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Advanced Care Directive

An Advanced Care Directive allows a person to plan for their future health care, personal care, end of life care or living arrangements. In many Australian jurisdictions, an Advanced Care Directive can allow the appointment of a substitute decision maker to make decisions on behalf of a person if they are unable to do so.

Clinical Incident

An event of significant harm to a client or other person by a client. This includes suicide, suspected suicide, attempted suicide, and serious violence. It can also relate to relate to significant harm to a client resulting from an Open Arms service.

Assertive aftercare

Typically consists of assertive and rapid follow-up, case management and motivational support to remain in treatment following a suicide attempt. The term ‘assertive’ means that the care provider is responsible for maintaining contact with the client or patient. See also Postvention.

Care formulation

A systematic process of documenting a person’s presentation, problems and resources, and generating hypotheses that draw these together in a way that can inform interventions and help predict recovery. It is a reasoned conceptualisation of a client’s problem, based on information gathered from interviews, assessments and other sources, and built around a conceptual framework. A care formulation draws the presenting complaints together and generates hypotheses that informs a clinical intervention. A care formulation can be clinically based - for example, a care formulation to plan treatment, or peer based – for example, a wellness and recovery action plan. Care formulations are developed collaboratively between Open Arms workers and clients during the assessment phase, using a sound framework such as the 5P case formulation framework, and are revised as new information is gathered during the course of providing care.

Care plan

A care plan describes an Open Arms worker’s care formulation and outlines the treatment plan including counselling and other complementary interventions, and the health and wellbeing outcomes to be achieved. It is a plan that the Open Arms worker and client develop and agree together. A complete care plan incorporates either a clinical or peer support needs assessment and care formulation, risk formulation and safety planning. As needed, it also includes plans for counselling, care coordination, peer support or group treatment programs.

Carer

The Carer Recognition Act 2010 defines carers as people who provide personal care, support and assistance to another individual in need of support due to disability, medical condition, including terminal or chronic illness, mental illness or is frail and aged, but not if they only provide care, support or assistance either for payment, such as a care or support worker, or as a volunteer for an organisation, or as part of the requirements of a course of education or training. Further, a person is also not a carer, for the purpose of this legislation, simply because they: are the spouse, de facto partner, parent, other relative or guardian of an individual who requires care or lives with an individual who requires care.

Case review

A mandatory follow-up clinical report, which functions as either a progress report at the end of approved sessions, or as a case closure report. A case review documents the current progress of treatment, changes in psychosocial stressors, symptoms and ability to function, and current risk status. If serving as a review, it must also include recommendations regarding continuation of treatment based on a clear clinical justification.

Clinical audit

New Principles for Best Practice in Clinical Audit (2011)  defines clinical audit as, “a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, process and outcome of care are selected and systematically evaluated against explicit criteria. Where indicated changes are implemented at an individual, team, or service level and further monitoring is used to confirm improvement in healthcare delivery.”

Community

For the purposes of Community Engagement, ‘Community’ is defined as “groups of people affiliated by geographic proximity, special interest, or similar situations” (United States Department of Health and Human Services, 2011). 

Community Engagement

The World Health Organisation has defined Community Engagement as “a process of developing relationships that enable stakeholders to work together to address health-related issues and promote wellbeing to achieve positive health impact and outcomes. At its core, Community Engagement enables changes in behaviours, environments, policies, programs and practices within communities. There are different levels, depths and breadths of Community Engagement which determine the type and degree of involvement of the people”. Community and stakeholder engagement occur at all levels across Open Arms. At an individual level, community engagement can include the way in which a practitioner involves or collaborates with an individual client’s personal community to improve their recovery journey. Within the Open Arms Community Engagement and Peer Program, it also involves engaging with the broader military and veteran community and with ex-service organisations (ESOs), health and community services and stakeholders in strategic ways, taking a systemic improvement approach to influence the overarching objective of Open Arms: “Improved quality of life for veterans and their families”.  

Consent

The Office of the Australian Information Commissioner (OAIC) has defined consent as voluntary and informed agreement with what is being done or proposed, where the individual has the capacity to understand, provide and communicate their consent. Consent can be either express (given explicitly either verbally or in writing) or implied (where consent may be reasonably inferred in the circumstances from the conduct of the individual). The OAIC recommends that in the handling of personal health information deemed ‘sensitive’ under the Privacy Act 1988, undue reliance should not be placed upon implied consent. Open Arms requires client consent for the provision of services and to collect, store, use and disclose the client’s personal information. The client is given an opportunity to consider and understand the information before making a decision to consent, and freedom to make a decision without unfair pressure or influence from others. This includes discussion of options, answering client or carer questions, and a formal record of the consent.

Counselling

The Australian Institute of Family Studies  describe counselling as involving, “collaborative discussions in a supportive and confidential environment aimed at an account (or accounts) of a set of problems (or set of problems) for the purpose of assisting the client(s) to reach a point at which the problem(s) no longer exist; are transformed into opportunities; or continue, but in less debilitating, more manageable form(s).” Open Arms provides counselling services across a spectrum of care from evidence-based treatment to counselling support to eligible clients. Counselling support is also available for relationship and family matters, including those due to the unique nature of the military lifestyle, although attribution of a problem to military lifestyle is not a pre-requisite for counselling.

Consumer, Carer and Community Partnering

Open Arms aligns with definitions of Partnering as outlined in the National Quality and Safety Health Standards, whereby Standard 2, ‘Partnering with Consumers’, aims to create health service organisations in which there are mutually beneficial outcomes by having: 

  • consumers* as partners in planning, design, delivery, measurement and evaluation of systems and services
  • patients as partners in their own care, to the extent that they choose. 

*Open Arms broadens the concept of Partnering to include consumers, carers, those with lived experience, and communities (see Lived Experience). 

 Community Engagement practices apply the Partnering Standard by adopting definitions of engagement that include: 

  • Proactively seeking out community values, concerns and aspirations; 
  • Incorporating those values, concerns and aspirations into a decision-making process or processes; and 
  • Establishing ongoing partnerships with the community to ensure that the community’s priorities and values continue to shape services and the service system. 

Community engagement

A key strategy for improving outcomes for Australian families | Child Family Community Australia (aifs.gov.au)

Dignity of Risk

The individual’s right to make informed choices in relation to a variety of life experiences and to take advantage of opportunities for learning, developing competencies and independence and, in doing so, take a calculated risk.

Episode of care

An episode of care describes a discrete period of care for an individual, couple or family, guided by goals that are identified within a care plan or recovery action plan. An episode of care encompasses all of the services provided to the client within an interval of engagement with Open Arms. The episode of care commences at allocation and ends when all services are closed, such as when a client is discharged from care because they have achieved their goals, the client does not wish to continue, the interventions are not achieving change, or by a service break of three months. The episode of care may be continuous or it may consist of a period of service marked by one or more brief separations from care.  There is no limit to the number of sessions in an episode of care, however goals of care are to be reviewed with the client at regular intervals, e.g., at the completion of each set of approved counselling sessions, or the completion of a group treatment program, to ensure clinical justification and clinical efficacy.

Family

For the purpose of Open Arms eligibility, family is defined as the partner, former partner, or child (of any age) of an eligible current or former Australian Defence Force (ADF) member. In specific circumstances, such as the death of a member or their eligibility for a Defence Abuse Response Taskforce (DART) reparation payment, eligibility may be extended to parents and siblings.

Family and domestic violence

The DVA Family and Domestic Violence Strategy 2020–25 defines family and domestic violence as “conduct that is violent, threatening, coercive, controlling or intended to cause the family or household member to be fearful”. DVA uses the term ‘family and domestic violence’ because violent behaviour is not necessarily limited to members of families connected by kinship or marriage. The DVA definition also recognises that both men and women can use violence. One in six women and one in sixteen men have experienced physical or sexual violence from a current or previous cohabiting partner since the age of 15 . Survivors of family and domestic violence can be from any age group including children, adults and the elderly. The definition also recognises that a person suffering a form of family and domestic violence may not wish to take action, and the effects of abuse is an individual experience with no single response to its causes or effects. See also Intimate partner violence.

Guardianship order

A legal document issued by a court that gives a person (called a ‘guardian’) power to make decisions on behalf of another person about personal matters. This may include decisions about accommodation, health care and access to services. In some cases, there may be more than one guardian (called ‘joint guardians’). Guardianship orders can include what actions a guardian can, or cannot, take in relation to the other person.

Housing instability

Encompasses a number of challenges, such as having trouble paying rent, overcrowding, moving frequently, staying with relatives, or spending the bulk of household income on housing. Can result in rough sleeping, temporary accommodation and inappropriate housing (which may include exposure to family and domestic violence situations).

Intimate partner violence

This term is often used to describe a behaviour by a person in a relationship that causes physical, sexual or psychological harm to those in a relationship. Violence against women may refer to any public or private act of gender-based violence resulting in physical, sexual or psychological harm or deprivation of liberty. Family violence is a broader term encapsulating violence between family members as well as intimate partners . Family violence is the preferred term in Indigenous populations as it better captures the kinship and extended family relationships in Indigenous communities . See also Family and domestic violence.

Lived Experience

The term ‘lived experience’ is utilised broadly across a range of sectors and settings. Queensland Health’s Lived Experience Engagement and Participation Strategy define persons with lived experience as those who: 

  • Have experienced a mental illness or accessed mental health treatment services (also known as a ‘consumer’)
  • Have experienced problematic alcohol and/or other drug use, including those who have received services from alcohol and other drug treatment services 
  • Have experienced suicidal thoughts or survived a suicide attempt
  • Is or has been a carer for a person who has received services from a mental health treatment service (also known as a carer)
  • Has cared for someone through suicidal crisis, or been bereaved by suicide 
  • Is a significant other who has provided support to a person who has received services from a mental health or alcohol and other drug treatment service

Open Arms also recognises the importance of the cultural wisdom held by those with specific experiences, in particular of military service and Defence family life to ensuring the delivery of a military aware service and seeks to engage representatives of these communities to inform service design and delivery. 

Lived Experience - Aboriginal and Torres Strait Islander people

For Aboriginal and Torres Strait Islander people, lived experience recognises the effects of ongoing negative historical impacts and or specific events on the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples. It encompasses the cultural, spiritual, physical, emotional and mental wellbeing of the individual, family or community and is inclusive of Lived Experience of suicide. This experience is significantly different and true to Aboriginal and Torres Strait Islander people ways of understanding social and emotional wellbeing.  mentalhealthcommission.gov.au

Lived Experience roles

As per the Queensland Framework for the development of the Mental Health Lived Experience Workforce, lived experience roles are defined as people employed specifically to:

  • Use their personal understanding of life-changing (mental health, suicide related) challenges, service use and periods of healing/personal recovery, to assist others 
  • Use their life-changing experience of supporting someone through (mental health, suicide related) challenges, service use and periods of healing/personal recovery, to assist others 

Those in lived experience roles bring forward what has been learned through their experiences and apply those learnings in intentional and safe ways in order to influence individual and systems change.   The Lived Experience workforce in Open Arms also bring forward lived experience of the Australian Defence Force as a veteran or family member.  Open Arms encourages lived experience to be brought forward by those employed specifically in lived experience roles and others for whom lived experience is part of their personal or professional background.

Mandatory reporting

A term used to describe the legislative requirement for certain classes of people to report suspected cases of child abuse and neglect to relevant government authorities . All state and territory jurisdictions have mandatory reporting requirements. However, the people mandated to report and the abuse types for which it is mandatory to report concerns, suspicions or beliefs vary across the jurisdictions. 

Mental health training

Brief workshops (typically half to two days) delivered by Open Arms, designed to impart information and promote skill-building and confidence related to a specific area of concern or interest.

Military culture

For Australian Defence Force (ADF) members and their families the ADF experience, including the challenges of service deployments and then separation from service, results in beliefs, attitudes and understandings that are particular to this community. These experiences also act as a bond that connects the community’s members.

Open Arms worker

An Open Arms worker is a mental health professional, a lived experience mental health peer worker, a member of the management team, a clinical support member or an administrative support person employed by Open Arms directly.

Peer Support

Peer Support is a service provided by Open Arms peer workers. Open Arms employs both Veteran Peers and Family Peers. Peer workers support client recovery in a range of ways by working collaboratively with veterans, their families, Open Arms clinicians, community agencies, services and networks.

Postvention

Support provided to families and friends bereaved by suicide. Postvention includes interventions provided within a community, service or family context that mitigate risks and promotes recovery. This is different from assertive aftercare for a survivor of a suicide attempt. See also Assertive aftercare.

Privacy

Broadly, privacy is a fundamental human right that encompasses freedom from interference and intrusion; freedom of association; and control of who can see or use personal information. Information privacy is of most relevance to Open Arms, relating to the protection of sensitive personal information, and in particular the health and treatment information of clients and their families. The DVA Privacy Policy (19945252E) defines personal information in line with the Privacy Act 1988 (Cth) and the Australian Privacy Principles, and describes the specific legal obligations of DVA when collecting, storing, using, disclosing and disposing of personal information. 

Rape

Australian jurisdictions vary in legal use of the term ‘rape’. Whereas Queensland, South Australia, Tasmania and Victoria use the term ‘rape’ in their criminal legislation, New South Wales uses ‘sexual assault’, the Australia Capital Territory and Northern Territory refer to ‘sexual intercourse without consent’ and Western Australia to ‘sexual penetration without consent’. Notwithstanding these differences, in Australia, rape is generally defined as the penetration of the vagina, anus or mouth without consent, with the use of any body part or object.

Recovery

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.

Recovery-oriented risk formulation

Open Arms conducts risk formulation using the SafeSide Connect, Assess, Respond, Extend (CARE) recovery-oriented framework. Typically related to suicide or violence, risk formulation is the synthesis of client information to consider risk status (relative to a sub-population), risk state (the client’s risk at a given point compared to baseline or other points in time), available client resources which they may draw upon in times of crisis, and foreseeable changes in the future that may exacerbate risk. 

Referral

A request from one health professional to another health professional or health service, asking them to see a client for assessment, treatment, or a review for further action.

Reputational risk

The potential for an event, or the public perception of an event, to diminish the reputation of Open Arms, its leadership and staff, the Department or the Government in the eyes of the community.

Risk (organisational)

Open Arms uses the DVA definition of organisational risk, that it is “the effect of uncertainty on objectives”. This considers both favourable and unfavourable outcomes, expressed as a consequence or impact of an event and the likelihood of its occurrence.

Risk screening

A brief assessment conducted with all clients of their risk of harm, based on an agreed prevention-oriented protocol and which yields a simple indicator of risk. Where a risk is indicated, a comprehensive recovery-oriented assessment of risk of suicide and other harms is then conducted.

Safe Zone Support

Safe Zone Support is a free and anonymous counselling line, for veterans and their families – call 1800 142 072 (available 24/7). This service provides access to specialised counsellors, with an understanding of military culture and experience.  The service offers care without the need for individuals to identify themselves or be concerned that their call will be recorded.

Safety plan

In relation to harm prevention, a structured safety plan helps a person to work through periods of distress, crisis, or suicidal thoughts or feelings. It is also a communication tool for clinicians to know what strategies have been put in place to support an individual client in managing safety concerns.

Self-harm or non-suicidal self-injury

Behaviours that are self-directed and deliberately result in injury or the potential for injury to oneself, but without a clear intent to die.

Sexual assault

An act of a sexual nature carried out against a person’s will or without their expressed consent, and may include the use of physical force, intimidation or coercion, and includes any attempts to do this. Refer also to Sexual harassment and Sexual violence and Rape.

Sexual harassment

Unwelcome sexual behaviour, which could be expected to make a person feel offended, humiliated or intimidated. This may include comments about their body or sex life, unwanted physical contact, indecent exposure or an indecent text, email or post. Refer also to Sexual assault and Sexual violence and Rape.

Sexual violence

Sexual violence is an act of a sexual nature carried out without consent using physical force, intimidation or coercion. It can refer to a broad range of behaviours that may include sexual threats, assault with an object, enforced prostitution or enforced sexual activity with a perpetrator or their acquaintances. Refer also to Sexual assault and Sexual harassment and Rape.

Stakeholder relationships

Open Arms stakeholders are individuals, groups and entities affected by the operation of Open Arms. Stakeholder relations is the practice of forging mutually beneficial connections with individuals and third-party groups that have an interest in Open Arms’ activities. These internal and external relationships build networks that develop credible, united voices about issues, products, and/or services that are important to Open Arms clients.

Suicidality

The term suicidality covers suicidal ideation (serious thoughts about taking one’s own life), suicide plans and suicide attempts. People who experience suicidal ideation and make suicide plans are at increased risk of suicide attempts, and people who experience all forms of suicidal thoughts and behaviours are at greater risk of completed suicide .

Trauma-informed

The re-conceptualisation of traditional approaches to health and human service delivery whereby all aspects of services are organised acknowledging the prevalence of trauma throughout society. Trauma-informed services are aware of and sensitive to the dynamics of trauma as distinct from directly treating trauma.

Group treatment programs

Group treatment programs are an integral part of Open Arms’ service delivery and complement other Open Arms services to assist veterans and families to build the resilience and capacity of individuals and families. Open Arms develops, delivers and promotes group treatment programs for the veteran community and their families in metropolitan, regional and remote areas. These focus on psychological problems commonly experienced within the veteran community, using evidence-based treatment within a group format.

VERA (Veterans Electronic Records Application)

An internet-accessed Client Management System (CMS) hosted by Athena Software and accessed by Open Arms staff and outreach counsellors, using an ID issued by Open Arms and an individually managed password. VERA is a customised version of Penelope published by Athena Software and is used under licence.

Veteran

The Australian Veterans’ Recognition (Putting Veterans and Their Families First) Act, 2019 defines a veteran as, “a person who has served, or is serving, as a member of the Permanent Forces or as a member of the Reserves.” This Act retains the definition of Permanent Forces in the Defence Act, 1903 as, “the Permanent Navy, the Regular Army and the Permanent Air Force.”