The new Qld Mental Health bill has been passed in Parliament. There have been many different draft mental health acts/white-papers for a new Queensland Mental Health Act since mid-2013.
Due to community input, some significant advances were made in improving human rights of patients, increased oversight and review, along with shorter times to come before the Tribunal. These improvements lower the potential for patient abuse and trauma.
However major parts of the law have remained in place in violation of the United Nations Committee on Torture. Parental rights also continue to be undermined in mental health laws around Australia.
The time for this new law to go into effect is not yet laid down. There are some significant changes which will require re-training of staff for better patient care and also an entirely new system put in place in order to send someone for psychiatric assessment. Thank you to everyone who worked very hard to help bring about these improvements.
We will be continuing to push through further needed changes for patient rights. What follows is a summary of the key improvements in the law.
- A psychosurgery ban is now in place for all ages for the forms of psychosurgery involving cutting and burning the brain. This means we now have a complete ban for all forms of psychosurgery in NSW and the NT, a complete ban for under 16’s in South and Western Australia and in Queensland a partial ban for all ages.
- The fine for giving psychosurgery outside the act has increased from $11,000 to $22,000.
- In mid 2014 it was proposed to not include deep brain stimulation (DBS) in the new Mental Health Act (where a hole is drilled into the head to implant electrodes through which an electrical current surges from a pacemaker like device inserted under the skin in the chest). This meant that a child or adult if considered to have the capacity to consent, could have simply consented to DBS at the psychiatrist’s office without the need for any parental consent or Tribunal approval. It would have been considered “normal medical treatment.” Due to public outrage this proposal to have DBS taken out of the law was dropped. DBS is in the new Mental Health Act. More work is needed in this area to ban DBS.
- All children being given electroshock must now have a Tribunal final approval before it is given, increasing the oversight. Previously it could be given to voluntarily admitted children who consented, if a psychiatrist determined they needed it. It is still completely unacceptable that children are allowed to be given ECT at any age. The World Health Organization has stated, “There are no indications for the use of ECT on minors, and hence this should be prohibited through legislation”.
- Both children and adults will be provided with a lawyer for any electroshock tribunal hearings. The lawyer is to be paid for by the state.
- Fines for the mistreatment of patients and giving treatment outside the law have increased. This was due to outrage that the maximum penalty for causing pain to, abusing, worrying or for terrifying an animal under the Queensland Animal Care and Protection Act is $235,600. Yet a fine of only $11,000 were being imposed if this was done to a human being in the mental health system.
** The fine for giving electroshock outside the law has increased from $11,000 to $22,000.
** The fine for ill treatment of a patient has been increased from $17,550 to $23,400.
** The fines for giving restraint outside of the law have increased from $6,000 to $23,400. There is a new clause and fine ($23,400) for the drugging of an involuntary patient when it is not clinically necessary or is not needed to save a life (chemical restraint).
** The fine for putting a patient in seclusion outside the law has gone up from $6,000 to $23,400.
- Only the chief psychiatrist will be able to approve mechanical restraint to be used on a patient. Restraint has no therapeutic value and in fact causes significant trauma and stress on a patient. This means that a psychiatrist can no longer just order it. Also anyone restrained is to be monitored with 24 hour attendance to reduce deaths. If an application is put in to the Chief Psychiatrist for the use of mechanical restraint it must also have a “reduction and elimination plan” that the medical staff will use for the person to reduce and eliminate the use of mechanical restraint.
- Living Wills have also been written into the new law. This is where a patient writes down their wishes for their future treatment should they become ill, such as declining the use of ECT, or certain drugs to which they have/there are adverse reactions. Such living wills can be overridden by other clauses, but this is a start towards making a living will not only available by law but also enforceable. There is much more work to be done on this.
- How someone is involuntarily detained for psychiatric assessment in Queensland has been the worst in Australia. Currently anyone can put in writing that they suspect someone they know to be mentally ill. This can be given to a Justice of the Peace (JP) with special qualifications to fill in forms for someone to be seen/picked up to be assessed for involuntary detainment. And all this without the JP ever having seen the person in question.
This has meant many people have been taken to psychiatric hospitals as a result of disputes. In 2011, 7,000 people were sent to psychiatric hospitals because of Justice of the Peace orders with 4,500 of those being detained. Some are let go once they are seen in the psychiatric hospital but if the person has been driven hundreds of miles from their home to be assessed, they are then left to find their own way home.
The new law has removed this abusive system. A doctor first has to examine a person in order for them to be referred for assessment for involuntarily detention. Justices of the Peace will have no power under the new Act to order involuntary assessments. A family member will have to tell a doctor first, who must then see the person before they are sent to a psychiatric hospital.
- Involuntary commitment reviews will be done within 28 days not 42 days as has been the case.
- It was proposed during the review that automatic involuntary commitment hearings be done every 12 months instead of 6 months. This was prevented and it has remained at 6 months.