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.

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