help to understand and act on your rights in the mental health system.
Our independent advocates can:
- listen to what you want and talk to you about your options
- give you information and support to act on your rights
- work with you so you can have your say
- refer you to other services if needed.
Find out more about how we can support you.
We do not provide legal representation or specific advice about how the law applies in your particular situation. If you require legal help, ask your advocate to put you in touch with Victoria Legal Aid.
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