A day in the life of a Guardian
I’m starting the day at a Mental Health Review Tribunal (MHRT) hearing for one of my clients, Eric.* This is a very complex issue that has involved working with our legal services team, community visitors, and a lawyer from an external non-government advocacy organisation. Eric is subject to long periods of seclusion, and significant amounts of electro-convulsive therapy (ECT).
Eric has repeatedly and consistently stated that he doesn’t want ECT, and over the past two years we have been advocating for Eric and questioning both his diagnosis and the treatment he is receiving. What is particularly concerning is that there seems to be a lack of investigation by his treating team into alternative conditions that might be impacting on Eric’s health and wellbeing. The hearing is a success and as a result of our joint advocacy, the MHRT didn’t consent for ECT to continue. This isn’t the end of the road for Eric, but we can now work with the relevant medical professionals to ensure alternate diagnosis are explored for Eric, and his rights and interests are protected.
Back at the office, it’s time to check my email. I see one from a Community Visitor who has just visited a residential disability site where one of my clients, Jane* is residing. She tells me she sighted a document that Jane has signed stating, among other things, that Jane would take responsibility for costs over and above the hours of service provision she uses above her NDIS funding, and she would give reasonable notice if she wished to cease the agreement. The Community Visitor was pretty sure that Jane wasn’t legally able to sign the document as the Public Guardian is appointed as decision maker for service provision. I put in a call to the service provider asking them to immediately address the situation, and to make sure they were aware that decisions like this should come to me as Jane’s formally-appointed Guardian.
Time to attend a National Disability Insurance Scheme (NDIS) planning meeting on behalf of my client Monica.* Monica has a mild intellectual disability and poor literacy skills, and has been on the waitlist for disability support services since 2014. I have been supporting her through the NDIS planning process for some time. This afternoon’s meeting is with the NDIS Local Area Coordinator and the outcomes are very positive. Monica now has a Support Co-ordinator and will receive eight hours a week in house support, plus funding for needed therapies, which will allow her to live more independently as part of the community. When I go back to the office I will need to complete a decision for the Support Co-ordination service that the client and I selected and send them a letter of consent.
I grab a sandwich, and while checking my emails I discover that one of my clients, Graeme,* has been involved in a critical incident where he has damaged property and has been evicted from his accommodation. Graeme receives treatment from an authorised mental health service and is subject to a Forensic Order. As a result I need to urgently organise a mental health review, so I get right on to contacting his Mental Health Case Manager for review of Graeme’s treatment and assistance to locate new accommodation.
I’ve just finished resolving that issue, when I get a phone call from Disability Services, but this time it’s good news. It’s regarding my client John,* whom the Public Guardian was appointed for very recently. John was living with his mother and his partner, and information from his service provider suggested he was at serious risk of neglect. They had organised a respite care placement for him, which was to be actioned immediately should the Public Guardian be appointed. However we discovered that John’s mother had taken him to New South Wales where she was looking to relocate. I managed to get the respite place held for John, and persuade his mother to return to their Queensland home so I could visit.
Because of the risk of continuing neglect if John’s mother returns to New South Wales with him, I knew it was important to get the accommodation decision made quickly. I organised with the service provider at short notice to meet me at John’s home to support him into respite care. When I arrived at John’s home, I discovered four adults living in a one bedroom property, and that John was sleeping in a small tent outside. We were able to get him into his respite placement that night. The call I just received was letting me know that John has just been offered a permanent place in accommodation with shared support with two other gentlemen.
For the rest of the afternoon I’m rostered to be on the OPG health care phone line, which means I’ll be required to consider requests for consents for health care treatments both for our clients, and for non-clients with impaired decisions making capacity where there is no one else to make decisions and we are the statutory health attorney of last resort.
I could be asked to provide consent for procedures to diagnose a health condition of a patient, perform an operation to repair a fracture or for someone’s end of life care (although this last one would be referred to a member of the Executive team).
I finish the day by entering all of my client records and pulling together a rough schedule for tomorrow – it looks like it’s going to be another busy one!
*All names have been changed to protect identities.