Citizens Commission on Human Rights

The Mental Health Watchdog

Australian National Office

Restraint, Seclusion and Forced Electroshock of Children are Legal in Queensland

Queensland had the highest number of Medicare funded electroshocks in Australia in 2020/21. Electroshock and other psychiatric human rights abuses must be banned.

The Qld Mental Health Act allows psychiatry to commit the above torturous practices on vulnerable children.
No parental consent is needed.

Queensland’s Mental Health Act was reviewed in early 2022. This review completely ignored the World Health Organisation’s June 2021 Guidance to eliminate coercive practices such as restraint, seclusion, forced electroshock and involuntary admission and treatment. This law urgently needs amendments to ban all coercive practices which are rife in Qld.

HIGHLIGHTING A MAJOR FLAW IN THE CURRENT QLD MENTAL HEALTH LAW IS THIS COMPARISON: Under the Qld Animal Care and Protection Act 2001, if someone is cruel to an animal including injuring, wounding or terrifying the animal, it carries a maximum penalty of $275,700 or 3 years imprisonment. Yet in stark contrast, if a psychiatrist or mental health worker ill-treats a psychiatric patient it carries a maximum penalty of only $27,570 or imprisonment for 2 years under the current Mental Health Act—significantly less than the penalty for being cruel to an animal. The fact that Qld mental health patients are thought of as not worthy of the same protection under law as an animal has opened the door for mistreatment against those in the mental health system.1 Recommendation: Criminal fines and prison terms must be dramatically increased with further amendments to the Qld Mental Health Act to protect vulnerable children and adults.

IN JUNE 2021, THE WORLD HEALTH ORGANISATION (WHO) RELEASED GUIDELINES THAT LASHED OUT AGAINST COERCIVE PSYCHIATRIC PRACTICES SUCH AS RESTRAINT, SECLUSION, FORCED ELECTROSHOCK AND FORCED DETAINMENT AND TREATMENT that it says are “are pervasive and are increasingly used in services in countries around the world, despite the lack of evidence that they offer any benefits, and the significant evidence that they lead to physical and psychological harm and even death.” It points to the United Nations Convention on the Rights of Persons with Disabilities (CPRD) which in essence, call for a ban on “forced hospitalization and treatment.”

The WHO report highlights the fact that coercive practices such as restraint, seclusion, involuntary commitment and treatment occur because “they are mandated in the national [or state] laws of countries.

Despite the challenges to changing laws and treatment paradigms, WHO says

it is important for countries…to eliminate practices that restrict the right to legal capacity, such as involuntary admission and treatment.2

Recommendation: The WHO’s guidance is followed and the Qld Mental Health Act is amended immediately so that restraint, seclusion and involuntary admission and treatment are banned with heavy criminal penalties for violations of these bans.

Download a short fact sheet

PSYCHIATRIC DRUGS: There have been over 80 psychiatric drug warnings issued by the Australian Government to warn of such risks as, aggression, increased blood pressure, hallucinations, suicide, heart problems, withdrawal symptoms and possible death.3

  • Seven of these drug warnings are to warn of suicidal behaviour linked to antidepressants, including one for the “ADHD” drug Strattera which is an antidepressant.4
  • Australia wide, by December 2019, there were 49,248 adverse drug reaction reports linked to antipsychotics and antidepressants, 1,907 of these were deaths.5
  • Despite this, there were over 9 million psychiatric drug prescriptions written in Queensland in 2019/20. This equates to a staggering 976,389 Qld children and adults on a psychiatric drug.6
  • Over 35,500 of these are children, aged 0-17 on “ADHD” drugs. 81.5% of the “ADHD” drugs given to these 0-17 year olds are classed in the same category as cocaine, morphine and opium in Australia.7 Parents are not always told the above information at time of prescribing, violating their rights.

Recommendations: Qld Parliament recommends that the Federal Government implement immediately the recommendation before them since 2020, that all mental health prescriptions include a clear and prominent warning statement saying that their doctor should have discussed possible side effects and proposed evidence based alternatives to psychiatric drugs prior to prescribing.8 ♦ Psychiatric drugs are investigated as a reason for the failing Qld mental health system. ♦ For every child and adult suicide, autopsies need to include tests for the presence of psychiatric drugs at time of suicide (by methods other than drug poisoning). This will give a true picture of the harm these drugs cause. ♦ The law is amended to ensure that every death involving negligence or misconduct involving psychotropic prescription practices that leads to death in the mental health system is investigated for criminal culpability.

ELECTROSHOCK (ECT): is the application of hundreds of volts of electricity to the head to create a seizure (convulsion). It can cause brain damage, permanent memory loss, heart problems and stroke.9 It is legal for use on children, pregnant women and the elderly in Qld.

  • So torturous is ECT that one Australian woman forced to undergo electroshock against her will, close to 100 times, said she has had security guards wheel her to the “treatment” room holding her down so she didn’t escape. “I felt like I was being wheeled down to the gas chamber really,” she said. She would even eat from stashed food to avoid the general anaesthetic and when staff found her food, she resorted to eating grass to avoid the electroshock.10
  • The World Health Organisation states, “There are no indications for the use of ECT on minors, and hence this should be prohibited through legislation.”11
  • Qld’s current electroshock consent form lists, short term memory loss, irregular heart rate and rhythm, bone fractures, heart attack, stroke and death as side effects of electroshock.12
  • Any claim that electroshock does not cause brain damage, ignores basic electrical science. When electricity is sent through the brain, it generates heat, increasing the temperature. Cells can suffer dysfunction, temporary injury, permanent damage or even cell death according to Dr. Ken Castleman, Ph.D., a biomedical engineer who has provided legal testimony in ECT device litigation.13

Involuntary electroshock is one of the forced treatments the World Health Organisation has said needs to be eliminated. This is so rife in Qld that not only can children and adults be forced to have electroshock if they are involuntarily detained, but they can also be given “emergency electroshock” which means not even a Tribunal Hearing is held before the electroshock is given. In 2020/21 there were 126 applications to the Qld Mental Health Tribunal to give “emergency electroshock.” There were also 444 applications to perform forced electroshock on involuntary patients to the Mental Health Tribunal.14

In 2018 there were 178 Medicare funded electroshocks given to 15-19 year olds in Qld, the highest of any Australian State or territory for this age group.15 There were 10,995 Medicare funded electroshocks given to Queenslanders in 2020/21, again the highest in Australia and an increase of 29% in just 4 years.16 Recommendation: Electroshock must be banned for all ages with severe criminal fines and prison terms for violation of the ban.

RESTRAINT & SECLUSION: Psychiatric restraint can and does cause death. It is well-known within psychiatric circles to have zero therapeutic benefits and instead can greatly increase trauma.17

  • Dr Minh Le Cong who works for the Royal Flying Doctor Service in Queensland, detailed specifics of 4 of the many restraint deaths that have occurred in Australia. Two of the deaths were linked to the excessive use of the benzodiazepine, midazolam as a chemical restraint. The third person who died was given the antipsychotic olanzapine and then midazolam and the fourth person was physically restrained and given midazolam.18
  • Aboriginal and Torres Strait Islander peoples are subjected to higher rates of seclusion and potentially deadly restraint in hospital.19
  • There were 4,834 physical restraint events (bodily force) and a further 212 mechanical restraint (e.g., being cuffed to a bed) instances in Qld in 2020/21. The use of psychiatric drugs to subdue (chemical restraint) is not reported despite this being legal in the Qld Mental Health Act.20

In addition there were 17,359 seclusions in 2020/21.21

There are valid ways to calm and work with traumatised people that preclude the need for harsh and inhumane treatment. Often when patients are treated abruptly, harshly and their opinions ignored, they become more fearful and aggressive.

A 2017 NSW review of restraint and seclusion in mental health facilities report states,

It is not unusual for staff to raise concerns that staff and consumer safety will be compromised if seclusion and/or restraint are reduced, but this concern is not supported by the weight of evidence.22


Recommendation:The Mental Health Act is further amended so both psychiatric restraint and seclusion are banned, with heavy criminal penalties for violation of the ban.

INVOLUNTARY TREATMENT: A child or adult in Qld can be locked up in a psychiatric facility and forcibly treated including with psychiatric drugs, electroshock, restraint and seclusion. They can also be forced to have treatment in the community while at home. The Mental Health Tribunal must review the involuntary treatment authority within 28 days. Further reviews if the person remains on a treatment authority occur within 6 month intervals for a year and then within every 12 months. While the patient can also appeal their detainment, while they wait for their review they are treated against their will and there is no guarantee the patient will be allowed to go home after the review hearing.23

  • In 2020/21, there were 11,765 involuntary treatment authorities (inpatient and in the community) reviewed by the Mental Health Tribunal, only 119 of these were revoked.24
  • In 2020/21 there were around 23,800 involuntary admissions to a psychiatric facility/ward.25

The United Nations Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment reported to the United Nations on abuse in health care settings, he called upon all States to,

…Impose an absolute ban on all forced and non-consensual medical interventions against persons with disabilities, including the non-consensual administration of psychosurgery, electroshock and mind-altering drugs such as neuroleptics [antipsychotics] for both long-and short-term application.26

In South Australia, anyone who has a mental health tribunal hearing regarding a request to end involuntary detainment or forced treatment in the community or to appeal to the Supreme Court, has the right to choose their own lawyer and it is paid for by the State government.27 Qld patients do not have this same right. A lawyer is appointed by the Qld Mental Health Tribunal for minors and electroshock hearings, they/parents cannot choose their own lawyer unless they are willing to pay for them. Adults have to organise and pay for their own lawyer for all other hearings if they are unable to find free legal help.

Psychiatry has the power to prevent a parent from visiting their child and speaking to them on the phone if they are involuntarily detained in a psychiatric facility and it is decided it is in the child best interests. This also applies to adults.28 Recommendation: Involuntary detainment and treatment are eliminated in the law per the World Health Organization’s guidance, with heavy criminal penalties for each instance of these occurring.29

PSYCHOSURGERY: It is commendable that the forms of psychosurgery that involve cutting and burning the brain have been banned for all ages since March 2017 in Qld. However NSW and the NT correctly ban all forms of psychosurgery for all ages. In Queensland deep brain stimulation (DBS) for “mental illness” a form of psychosurgery, has been re-named a “neurosurgical procedure” in an attempt by psychiatry to hide the true nature of this barbarity.30

DBS involves drilling a hole in the head to implant electrodes through which an electrical current surges from a pacemaker device inserted under the skin in the chest. It can cause memory loss, irreversible brain damage, bleeding in the brain, coma and post-operative death.31 DBS is legal for all ages in Qld including children. There were 4 deep brain stimulations approved by the Qld Mental Health Tribunal in the last 3 years.32 Recommendation: Deep brain stimulation is banned for all ages with very severe criminal fines and prison terms for violation of the ban.

SEXUAL CONTACT: Psychiatric facilities should be safe havens where there is no risk of harm. There are no provisions in the Qld Mental Health Act to protect children from being placed in adult wards or to protect women from being placed in male wards, placing both women and children at risk when placed in a psychiatric ward. Instead the act states, that minors “receive treatment and care separately from adults if practicable.33

To even consider exposing children to such an environment shows pitiful respect for them and leaves them open to physical and sexual abuse in an environment where there is insufficient supervision.

In 2020 The Medical Journal of Australia published an analysis that looked at sexual misconduct notifications/complaints to regulatory authorities for all 15 registered health professions in Australia between 2011-2016. It found that psychiatrists had the highest rate of notifications/complaints alleging a sexual relationship, sexual harassment or sexual assault.34

The Qld Mental Health Act does not mandate that alleged sexual assault of a child or adult by staff must be reported. Western Australia makes a start towards ensuring alleged sexual assault/sexual assault is reported with a $6,000 fine for not reporting. This lack of safeguard needs to be rectified in Qld.35

Australia’s Productivity Commission recommended that, “State and territory governments should provide child and adolescent mental health beds that are separate to adult mental health wards.”36 Recommendations: Children should never be placed in wards with adults and criminal fines and prison terms should be implemented for violations of this. ⬥ The Qld Mental Health Act must mandate that men and women have separate wards. ⬥ Criminal penalties must be added to the Qld Mental Health Act for failure to report alleged sexual assault/sexual assault of a patient by staff.

DEATHS & COMPLAINTS: Psychiatrist and former Director of Mental Health, Alcohol and Other Drugs for Qld, Dr Kingswell testified to Parliament, “there are a number of appalling outcomes for people who have mistakenly been thought to have a mental health issue when it was clearly a physical problem. Very recently there was a death from a ruptured spleen, when somebody had made the mistaken diagnosis of delusional shoulder pain.”37

Data from a Right to Information request to Queensland Health for all Critical Incidents including deaths, reported to the chief psychiatrist for the 2018 calendar year revealed:

  • 161 deaths and a further 31 reported attempted suicides.
  • Of the 161 deaths, there were 148 completed suicides, 2 deaths by restraint and 11 other deaths noted.38

Mental health complaints are made to the Qld Health Ombudsman who report the numbers in their annual report. Below are the number of complaints:

2014-15 2019/20 % Increase
Mental health service organisations 6139 49640 713.1%
Psychologists 7041 24342 247.1
Psychiatrists The number of complaints made against Qld psychiatrists is not reported.

Recommendations: The law is amended to ensure that every death in the mental health system is investigated for criminal culpability. ⬥ The Health Ombudsman reports in their annual report the number of complaints made against psychiatrists.

MENTAL HEALTH STAFF PROTECTED FROM LIABILITY IF THEY CAUSE HARM: The current Qld Mental Health Act prevents anyone who has been harmed by a psychiatrist or mental health worker from civilly suing them, so protecting the perpetrator from civil liability. Instead liability is attached only to the State Government. The 2022 amendments to the Mental Health Act made this situation worse, adding in the chief psychiatrist as also being protected from civil liability. The chief psychiatrist approves such actions as, which restraint devices can be used in facilities and authorises each instance of mechanical restraint performed.43 Recommendation: The Qld Mental Health Act is amended to ensure no one is protected from civil liability for their acts that cause harm or death.

LACK OF ACCOUNTABILITY: Spending on mental health has increased 33.05% in 5 years and reached over $1.26 billion in 2019/20. Spending increased around 11% to an estimated $1.49 billion in 2020-21.44

Despite the huge increase in spending, the latest statistics reveal that results in Qld were appalling in 2018/19:

  • 42.6% of children aged 0-17, discharged from a psychiatric ward/facility had not significantly improved.
  • 62.9% of children aged 0-17 in ongoing outpatient community based care did not significantly improve.
  • 50.5 % of patients did not have a positive experience from their admitted care to mental health services.45

The Productivity Commission who are the federal government’s main review and advisory body on economic policy has stated, “there is very little information to allow us to determine whether investments in mental health and wellbeing are delivering improvements and what policy initiatives have been effective.” It further pointed out that despite spending billions of dollars, countless hours of work by teachers, education professionals, doctors, nurses, specialists on early intervention and preventative measures – improvements in the mental health of children and young people have been limited.46

If psychiatric treatments were working, this would be evidenced in the reduction of children and adults seeking care.

No other industry would be allowed such a poor performance for money invested. In contrast, money given to other areas of medicine show noticeable progress, such as improving survival rates from cardiovascular disease.47 Recommendation: Funding is only given to services that are held fully accountable, report their results once a year and are actually producing results as would be evidenced by the decline in numbers of children and adults requiring care.

ALTERNATIVES: Advance health directives are a key part of fully informed consent, yet they are not legally binding in the Qld Mental Health Act. They can currently be overridden by psychiatry as this act specifically covers when an advance health directive does not have to be followed- when the psychiatrist decides to ignore it. They must be made legally binding for psychiatric treatment.48

There is no doubt that some children who are troubled require special care. But they should be given holistic, humane care that improves their condition. Institutions should be safe havens where children and adults voluntarily seek help for themselves or their child without fear of indefinite incarceration or harmful and terrifying treatment. They need a quiet and safe environment, good nutrition, rest, exercise and help with life’s problems. Extensive medical evidence proves that underlying and undiagnosed physical illnesses can manifest as “psychiatric symptoms” and therefore should be addressed with the correct medical treatment, not psychiatric techniques. Studies show that once the physical condition is addressed, the mental symptoms can disappear. With proper medical treatment and real help people can lead healthier, happier lives. Recommendation: Existing money spent needs to be re-directed into proven workable solutions that provide real help. ⬥ Advance Health Directives must be made legally binding for psychiatric treatment in the Qld Mental Health Act.

It is the role of Parliament to protect citizens from harmful psychiatric practices. If NSW Parliament had not banned deep sleep treatment (where patients were put into a drug induced coma and battered with electroshock, 48 people died), it would still be legal. It took a Royal Commission to expose the human rights abuses. For years the psychiatric profession had turned a blind eye and failed to effectively act against its members. Psychiatry must have external scrutiny and review.

TAKE ACTION

Email, write, phone or visit the Qld Premier, the below Ministers and your local Member of Parliament

Please express your concerns and request the below actions are taken:

  1. The Qld Mental Health Act is amended to ban electroshock, restraint, seclusion, deep brain stimulation and dramatically increase criminal fines and prison terms for ill-treatment of a patient.
  2. Involuntary detainment and treatment are eliminated from the Qld Mental Health Act per the World Health Organisation’s guidance.
  3. Every death in in the mental health system is investigated for criminal culpability and negligence and any misconduct involving prescription practices is also reported to police for criminal investigation.
  4. Existing money is re-directed to proven workable solutions that do not harm and money is only given to organisations that are held fully accountable and are actually producing results.

The Premier: The Hon Annastacia Palaszczuk MP, PO Box 15185, City East QLD 4002 ⬥ Email: premier@ministerial.qld.au ⬥ Phone: (07) 3719 7000

The Leader of the Opposition: Mr David Crisafulli MP, PO Box 15057 City East QLD 4002 ⬥ Email: reception@opposition.qld.gov.au ⬥ Phone: (07) 3838 6767

The Minister for Health: The Hon Shannon Fentiman, PO Box 48 Brisbane QLD 4001 ⬥ Email: health@ministerial.qld.gov.au ⬥ Phone: (07) 3035 6100

The Shadow Minister for Health: Ms Rosslyn (Ros) Bates MP, PO Box 897 Mudgeeraba QLD 4213 ⬥ Email: mudgeeraba@parliament.qld.gov.au ⬥ Phone: (07) 5601 7100

PLEASE ALSO CONTACT YOUR LOCAL MEMBER OF PARLIAMENT HERE

Tell others so they too can take action as well as share CCHR’s Facebook Posts and Tweets with others.


Warning: No one should stop taking any psychiatric drug without the advice and assistance of a competent medical doctor.


References

  1. Queensland Animal Care and Protection Act 2001, s18 (1), current as at 27 September 2021. https://www.legislation.qld.gov.au/view/pdf/2016-07-01/act-2001-064; Queensland Mental Health Act 2016, s621. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005; A penalty point is $137.85 (current from 1 July 2021). https://www.qld.gov.au/law/fines-and-penalties/types-of-fines/sentencing-fines-and-penalties-for-offences
  2. Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches, World Health Organization, 10 June 2021, pages 4,6,7,8. https://www.who.int/publications/i/item/9789240025707 (to download report).
  3. Fully referenced layman’s summary of all psychiatric drug warnings issued by the Therapeutic Goods Administration, https://cchr.org.au/ptanegul/2023/10/Australian-Psychiatric-Drug-Warnings-Fact-Sheet-.pdf
  4. Department of Health and Ageing Therapeutic Goods Administration, Medicines Safety Update, “Medicines associated with a risk of neuropsychiatric adverse events,” Vol. 9, Number 2, June 2008; Department of Health and Ageing Therapeutic Goods Administration, Medicines Safety Update, “Antidepressants – Communicating risks and benefits to patients,” Vol. 7, Number 5, October-December 2016; Department of Health and Ageing Therapeutic Goods Administration, Medicines Safety Update, “Atomoxetine and suicidality in children and adolescents,” Vol. 4, Number 5, October 2013; “Australian ADHD drug warnings are already in place: TGA,” AAP Newswire 22 February, 2007; “Suicidality with SSRIs: adults and children,” The Australian Therapeutic Goods Administration, Adverse Drug Reactions Bulletin, Vol. 24, No. 4, August 2005; “Use of SSRI antidepressants in children and adolescents” The Australian Therapeutic Goods Administration, Adverse Drug Reactions Bulletin, Vol. 23, No. 6, August 2004; “Warnings for high dose tricyclic antidepressants,” The Australian Therapeutic Goods Administration, Adverse Drug Reactions Bulletin, Vol. 23, No. 5, October 2004.
  5. Therapeutic Goods Administration Database of Adverse Event Notifications-Medicines, List of reports generated for each antidepressant, as of 05/03/2020 and added manually. https://www.tga.gov.au/database-adverse-event-notifications-daen; Therapeutic Goods Administration Database of Adverse Event Notifications-Medicines, List of reports generated for each antipsychotic, as of 05/03/2020 and added manually. https://www.tga.gov.au/database-adverse-event-notifications-daen
  6. “Table PBS.11: Number of mental health-related prescriptions dispensed, by type of medication prescribed and prescribing medical practitioner, states and territories, 2019-20”; “Table PBS.2, Number of patients dispensed one or more mental health-related medications prescribed and prescribing medical practitioner, states and territories, 2019/20,” Mental Health Services in Australia, Australian Institute of Health and Welfare, Australian Government, Last updated 8 Dec 2021. https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/mental-health-related-prescriptions
  7. “Services Australia statistics request number, RMS1050 PBS Report, ADHD Report 3a & 3b, Run date: 1/3/2021.” https://cchr.org.au/ptanegul/2022/01/2019-ADHD-drugs-PBS_ADH_RMS1050.pdf
  8. Productivity Commission Mental Health Inquiry Final Report, Actions and Findings, No. 95, 30 June 2020, p.21. https://www.pc.gov.au/inquiries/completed/mental-health/report
  9. Electroconvulsive Therapy (ECT) Devices for Class II Draft Guidance for Industry, Clinicians and Food and Drug Administration Staff, US Food and Drug Administration, 29 December 2015, pages 13,14. https://www.fdanews.com/ext/resources/files/2016/01/01-16-FDA-ECT.pdf?1451949526; Electroconvulsive Therapy (ECT) Services: Monitoring and Auditing – MHDA, Guideline, NSW Government Health, Northern Sydney Local Health District, GE2013_022, 22 June 2016, s4(2.3).
  10. Sarah Farnsworth, “Hundreds of patients forced to have ECT in Victoria without legal representation,” ABC News, 21 November 2016. https://www.abc.net.au/news/2016-11-20/patientsforced-to-have-ect-without-legal-representation/8030996
  11. WHO Resource Book on Mental Health, Human Rights and Legislation, World Health Organisation, 2005, p.64. https://catalogue.nla.gov.au/Record/3621404
  12. “Electroconvulsive Therapy (ECT) Consent,” Queensland Health, 2017, p.1. https://www.health.qld.gov.au/__data/assets/pdf_file/0022/148342/psychiatry_01.pdf
  13. Ken Castleman, Ph.D., “Testimony presented to the Maryland Senate Finance Committee Hearing on the SB 302: Mental Health – Electroconvulsive Therapy for Minors – Prohibition,” 20 February 2019.
  14. Qld Mental Health Act, s236, s237, s507, s509. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005; QLD Chief Psychiatrist Annual Report 2020-21, p.39. https://www.health.qld.gov.au/__data/assets/pdf_file/0020/1119530/chief-psychiatrist-annual-report-2020-2021.pdf
  15. Freedom of Information Request: “FOI 1150 Document 1, Number of electroconvulsive therapy treatments (Item 14224) by state and territory for calendar years 2016, 2017, 2018, for age groups under 10 years, 10-14 years and 15-19 year olds,” Department of Health, Australian Government, 30 May 2019.
  16. Statistics generated on Medicare Australia website using MBS item code: 14224 for electroconvulsive therapy. http://medicarestatistics.humanservices.gov.au/statistics/mbs_item.jsp; For the MBS Item Code: http://www9.health.gov.au/mbs/search.cfm and enter “electroconvulsive therapy” in the search box.
  17. “Minimising the use of seclusion and restraint in people with mental illness,” RANZCP, Position Statement 61, February 2016. https://www.ranzcp.org/News-policy/Policy-submissions-reports/Document-library/Minimising-the-use-of-seclusion-and-restraint-in-p
  18. Minh Le Cong, “Chemical restraint or lethal injection?” MJA InSight, 6 March 2017. https://www.doctorportal.com.au/mjainsight/2017/8/chemical-restraint-or-lethal-injection/
  19. “Inquiry into the opportunities to improve mental health outcomes for Queenslanders.” Report No. 1, 57th Parliament Mental Health Select Committee, June 2022, p.52. https://documents.parliament.qld.gov.au/tp/2022/5722T743-64F1.pdf
  20. QLD Chief Psychiatrist Annual Report 2020-21, pages 33,37. https://www.health.qld.gov.au/__data/assets/pdf_file/0020/1119530/chief-psychiatrist-annual-report-2020-2021.pdf; Qld Mental Health Act, s 271, s 272. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005
  21. QLD Chief Psychiatrist Annual Report 2020-21, p.31. https://www.health.qld.gov.au/__data/assets/pdf_file/0020/1119530/chief-psychiatrist-annual-report-2020-2021.pdf
  22. Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities, NSW Government, December 2017, p.II. https://www.health.nsw.gov.au/mentalhealth/reviews/seclusionprevention/Pages/about.aspx
  23. Queensland Mental Health Act 2016, s 413. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005
  24. Qld Mental Health Review Tribunal, Annual Report 2020-2021, Queensland Government p.25. https://www.mhrt.qld.gov.au/resources/reports
  25. QLD Chief Psychiatrist Annual Report 2020-21, p.10. https://www.health.qld.gov.au/__data/assets/pdf_file/0020/1119530/chief-psychiatrist-annual-report-2020-2021.pdf
  26. A/HRC/22/53, “Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment,” Juan E. Mendez, United Nations, General Assembly, Human Rights Council, Twenty-second Session, Agenda Item 3, 1 February 2013, s89(b) p.23. https://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf
  27. South Australia Mental Health Act 2009, s79, s84. https://www.legislation.sa.gov.au/LZ/C/A/Mental%20Health%20Act%202009.aspx
  28. Queensland Mental Health Act 2016, s281, s284. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005
  29. Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches, World Health Organization, 10 June 2021, pages 7,8,187. https://www.who.int/publications/i/item/9789240025707 (to download report).
  30. Queensland Mental Health Act 2016, s241, s602. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005
  31. Freedom of Information Request 1213/11807, North Western Mental Health’s “Deep brain stimulation (DBS) for psychiatric illness. Information for patients and referrers,” for OCD DBS trial, Melbourne Health, 8 July 2013; “Deep brain stimulation,” Department of Neurosurgery, VCU Medical Center, Harold F Young Neurosurgical Center, accessed 29 December 2010.
  32. Mental Health Review Tribunal, 2018-19 Annual Report, Queensland Government, p.29; Mental Health Review Tribunal, 2019-20 Annual Report, Queensland Government, p.24; Mental Health Review Tribunal, 2020-21 Annual Report, p.26.
  33. Queensland Mental Health Act 2016,s5,(i). https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005
  34. Marie M Bismark, David Studdert, Katinka Morton, Ron Paterson, Mathew Spittal, Yamna Taouk, “Sexual Misconduct by health professionals in Australia, 2011-16: a retrospective analysis of notifications to health regulators,” Medical Journal of Australia, 10 August 2020, pages 1,5. https://www.mja.com.au/journal/2020/213/5/sexual-misconduct-health-professionals-australia-2011-2016-retrospective
  35. WA Mental Health Act 2014, s254. https://www.legislation.wa.gov.au/legislation/statutes.nsf/law_a147019.html
  36. Productivity Commission Inquiry into Mental Health Final Report, Actions and Findings, 16 Nov. 2020, p.27. https://www.pc.gov.au/inquiries/completed/mental-health/report/mental-health-actions-findings.pdf
  37. “Public Briefing-Mental Health Bill 2015 and Mental Health (Recovery Model) Bill 2015″, transcript of proceedings, Health and Ambulance Services Committee, 14 October 2015, p.10. https://documents.parliament.qld.gov.au/com/HCDSDFVPC-48D8/RN955PMHB2-E8DB/02-trns-14Oct2015.pdf
  38. Right To Information request to Queensland Health, “Right To Information – 5221 – Data relating to Critical Incident notifications for Mental Health Services as required under the Mental Health Act 2016.” https://www.health.qld.gov.au/__data/assets/pdf_file/0027/932472/dohdl1819089.pdf
  39. “Number and type of complaints by health service organisation,” Office of the Health Ombudsman Annual Report 2014-15, p.91. https://dxcgqpir544a8.cloudfront.net/reports/OHO-Annual-Report-2014-15.pdf?mtime=20200430140554&focal=none
  40. “Profile of complaints about health service organisations,” column ‘Number of facilities identified in complaints’, Office of the Health Ombudsman Annual Report 2019-20, p.53. https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2020/5720T423.pdf
  41. “Number and type of complaints by health practitioner,” Office of the Health Ombudsman – Annual Report 2014-15, p.90, https://dxcgqpir544a8.cloudfront.net/reports/OHO-Annual-Report-2014-15.pdf?mtime=20200430140554&focal=none
  42. Profile of complaints about health practitioners, column ‘Number of practitioners identified in complaints’, Office of the Health Ombudsman Annual Report 2019-20, p.52. https://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2020/5720T423.pdf
  43. Queensland Mental Health Act 2016, s797, s243, s246. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005; Queensland Health and Other Legislation Amendment Bill 2021. https://www.legislation.qld.gov.au/view/html/bill.first/bill-2021-037
  44. “Table EXP.1: Recurrent expenditure ($000) on state on territory specialised mental health services, states and territories, 2019-20,” Mental health services in Australia: Expenditure on mental health services, Mental Health Services in Australia, Australian Government, Australian Institute of Health and Welfare, last updated 1 February 2022. https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/expenditure-on-mental-health-related-services; “Table EXP.1: Recurrent expenditure ($000) on state on territory specialised mental health services, states and territories, 2014-15,” Mental health services in Australia: Expenditure on mental health services, Mental Health Services in Australia, Australian Government, Australian Institute of Health and Welfare. https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/archived-reports-and-data ; “Inquiry into the opportunities to improve mental health outcomes for Queenslanders.” Report No. 1, 57th parliament Mental Health Select Committee, June 2022,  p.25. https://documents.parliament.qld.gov.au/tp/2022/5722T743-64F1.pdf
  45. “People who received mental health care provided by State and Territory public mental health services and who significantly improved, by service type and age group,” Table 13A.63; “Specialised public mental health services episodes with completed consumer outcomes measures collected,” Table 13A.62; “Consumer and carer experiences of mental health services,” Table 13A.30, Productivity Commission Report on Government Services 2022, Part E, Section 13, 1 February 2022. https://www.pc.gov.au/research/ongoing/report-on-government-services/2022/health/services-for-mental-health
  46. Mental Health Inquiry Draft Report, Vol. 2, Productivity Commission, October 2019 pgs. 650, 693. https://www.pc.gov.au/inquiries/completed/mental-health/draft
  47. “Cardiovascular disease most deaths and highest costs, but situation improving,” Australian Institute of Health and Welfare, Media Release, 17 March 2011.
    https://www.aihw.gov.au/news-media/media-releases/2011/2011-mar/cardiovascular-disease-most-deaths-and-highest-co
  48. Queensland Mental Health Act 2016, s54. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005