Building collaborative cultures of care

within NSW mental health services

Back to accessibility links



A carer is a person of any age who provides personal care, support and assistance to another person because the other person has a disability, a medical condition, a mental illness or is frail. Carers may include the consumer’s family as well as other people significant to the consumer. An individual is not a carer merely because he or she is the spouse, de facto partner, parent, child or other relative of an individual. The term carer does not apply if personal care, support and assistance is provided under a contract of service or when the person is completing requirements of a course of education or training.


Co-design is a way of bringing consumers, carers, families and multidisciplinary teams together to improve services. It creates an equal and reciprocal relationship between all stakeholders, enabling them to design and deliver services in partnership with each other. Planning, designing and producing services with people that have experience of the problem or service means the final solution is more likely to meet their needs.

Collaborative care planning

Collaborative care planning prioritises the preferences and values of the person with lived experience, their carers, families and kinship groups. The collaborative care plan draws together goals, needs and actions of the person with lived experience; which may be supplemented by more structured plans giving guidance from policies on treatment and interventions e.g. personalised care and support plan, medication such as Clozapine, specific physical health needs, Mental Health Act, Borderline Personality Disorder and electroconvulsive therapy.


Conflict collectively names all those consumer behaviours that threaten their safety or the safety of others (violence, suicide, self‐harm, absconding etc.).


Containment collectively names all the things that staff do to prevent conflict events from occurring or to minimize harmful outcomes by using measures to exert control (e.g. coerced medications, special observation, seclusion and restraint etc.).


Implementing, delivering and evaluating supports, systems and services, where consumers, carers and multidisciplinary teams work in an equal and reciprocal relationship, with shared power and responsibilities, to achieve positive change and improved outcomes.

Dignity of risk

The right to take risks in the activities of daily living, therefore striking a balance between care and autonomy.

Hot Debrief

A hot debrief is a lessons learned review carried out immediately after the event to ensure all feedback, outcomes and actions required are obtained before anyone leaves. Minor details aren't lost because of time delay, or a later emphasis on the bigger issues.

Mental health advance directives

Advance directives or similar approaches help to reduce loss of autonomy and increase a person’s sense of control when they have temporarily lost capacity to make reasoned and informed decisions. Advance directives are empowering as they enable a person to indicate their views, wishes and preferences while they are well. Advance directives guide mental health clinicians in keeping a person’s values and wishes foremost during a crisis.

Peer worker

Paid roles for people with lived experience who support recovery and collaboration with the person with lived experience, their families, kinship group and carers.

Person-centred care

Person-centred care takes into account individual differences, diversity and personal preferences. It emphasises the relationship between people receiving care, carers and staff, and suggests a more active, collaborative role of people with lived experience.


There is no single definition of recovery; its meaning and pathway is highly personalised and unique to the individual. Recovery encompasses hope for the future as well as acknowledgement of a person’s abilities and difficulties. It is an ongoing process with self at its core, and includes engaging in an active and purposeful life, personal autonomy and a positive sense of self. Recovery is further informed by a person’s strengths, preferences, needs, aspirations, experiences and culture.


Restraint is defined as restriction of an individual’s freedom of movement by physical or mechanical means. It can be mechanical (the application of devices on a person’s body to restrict his or her movement) or physical (the application by health care staff of hands-on immobilisation to prevent the person from harming themselves or endangering others or to ensure the provision of essential medical treatment).

Restrictive practices

Restrictive practices is a term used to refer to interventions (involuntary treatment, seclusion and restraint) that may be used in mental health facilities to manage a person’s behaviour, restricting the rights or freedom of movement of a person.


Seclusion is the confinement of the consumer at any time of the day or night alone in a room or area from which free exit is prevented.

Shared decision-making

Shared decision-making involves collaboration between a person with lived experience and service providers, assuming that all people have capacity to make their own decisions. Decisions are made based on preferences and expertise of the individual, together with provider knowledge about effective interventions and risks. This is in contrast with other models where power is held by others, and decisions are driven by what others determine to be the persons ‘best interests’ which may or may not be in line with the person’s will.

Trauma-informed care

Trauma-informed care is a strengths-based approach which understands and responds to the impact of trauma. Prevalence and impacts of trauma are realised, how trauma has affected the person is recongised and a response that does not re-traumatise is orchestrated from staff to ensure appropriate person-centred management is achieved.

Trauma-informed recovery oriented practice

The purpose of trauma-informed recovery oriented practice is to support the person with a lived experience to achieve their aims for meaningful life, with a positive personal identity. Trauma-informed recovery oriented approaches recognise the expertise of the person with a lived experience, and support this expertise with the knowledge, strategies and skills of service providers.