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The campaign against NSW mental health laws is heating up

Dr Tad Tietze writes:

Recent limitations to the rights of patients detained under the NSW Mental Health Act are being challenged by a campaign that has brought together an unprecedented coalition of psychiatrists, people living with mental illness and patient advocacy groups.

So far 150 NSW psychiatrists, about one in seven of those practicing in the state, have signed an open letter to the NSW Parliament calling for the restoration of timely external review of doctors’ decisions to detain patients. Seventeen university professors are among the signatories.

As Crikey reported in October, after responsibility for routine Mental Health Inquiries was transferred from magistrates to the Mental Health Review Tribunal, the Tribunal decided to delay Inquiries to between three and four weeks after detention begins. This bureaucratically redefined the words “as soon as practicable” in the Mental Health Act, which had been understood as meaning “within 7-10 days” since 1958.

The delay was the focus of an article in the latest issue of Alternative Law Journal co-authored by Sydney psychiatrist Christopher Ryan. Following from Crikey’s coverage, the story was taken up in the mainstream media and caught the attention of Greens upper house MP John Kaye, who drafted an amendment to the Mental Health Act to clarify the definition of “as soon as practicable”. Encouraged by Kaye, Ryan initiated an open letter supporting the amendment, gaining 75 psychiatrists’ signatures in just a few days, utilising only word of mouth.

But the Greens amendment was not supported by the major parties. Kaye told Crikey, “Neither the Coalition nor the Government supported our amendment. It seems strange that the Shooters and Fishers Party, Family First and the Christian Democrats understood the importance of a visit within a week, while Labor, Nationals and the Liberals didn’t seem to understand.”

Kaye is hoping that the campaign will force the government to direct the Tribunal to abide by the 7-10 day precedent. The campaign has made it to the television news, with the Minister for Mental Health reportedly promising a review of the arrangements in the New Year.

Ryan has been bowled over by the strong response from his colleagues. He told Crikey, “Psychiatrists are not natural rabble rousers. I can’t recall there being a similar petition on an issue ever before. It’s clear very many people in the profession feel strongly about this. Psychiatrists in NSW understand the importance of protecting the rights of their patients, and don’t see this as interfering with offering the best possible care.”

Responding to claims by Tribunal President Greg James that Inquiries were traumatic for patients he said, “We feel, and NSW consumer groups agree, that earlier hearings do not as a rule, harm or distress patients, in fact they are more likely to a positive therapeutic effect.”

There is growing concern that the Tribunal is being driven by bureaucratic convenience and resource shortages—it has even announced a complete shutdown over the Xmas-New Year break. John Kaye sees the decision as an ugly penny-pinching exercise: “Human rights and the ability of patients to get well again are being sacrificed for a measly $500,000 a year — less than 0.04 percent of the state’s mental health budget.”

Ryan is hopeful that the campaign will reverse what he sees as a significant erosion of basic human rights: “The parliament has very sensibly held that an independent review of a patient’s involuntary status should be held ‘as soon as practicable’, which is not the same as ‘when we happen to get around to it’.

“No matter what the circumstances, if society takes away someone’s liberty, we need to be sure their rights are protected.”

*Dr Tad Tietze is a Sydney-based public hospital psychiatrist. In his spare time he co-runs the blog Left Flank.

This article first appeared in today’s Crikey bulletin.

Comments 5

  1. achimova1 says:

    Congratulations to Christopher Ryan for raising this issue – the human rights of people with psychiatric disorders are not well served by the NSW mental health act – or any other in Australia.It is time for a public debate on involuntary treatment and the efficacy or otherwise of our present legal structures.

  2. whitewreath says:

    Suicide Prevention is the sole responsibility of the Mental Health Prevention.

    Suicide results from a chronic progressive neurological condition commonly referred to as a Mental Illness. In both Australia and throughout the world suicide rates have risen because of the change in Mental Health Practice. 30 Years ago a person expressing Suicidal, Homicidal, Violent & Paranoid Ideas and Behaviours would have been admitted, compulsoraraly if necessary to a Mental Health Hospital. The relationship between Suicide, Murder and Violence has been known for at least 3,000 years.

    Caring for in the community “The Recovery Model” simply means that everyone is put at risk. Mental Health disasters happen many times a day in Australia.

    The hard evidence is that at least 81% of these tragic events are preventable by compulsory admission.

    Fanita Clark
    CEO
    White Wreath Assoc Ltd
    Action Against Suicide
    W: http://www.whitewreath.com
    E: white.wreath@bigpond.com
    P: 1300 766 177
    M; 0410 526 562

  3. Tully Rosen says:

    Suicide prevention is _not_ the sole responsibility of the Mental Health Review Tribunal. http://www.mhrt.nsw.gov.au/

    The recovery model specifically addresses the historic lack of rights of the individual, hence the reason a single simple solution (e.g. compulsory admission) just doesn’t cut it.

    For reference, and from the MHRT website:

    The Tribunal actively seeks to pursue the objects of the Mental Health Act. These are:

    to provide for the care, treatment and control of persons who are mentally ill or mentally disordered;
    to facilitate the care, treatment and control of those persons through community care facilities;
    to facilitate the provision of hospital care for those persons on a voluntary basis where appropriate and, in a limited number of situations, on an involuntary basis; and
    while protecting the civil rights of those persons, to give an opportunity for those persons to have access to appropriate care;
    to facilitate the involvement of those persons, and persons caring for them, in decisions involving appropriate care, treatment and control.
    The Mental Health Act itself establishes principles for care and treatment as follows:

    people with a mental illness or mental disorder should receive the best possible care and treatment in the least restrictive environment enabling the care and treatment to be effectively given,
    people with a mental illness or mental disorder should be provided with timely and high quality treatment and care in accordance with professionally accepted standards,
    the provision of care and treatment should be designed to assist people with a mental illness or mental disorder, wherever possible, to live, work and participate in the community,
    the prescription of medicine to a person with a mental illness or mental disorder should meet the health needs of the person and should be given only for therapeutic or diagnostic needs and not as a punishment or for the convenience of others,
    people with a mental illness or mental disorder should be provided with appropriate information about treatment, treatment alternatives and the effects of treatment,
    any restriction on the liberty of patients and other people with a mental illness or mental disorder and any interference with their rights, dignity and self-respect is to be kept to the minimum necessary in the circumstances,
    the age-related, gender-related, religious, cultural, language and other special needs of people with a mental illness or mental disorder should be recognised,
    every effort that is reasonably practicable should be made to involve persons with a mental illness or mental disorder in the development of treatment plans and plans for ongoing care,
    people with a mental illness or mental disorder should be informed of their legal rights and other entitlements under this Act and all reasonable efforts should be made to ensure the information is given in the language, mode of communication or terms that they are most likely to understand,
    the role of carers for people with a mental illness or mental disorder and their rights to be kept informed should be given effect.

    The Tribunal is also cognisant of the requirements of the United Nations Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, as well as the National Mental Health Service Standards.

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Health in All Policies
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Media Doctor Australia
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Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
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#IHMayDay 2014
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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
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#OTCC2017
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#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference