Forcing family involvement in patient care: legislative and clinical issues. 2007

Gregory Spencer, and Jeremy Skipworth
Regional Rehabilitation Service, Capital and Coast District Health Board, Wellington, New Zealand. greg.spencer@ccdhb.org.nz

OBJECTIVE Families have an important role in the recognition and treatment of mental illness in their family members. However, the extent to which families are consulted during compulsory assessment processes has received little attention. In 2000, mandatory family/whānau consultation was introduced in New Zealand. This paper reviews the extent of family consultation during compulsory assessment and surveys clinicians' views and experience. METHODS All applications for compulsory assessment in a representative sample of districts were audited over a 2-month period. An email survey of clinicians investigated changes in their practice since the introduction of mandatory family consultation, their views and training experiences. RESULTS A total of 283 compulsory assessments were audited; 187 (66.1%) family/whānau consultations occurred and were completed by the assessing doctor 82.1% of the time. Of the remaining assessments, 12 did not appear consistent with the legally permitted exceptions to mandatory consultation. Some 88.6% of clinicians were aware of the legislative requirements about consultation. A significant percentage (54.7%) believed their practices had altered following legislative change. CONCLUSIONS Family/whānau consultation occurred in the majority of compulsory assessments. The introduction of mandatory consultation with family/whānau may have improved clinical practice in this regard, although training and guidelines issued at a similar time are also likely to have contributed to the change in practice.

UI MeSH Term Description Entries
D007883 Legislation, Medical Laws and regulations, pertaining to the field of medicine, proposed for enactment or enacted by a legislative body. Medical Legislation
D009520 New Zealand A group of islands in the southwest Pacific. Its capital is Wellington. It was discovered by the Dutch explorer Abel Tasman in 1642 and circumnavigated by Cook in 1769. Colonized in 1840 by the New Zealand Company, it became a British crown colony in 1840 until 1907 when colonial status was terminated. New Zealand is a partly anglicized form of the original Dutch name Nieuw Zeeland, new sea land, possibly with reference to the Dutch province of Zeeland. (From Webster's New Geographical Dictionary, 1988, p842 & Room, Brewer's Dictionary of Names, 1992, p378)
D009790 Occupations Crafts, trades, professions, or other means of earning a living. Vocations,Occupation,Vocation
D011368 Professional-Family Relations The interactions between the professional person and the family. Professional Family Relationship,Family Relationship, Professional,Family Relationships, Professional,Professional Family Relations,Professional Family Relationships,Professional-Family Relation,Relation, Professional-Family,Relations, Professional-Family,Relationship, Professional Family,Relationships, Professional Family
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003256 Community Participation Involvement of members of the community in the affairs of that community. Community Action,Consumer Involvement,Consumer Participation,Community Involvement,Public Participation,Action, Community,Actions, Community,Community Actions,Community Involvements,Consumer Involvements,Involvement, Community,Involvement, Consumer,Involvements, Community,Participation, Community,Participation, Consumer,Participation, Public
D003710 Demography Statistical interpretation and description of a population with reference to distribution, composition, or structure. Demographer,Demographic,Demographic and Health Survey,Population Distribution,Accounting, Demographic,Analyses, Demographic,Analyses, Multiregional,Analysis, Period,Brass Technic,Brass Technique,Demographers,Demographic Accounting,Demographic Analysis,Demographic Factor,Demographic Factors,Demographic Impact,Demographic Impacts,Demographic Survey,Demographic Surveys,Demographic and Health Surveys,Demographics,Demography, Historical,Demography, Prehistoric,Factor, Demographic,Factors, Demographic,Family Reconstitution,Historical Demography,Impact, Demographic,Impacts, Demographic,Multiregional Analysis,Period Analysis,Population Spatial Distribution,Prehistoric Demography,Reverse Survival Method,Stable Population Method,Survey, Demographic,Surveys, Demographic,Analyses, Period,Analysis, Demographic,Analysis, Multiregional,Demographic Analyses,Demographies, Historical,Demographies, Prehistoric,Distribution, Population,Distribution, Population Spatial,Distributions, Population,Distributions, Population Spatial,Family Reconstitutions,Historical Demographies,Method, Reverse Survival,Method, Stable Population,Methods, Reverse Survival,Methods, Stable Population,Multiregional Analyses,Period Analyses,Population Distributions,Population Methods, Stable,Population Spatial Distributions,Prehistoric Demographies,Reconstitution, Family,Reconstitutions, Family,Reverse Survival Methods,Spatial Distribution, Population,Spatial Distributions, Population,Stable Population Methods,Technic, Brass,Technique, Brass
D005190 Family A social group consisting of parents or parent substitutes and children. Family Life Cycles,Family Members,Family Life Cycle,Family Research,Filiation,Kinship Networks,Relatives,Families,Family Member,Kinship Network,Life Cycle, Family,Life Cycles, Family,Network, Kinship,Networks, Kinship,Research, Family
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D037141 Mandatory Programs Programs in which participation is required. Mandatory Program,Program, Mandatory,Programs, Mandatory

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