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1. Scope

1.1. This policy outlines the overarching framework within which Open Arms mental health care is provided.

2. Context

2.1. The Open Arms Principles of Care provide an overarching framework for the provision of mental health services to the Australian veteran community. The principles focus on meeting client needs and are shaped by clinical best practice and trauma-informed care, incorporating new and emerging evidence-based approaches. 

Figure 1: Open Arms Principles of Care

2.2.  The scope of services provided by Open Arms sits within a stepped care approach, to match the individual needs of clients to the most suitable service level and intensity. This ensures more targeted, personalised interventions for the most vulnerable individuals and families as well as supporting appropriate allocation of resources to meet service demand.

2.3.  Open Arms recognises the non-linear nature of recovery. As mental illness and injury can be episodic, so too can recovery. Health, mental health and wellness are interconnected concepts and Open Arms takes a whole-of-person approach to supporting the recovery of both veterans and their families.

2.4.  Open Arms is committed to providing a positive experience of care for clients. Within a collaborative model, Open Arms offers a welcoming environment, wraparound support and creative solutions to promote client health and wellbeing. Open Arms seeks to learn from client feedback and strives for continual improvement of service provision. Underpinning Open Arms service delivery are the following principles of trauma-informed care:

  • Recovery oriented and person centred 
  • Integrated, multidisciplinary and evidence based
  • Timely, accessible, nationally consistent and locally responsive
  • Safe, high quality and continually improving
  • Mental health promotion and prevention.

2.5. Open Arms services and staff practice are underpinned by the National Standards for Mental Health Services.

3. Service Delivery

3.1.    Open Arms supports veterans and families through the delivery of a range of services, including:

  • Client Assist contact centre: providing 24-hour telephone support, assertive outreach and national entry into Open Arms
  • Mental health treatment and counselling support: a team of mental health professionals, trained in military and veteran culture, to deliver specialised support and care to individuals, couple and families
  • Care coordination: to address the multiple issues impacting mental health for clients with complex needs
  • Crisis Accommodation Program: provides ‘time-out’ accommodation to alleviate a crisis situation, such as a potentially conflicting domestic situation or immediate housing issue
  • Community and peer program: lived-experience Australian Defence Force personnel and family peers provide cultural competence, early engagement, trauma-informed mental health support and a bridge to clinical services
  • Group treatment programs: provide opportunities for veterans and their families to share their experiences and develop life skills and resilience, while receiving treatment in a supportive environment
  • Suicide prevention and mental health training: help and support to prevent suicide is available at all points of contact with Open Arms, with the support of a clinician to help those at risk deal with suicidal thoughts. Suicide intervention and mental health literacy workshops are offered free of charge to those seeking to help family, friends, co-workers or others in the veteran community
  • Self-help resources and education: tools and educational resources to build resilience and wellbeing in the veteran community.

4. Stepped Care

4.1.    Stepped care is defined as an evidence-based, staged system comprising a hierarchy of interventions – from the least to the most intensive – matched to the individual’s needs. The goal of a stepped care approach is to ensure the right level of treatment is available to meet individual needs, at the point in time they require the treatment.

4.2.    Open Arms is working towards a close and collaborative relationship with the primary health networks (PHNs) to optimise access to general practitioners (GPs) and allied health services and to adopt best practice shared-care arrangements for clients experiencing mental illness. Open Arms also aims to work collaboratively with DVA to support clients in the provision of mental health care, where appropriate and only with client consent.

5. Recovery-Oriented

5.1.    Open Arms recovery-oriented practice aligns with the principles and service guidelines of the National Framework for Recovery-Oriented Mental Health Services and encapsulates mental health care that:

  • recognises and embraces the possibilities for recovery and wellbeing created by the inherent strength and capability of all people experiencing mental health issues
  • maximises self-determination and self-management of mental health and wellbeing
  • assists families to understand challenges and opportunities arising from their family member’s experiences and grows the capacity and resilience of families and community.

5.2.    Personal recovery is defined in the national framework as ‘being able to create and live a meaningful and contributing life in a community of choice with or without the presence of mental health issues’.

5.3.    A recovery-oriented approach to practice and service delivery recognises the value of lived experience.

6. Person-Centred

6.1.    In the Open Arms environment, person-centred care means:

  • the client is recognised as the expert in their own experience and a collaborator in care planning
  • the client’s values and preferences for service delivery and service provider are respected, inform decision-making and guide care
  • client care is needs driven. The client has access to the care they need, when they need it, in a manner that does not add to the stress they are experiencing
  • the client is fully informed about their care and, given the trust and respect that comes with sharing all relevant facts, feels more empowered to take responsibility for elements of their care that are within their control
  • care is delivered within a flexible and responsive framework that places the client at the centre
  • care and support promote the building of resilience and self-management, aid in capacity building and keep clients well in the future.

7. Integrated, Multidisciplinary and Evidence-Based

7.1.    Open Arms is committed to ensuring that all mental healthcare services provided to veterans and their families are evidence based. Open Arms supports the use of any mental health treatment technique that has been empirically validated for a particular mental health concern.

7.2.    Open Arms is actively involved in activities to enhance and further develop the evidence base  underpinning mental health treatment and to evaluate the efficiency of current service delivery.

7.3.    Open Arms services are integrated. Services provided by Open Arms are planned and delivered in partnership with the client, to support the client holistically. This means planning so that Open Arms services are complementary, and also integrating with other health and community services the client and their family or carers are accessing.

7.4.    Open Arms services are provided by multidisciplinary teams. Services are planned to draw on and integrate the skills and experiences of health and mental health professionals and lived-experience peers.

8. Timely, Accessible, Nationally Consistent and Locally Responsive

8.1.    Open Arms services are delivered in a timely and accessible manner. Clients are offered multiple access points for support and Open Arms lived-experience peer workers extend the organisation’s reach into the veteran community through attendance at events as well as through social media channels and online access. Open Arms has a ‘no wrong door’ policy and will facilitate client access to the services they need, regardless of how clients make contact.

8.2.    Open Arms is a national service and understands that some clients are mobile and may seek to access Open Arms services from multiple offices. Clients are entitled to expect that they will be provided a comparable service regardless of which Open Arms office they approach. Clients can also reasonably expect that services are sensitive to local needs. Accordingly, Open Arms has in place policies and procedures to promote the delivery of services that are both nationally consistent and locally responsive.

9. Safe, High Quality and Continually Improving

9.1.    Open Arms holds a strong commitment to promoting the safety of clients, family, carers and Open Arms workers. Safety is a key priority and focus; therefore risk assessment and safety planning are conducted as an integrated element of every service. Open Arms routinely provides staff with opportunities to undertake training on risk management, first aid, safe practice, and workplace health and safety.

9.2.    Open Arms is committed to providing a quality mental health service and maintains accreditation with the National Standards for Mental Health Services. In addition, Open Arms engages in an ongoing process of quality assurance, including audits and reviews of services (refer to the Adverse Event Review Procedure (102-05) and Continuous Quality Improvement Procedure (102)).

9.3.    Open Arms applies a continuous quality improvement framework to its delivery of client services. 

10. Mental Health Promotion and Prevention of Mental Health Problems

10.1.    Open Arms promotes the mental health of the Australian veteran community and, where possible, seeks to prevent the development of mental health problems and mental health disorders.

10.2.    Activities to promote mental health and prevent mental health problems are based on a combination of community engagement to reduce stigma, and secondary and tertiary interventions to minimise the impact of mental illness when it occurs. 

11. Implementation

11.1.    The National Manager:

  • ensures a process for implementation of the Open Arms Care Policy
  • considers the trends in data related to the delivery of Open Arms services – and the implications that emerging trends may present for delivery of Open Arms services – in accordance with this policy
  • ensures fulfilment of service delivery in accordance with this policy
  • ensures that related policies and procedures are considered at regular fixed intervals by the National Management Team
  • drives an organisational culture supportive of the model of service delivery described in this policy.

11.2.    The Assistant National Manager:

  • supports regional leadership teams to ensure compliance with the Open Arms Care Policy and related procedures
  • ensures continuing professional development plans and resources are in place to support Open Arms workers to develop and maintain capacity to comply with the Open Arms Care Policy
  • contributes to the fostering of organisational culture supportive of the model of service delivery described in this policy.

11.3.    The Assistant National Manager – National Operations (roles now within the Mental Health and Wellbeing Services Division):

  • ensures systems are in place to communicate the Open Arms Care Policy and related procedures to all Open Arms workers
  • ensures a continuing professional framework is in place for Open Arms workers
  • is responsible for an evaluation framework for the Open Arms Care Policy
  • contributes to the fostering of organisational culture supportive of the model of service delivery described in this policy
  • ensures that a system is in place to respond to enquiries and issues regarding the Open Arms Care Policy.

11.4.    The regional leadership team:

  • maintains knowledge of the professional obligations of multidisciplinary teams and support workers
  • ensures all personnel engaged in their region are conversant with and have access to the Open Arms Care Policy
  • ensures incidents where the Open Arms Care Policy and related procedures may not have been applied in the region are monitored and investigated, to improve operation of the policy and its implementation.

11.5.    Open Arms workers:

  • ensure they are aware of, and comply with, the Open Arms Care Policy and related procedures
  • seek advice from the relevant Director or Assistant Director if they require clarification regarding the application of the policy or related procedures.

12. Parent Policy

12.1. 200 – Clinical Governance Policy

13. Directly Subordinate Procedures

13.1. 202 - 01 Intake Procedure

13.2. 202 - 02 Clinical Assessment and Treatment Planning Procedure

13.3. 202 - 03 Counselling Procedure

13.4. 202 - 04 Group Treatment Programs Procedure

13.5. 202 - 05 Mental Health Training Workshops Procedure

13.6. 202 - 06 Crisis Accommodation Procedure

13.7. 202 - 07 Referral and Allocation Procedure

13.8. 202 - 08 Defence Referrals Procedure

13.9. 202 - 09 Care Coordination Procedure

13.10. 202 - 10 Anonymous Counselling Line (Safe Zone) Procedure

13.11. 202 - 11 Community Engagement Procedure

13.12. 202 - 12 Peer Support Procedure