A young man, until recently a law student, is wrestled into the emergency department by two police officers. He is distressed, agitated and acutely paranoid. Convinced he is being tracked by local underworld figures, he believes they have hospital staff in their pay. As the psychiatrist taking on his care, I have to make a decision that has profound implications for him: should I detain and forcibly treat him even though he has done nothing to harm himself or others?
Public hospital psychiatrists have long had the power of preventative detention, a power that bodies such as the Federal Police have only recently and controversially been allowed in respect of anti-terrorism laws. The necessary debate over that legislation stands in contrast to the limited public discussion of recent limitations to the rights of patients detained in NSW mental health units.