Questions from the Royal Commission: Can we do “local complaints” better?

‘Why bother?’. It’s something I have heard a lot from consumers of mental health services when I mention complaints processes. Another is ‘is it really worth it?’. People have a real sense that processes are designed to placate them and maintain systems, rather than serve people and drive improvement.

These questions are most apparent in complaints that are made directly to designated mental health services. They are often called “local complaints”.

Under the s266 of the Mental Health Act 2014 (Vic) (the Act), services need to establish their own local complaints handling systems, and s 267 requires services to report on their local complaints numbers to the Mental Health Complaints Commissioner (MHCC).

What standards or rights should guide those complaints processes? The Act is unclear.

What format should complaints processes be in? Who should complaints go to? What are the time-frames that consumers and carers should expect for their complaints to be responded to? What about confidentiality?

The Act is silent on these things. This silence is contrasted by s 132 of the Health Complaints Act 2016 (Vic) (HCCA), which makes clear that the Health Complaints Commissioner (HCC) should provide minimum complaints standards for health service providers.

Arguably these standards apply to designated mental health services, but it would seem confusing for both the HCC and the MHCC to be regulating local complaints in mental health services.

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There are opportunities to change this, and they are straightforward.

The Royal Commission has recommended the introduction of a new Mental Health and Wellbeing Act (MHWA). Work on this is beginning, as it is set to be introduced to Parliament by mid-2022, at the latest.

The MHWA should reform local complaints processes so that:

• Standards – there are clear minimum complaints standards, building on those set out in s 132 of the HCCA

• Consumer leadership – standards should articulate a clear role for consumer leadership in quality improvement, such as consumer consultants having an explicit role in overseeing complaints management processes

• Principles and the Charter – make clear that in resolving complaints locally, designated mental health services must do so consistently with the new principles of the MHWA, and that they still retain their obligations to consider and act compatibly with rights under the Charter of Human Rights and Responsibilities Act 2006.

These changes are minor, low-cost, but necessary. They align mental health complaints with general health complaints. Failure to do so would condemn consumers in mental health services to worse feedback and complaints mechanisms than in general health.