Citizens Commission on Human Rights

The Mental Health Watchdog

Australian National Office

Restraint & Seclusion of Children and Electroshock of Children Over 14 Years are Legal in Western Australia

The WA Mental Health Act is under review. Now is the time to change this.

The WA Mental Health Act allows psychiatry to commit the above torturous practices on vulnerable children and adults. Under the WA Animal Welfare Act, if someone is cruel to an animal it carries a maximum penalty of $50,000 and imprisonment for 5 years. Yet in stark contrast, if a psychiatrist or mental health worker ill-treats a psychiatric patient it carries a penalty of only $24,000 and imprisonment for 2 years under the current WA Mental Health Act—significantly less than the penalty for being cruel to an animal.1

Recommendation: Criminal fines and penalties must be dramatically increased in the WA Mental Health Act to protect vulnerable children and adults.

In June 2021, The World Health Organization (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 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 (CRPD) which in essence, calls for a ban on “forced hospitalization and forced 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.” Coercive psychiatric practices continue to be rife in WA.

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

With the WA Mental Health Act under review, these human rights abuses must be banned now.

Download a short fact sheet

CHILDREN CAN CONSENT TO PSYCHIATRIC TREATMENT WITHOUT PARENTAL CONSENT

Children under 18 are not allowed to drink alcohol or vote nor drive a car if they are under 16 years of age. Yet if psychiatry decides a child has capacity to consent, they can admit themselves to a psychiatric facility, consent to the administration of psychiatric drugs, electroshock if the child is over 14 years of age and psychosurgery if they are over 16 years of age. And all of this without the need for any parental consent at any stage.

Recommendation: No child should ever be treated without parental or guardian consent. [Western Australian Mental Health Act (WA MHA) p.4, s14, s15, s195, s175, s176, s414, s207. s208, s418, s420]

ELECTROSHOCK OF CHILDREN (ECT)

Also called electroconvulsive therapy, 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.3 In other words ECT inflicts harm. Yet the WA Mental Health Act allows this barbarity, despite provision for a $24,000 fine and 2 years imprisonment for ill treatment of a patient. Arguably this happens every time ECT is administered. Children over 14 years old can be given electroshock in WA.

  • Any claim that ECT does not cause brain damage ignores basic electrical science as when electricity is sent through the brain, it is converted into 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.4
  • A 2017 published review of more than 90 ECT studies since 2009, showed they remain “methodologically flawed” and “Given the well-documented high risk of persistent memory dysfunction, the cost-benefit analysis for ECT remains so poor that its use cannot be scientifically, or ethically, justified.” The review also found that there is still no evidence that ECT is more effective than placebo for depression or suicide prevention.5

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.6

16 years ago, the World Health Organisation stated, “There are no indications for the use of ECT on minors, and hence this should be prohibited through legislation.” While it is a good start that WA bans electroshock on children under the age of 14, the law does not go far enough.7

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.8

Despite all of this, children aged between 14 and 18 years can consent to ECT if considered competent to do so by psychiatry. Parental consent is not needed at any stage including when it goes before the Mental Health Tribunal for final approval. If the child is involuntarily detained, ECT can be forced on the child (or adult) with no consent required from the parents or the adult patient at any stage including at the Mental Health Tribunal. With the WHO calling for all countries to eliminate forced treatment, forced ECT must cease.

  • In 2016/17, there were 29 electroshocks shocks given to WA children under 18 years of age and it was also given to children under 18 in 2018/19 (numbers were not reported). There were 5,046 electroshocks funded by Medicare for all ages in 2020/21 in WA, a 151% increase since 2010/11.9

Recommendation: Electroshock is not therapy it is torture. Electroshock must be banned for all ages with severe criminal fines and prison terms for violation of the ban. [WA MHA s195, s14, s15, s196]

RESTRAINT AND SECLUSION OF CHILDREN

Children of any age can be restrained. 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.10

Restraint can be:

  1. Mechanical restraint is the use of belts, harnesses, manacles, sheets or straps;
  2. Physical restraint is being held down or restricted by bodily force of another person; and
  3. Chemical restraint, the use of psychiatric drugs to subdue or control.

An involuntarily detained patient at Graylands hospital in Western Australia repeatedly told staff restraining him to let him go and said, “You are going to kill me,” moments before he slumped to the ground and died. A post-mortem found significant bruising on his neck and that his death was consistent with cardiac arrhythmia during restraint.11

Former WA Chief Mental health Advocate Ms Debora Colvin said it can take up to 5 nurses and security staff to restrain a child and “It must be very traumatising for a child who often already has experienced significant trauma in their short life.12

  • In 2020/21 there were 146 incidents of restraint on children under 18 years of age and a further 989 incidents of restraint on adults.13
  • The use of chemical restraint is not reported or covered at all in the current WA Mental Health Act so there are no legal safeguards to prevent its use.

Former National Mental Health Commissioner, the late Ms Jackie Crowe, stated in 2015,

“There is a lack of evidence internationally to support seclusion and restraint in mental health services. There is strong agreement that it is a human rights issue, that it has no therapeutic value, that it has resulted in emotional and physical harm….”14

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.”15

  • In 2020/21 there were 86 seclusion incidents on children under the age of 18 years and over 890 seclusions occurred for adults.
  • There were calls for an end to the use of seclusion rooms in 2017 after one child was locked up for 12 hours.16

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.

Recommendation: Restraint is criminal, must be banned and made a criminal offence. Seclusion must also be banned. [WA MHA, s227, s212]

INVOLUNTARY COMMITMENT OF CHILDREN

A child or adult can be locked up in a psychiatric facility and forcibly treated, including with drugs, electroshock (if over 14 years old), restraint and seclusion without the consent of their parents or the patient. Initial detainment for a child is 14 days (21 days for an adult). Further detainment orders can then be made for up 28 days for a child (up to 3 months for an adult).

Psychiatry has the power to prevent a parent from visiting their child and speaking to them on the phone if they decide it is in the child’s best interests. Parents can request a review of their child’s detainment to the Mental Health Review Tribunal which will only be held “as soon as practicable” or it must be held within 10 days for a child (or within 35 days for an adult). The Tribunal only have to consider the parents “views.” At no stage is parental consent required.

While waiting for the tribunal hearing, the child will continue to be forcibly treated and there is no guarantee that the child will be allowed to go home after the hearing. In 2020/21, there were 835 initial detainment review hearings for patients of all ages. Only 28 (3.5%) initial involuntary treatment orders were revoked and another 37 were revoked but a community treatment order to receive forced treatment at home was written for the person.17

All of this violates a parent’s right to decide on the health care needs for their child.

In SA, 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 a higher tribunal, has the right to choose their own lawyer and it is paid for by the State government.18 Western Australians do not have this same basic right.

  • In 2019 there were 2,591 people who were involuntarily detained, 76 of these children. Additionally there were 839 community treatment orders made, a 23.6% increase over the previous year.19
  • Indigenous Australians are over 50% more likely to be placed on involuntary orders than the broader population in Western Australia.20

Even if you are a voluntary patient you can still be subjected to forced seclusion and restraint and have your right to see visitors, use a phone, send and receive emails and mail removed.21

Recommendation: The World Health Organisation’s guidance must be implemented and involuntary detainment and treatment must be eliminated with criminal fines and prison terms for any violation of the ban. Only a judge should have the right to detain someone and only with full legal representation for the person facing deprivation of liberty, paid for by the state. [WA MHA s7, s87, s89 (1) & (3), s261, s262, s390, s386, s394]

PSYCHOSURGERY

All forms of psychosurgery are correctly banned in NSW and the NT for all age groups and the forms involving burning or cutting the brain are banned in QLD for all ages. It is only banned in WA for under 16 year olds.22

Psychosurgery can also involve electrodes being inserted into the brain sending an electrical current through it, as in the case of deep brain stimulation (DBS). It can cause memory loss, irreversible brain damage, bleeding in the brain and post-operative death. In 2014 the NSW Ministry of Health commissioned an investigation into the efficacy of DBS which concluded, “There is insufficient evidence at this point in time to support the use of DBS as a clinical treatment for any psychiatric disorder.”23

A child in WA aged between 16 and 18 years can consent to psychosurgery if considered competent by psychiatry to give consent, no parental consent is needed at any stage of the process including at the Mental Health Tribunal who give final approval.

Australian child psychiatrist Dr Jon Jureidini, asked this very pertinent question about consenting to psychosurgery, “How could you be so psychologically impaired (that) you’re considered for psychosurgery, yet be considered to be competent to consent?”24

Recommendation: All forms of psychosurgery, including DBS, must be banned in the WA Mental Health Act for all ages with high criminal fines and prison terms for violation of the law. [WA MHA s205, s207, s208]

SEXUAL CONTACT

Psychiatric facilities should be safe havens where there is no risk of harm. Children are still placed in wards with adults in Western Australia with the proviso that the facility advises the parents in writing why it is safe to do so, the Chief Psychiatrist is notified and it has been decided that the child’s age and maturity is sufficient for them to be housed with adults. This does not protect the child. 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.

  • 363 Children were admitted to either an adult or youth (16 – 24 year olds) mental health ward in 2020/21.25
  • There were 11 alleged incidents of inappropriate sexual behaviour on children under 18 years of age that occurred during their mental health care that were reported to the WA Chief psychiatrist in 2019/20. It is not known exactly what occurred in these incidents.26
  • In WA, mental health inpatient units are generally mixed gender spaces.27 In 2020/21 there were 102 incidents of a sexual nature that were reported for all ages.28
  • Any child or adult can be frisk searched after removal of clothing down to underwear while admitted. The current WA Mental Health Act does not mandate that the person conducting the search needs to be of the same gender as the patient, instead stating “if practicable” they must be of the same gender.

In 2019, an analysis was published regarding over 8,000 complaints made to Australian health regulators over a 6 year time period. This analysis compared complaints received for psychiatrists and psychologists with physicians and allied health practitioners. Findings included, “In our study, mental health practitioners had three times the risk of complaint regarding sexual boundary breaches compared with physical health practitioners. High rates of concern about sexual misconduct by psychiatrists and psychologists are a consistent finding in previous studies of complaints, regulatory actions and self-reported behaviour.” While some psychiatrists and psychologists are criminally prosecuted, the abuse is largely treated as a disciplinary issue, which must change. Compassion, common sense and decency declare that sexual abuse of patients is a serious and criminal act.

Recommendation: Children should never be placed in wards with adults and criminal fines and prison terms should be implemented for violations of this. If a search of a person is required, they must be of the same gender. [WA MHA, s303, s163]

DEATHS

Deaths are reported for WA patients in mental health care and within 28 days of discharge or deactivation of a patient from a service.

  • There were 12 deaths of Western Australians aged under 25 years that were either a suspected suicide or a physical/unnatural death in 2019/20.29
  • And in 2020/21, there were 83 deaths for all ages that were suspected suicide or physical/unnatural death.30

Australia’s drug regulatory agency the Therapeutic Goods Administration has issued 70 psychiatric drug warnings to warn of such risks as agitation, aggression, increased blood pressure, hallucinations, suicide, heart problems, withdrawal syndrome and possible death.31

In Australia, by December 2019, there were 49,248 adverse drug reaction reports linked to antipsychotics and antidepressants, 1,907 of these were deaths.32

Despite the potential dangers of psychiatric drugs, there were over 4.2 million psychiatric drug prescriptions written for Western Australians in 2019/20. This equates to over 471,000 West Australians taking a psychiatric drug that year.33

COMPLAINTS

The WA Health and Disability Service Complaints Office (HaDSCO) stated in their 2019/20 annual report regarding mental health complaints,

“The service types that were most frequently the subject of complaints in 2019-20 were psychiatrists/psychiatry (46%), community mental health services (12%), and psychologist/ psychotherapists (11%).”34

MENTAL HEALTH STAFF PROTECTED FROM LIABILITY IF THEY CAUSE HARM

The current WA Mental Health Act prevents anyone who has been harmed by a psychiatrist or mental health worker from civilly suing them, except for the harm caused by the use of bodily restraint in a person suspected of being mentally ill to prevent them leaving. Only the State can be sued.

Recommendation: The law needs to be changed so the perpetrator of the harm must also be able to be sued. [WA MHA, s583, S584]

LACK OF ACCOUNTABILITY

Spending on mental health in 2019/20 was well over $763 million, a 43% increase since 2013/14.35

Despite this huge increase in spending, the Productivity Commission’s latest Report on Government Services 2020, reveals that results in WA were appalling in 2018/19:

  • 52.8% of children aged 0-17, discharged from a psychiatric ward/facility had not significantly improved.
  • 58.9% of children aged 0-17 in ongoing outpatient community based care did not significantly improve.36
  • WA had the highest percentage of readmission within 28 days of discharge in the country for children under 18 years of age, 18-24 year olds, 45-54 year olds and 55-64 year olds.37

From 2013 to 2017, there were 126 people who had a stay in a psychiatric ward that lasted 365 or more consecutive days. This cost the WA Government an estimated $115 million.38This would be an average cost of over $912,000 per person.

As at 30 May 2021, there were 27 patients who had been in a psychiatric ward for between 1 and 2 years and 53 patients who had been there longer than 2 years.39

If psychiatric treatments were working there would be evidence of this in the reduction of children and adults requiring assistance. Money cannot be continued to be poured into the current failing WA mental health system when there is a dire need for accountable and effective care.

No other industry would be allowed such a poor performance for money invested. In contrast, money given to other areas of medicine shows noticeable progress, such as improving survival rates from cardiovascular disease over the past 20 years.40

HOW A DIAGNOSIS IS MADE THAT RESULTS IN DETAINMENT AND FORCED TREATMENT

Psychiatrists themselves state there are no tests for psychiatric diagnosis (no X-ray, scan, blood or urine test) to determine any child or adult has a psychiatric disorder.41

Despite the lack of tests to scientifically prove any child or adult has a “mental Illness,” the WA Mental Health Act and its enforceable regulations cover that the decision as to whether or not a person has a “mental Illness” must be made in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the mental health section of the International Classification of Diseases (ICD). The mental health section of ICD and DSM-5 share many similarities.42

As of 3 November 2021, Medicare use both DSM-IV and DSM-5 and the Pharmaceutical Benefits Scheme which funds psychiatric drugs, uses DSM-5.

So called mental illnesses in the DSM IV and the DSM-5 include: Caffeine Withdrawal, Unspecified Mental Disorder, Mathematics Disorder and Noncompliance with Treatment (meaning the patient does not want to have the psychiatric treatment due to side effects….)43

A diagnosis is based solely on subjective opinion and it is this unscientific diagnosis which leads to detainment, forced drugging, restraint, seclusion and electroshock.

Recommendation: The DSM and mental health section of the ICD should not be used as a basis for determining mental state in the WA Mental Health Act or Regulations.

ALTERNATIVES

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.

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.

Lodge a Submission by Monday 31 January 2022 at 4pm

Please express your concerns and request the below changes to the law in your submission.

  1. Request that the revised WA Mental Health Act bans restraint, seclusion, electroshock and psychosurgery for all ages and that the World Health Organisation’s instructions to cease involuntary admission and treatment are implemented.
  2. Ask that the revised WA Mental Health Act ensures that criminal penalties are greatly increased including for ill-treatment and neglect of patients.

Submissions can be done in the below ways:

Email: statutoryreview@mhc.wa.gov.au

Mail: Mental Health Act Statutory Review, Mental Health Commission, GPO Box X2299, Perth Business Centre WA 6847

Phone: Call (08) 6553 0561 at any time and leave a voice message of up to 5 minutes (this will be transcribed).

Online Survey: Short summary survey or Longer survey based on the full discussion paper

Tell others so they too can take action and write a “Letter to the Editor” to your state and local newspapers as well as share CCHR’s Facebook Posts and Tweets with others.

Download a short fact sheet

PLEASE ALSO SEND A COPY OF YOUR SUBMISSION TO:

  • The Premier: The Hon. Mark McGowan MLA, 13th Floor, Dumas House, 2 Havelock Street, West Perth WA 6005 ⬥ Email: wa-government@dpc.wa.gov.au ⬥ Phone: (08) 6552 5000
  • The Leader of the Opposition: Hon. Mia Jane Davies MLA, The Old Town Hall, Mitchell Street, Merredin WA 6415 ⬥ Email: mia.davies@mp.wa.gov.au ⬥ Phone: (08) 9041 1702
  • The Minister for Health and Mental Health: Hon. Amber-Jade Sanderson MLA, 5th Floor, Dumas House, 2 Havelock Street, West Perth WA 6005 ⬥ Email: Minister.Sanderson@dpc.wa.gov.au ⬥ Phone: (08) 6552 5900
  • The Shadow Minister for Health and Mental Health: Ms Elizabeth (Libby) Mettam MLA, PO Box 516, Busselton WA 6280 ⬥ Email: libby.mettam@mp.wa.gov.au ⬥ Phone: (08) 9752 1949

Please also contact your local member of parliament HERE

It is expected to take 15 months from release of the Discussion Paper in August 2021 until a report is given to the Mental Health Minister to be tabled in Parliament.

To read the Discussion Paper: https://www.mhc.wa.gov.au/media/3847/19105-mha-2014-statutory-review-aw_web.pdf

To read the current WA Mental Health Act: https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13534_homepage.html

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


References

  1. WA Animal Welfare Act 2002, s19(1). https://www.legislation.wa.gov.au/legislation/statutes.nsf/law_a4340.html ; WA Mental Health Act 2014, s253. https://www.legislation.wa.gov.au/legislation/statutes.nsf/law_a147019.html
  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. “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, s.4(2.3).
  4. Ken Casselman, Ph.D., “Testimony presented to the Maryland Senate Finance Committee Hearing on the SB 302: Mental Health – Electroconvulsive Therapy for Minors – Prohibition,” 20 Feb. 2019
  5. John Read and Chelsea Arnold, “Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009,” Ethical Human Psychology and Psychiatry, Volume 19, Number 1, 2017. https://www.researchgate.net/publication/319984428_Is_Electroconvulsive_Therapy_for_Depression_More_Effective_Than_Placebo_A_Systematic_Review_of_Studies_Since_2009
  6. 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
  7. “WHO Resource Book on Mental Health, Human Rights and Legislation,” World Health Organisation, 2005, p.64. https://ec.europa.eu/health/sites/default/files/mental_health/docs/who_resource_book_en.pdf ; WA Mental Health Act 2014. https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13534_homepage.html
  8. A/HRC/22/53, “Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment,” Juan E. Méndez, 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
  9. Annual Report of Chief Psychiatrist of Western Australia, 01 July 2016- 30 June 2017, p. 50. https://www.chiefpsychiatrist.wa.gov.au/about/publications/ ; Annual Report of Chief Psychiatrist of Western Australia, 01 July 2018- 30 June 2019, p. 77. https://www.chiefpsychiatrist.wa.gov.au/about/publications/ ; 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.
  10. “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
  11. “’Misadventure’ as psychiatric patient died,” WA Today, 22 November 2011. https://www.watoday.com.au/national/western-australia/misadventure-as-psychiatric-patient-died-20111122-1nsoc.html
  12. Regina Titelius, “Perth mental health experts call for closure of seclusion rooms,” Perth Now, 1 January 2017. https://www.perthnow.com.au/news/wa/perth-mental-health-experts-call-for-closure-of-seclusion-rooms-ng-c17edef5d32366dadd8fe1d79844b27d
  13. Annual Report of Chief Psychiatrist of Western Australia, 01 July 2020 – 30 June 2021, p.64. https://www.chiefpsychiatrist.wa.gov.au/wp-content/uploads/2021/09/Chief-Psychiatrists-Annual-Report-2020-21.pdf
  14. Margaret Scheikowski, AAP, “Call to reform mental health practices,” The Australian (and 9news.com.au), 29 May 2015. https://www.9news.com.au/health/call-to-reform-mental-health-practices/8b2d6276-bd3a-4543-a664-21ee4ff1f7e0
  15. “Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities,” NSW Government, December 2017, p.11. https://www.health.nsw.gov.au/mentalhealth/reviews/seclusionprevention/Pages/about.aspx
  16. Annual Report of Chief Psychiatrist of Western Australia, 01 July 2020 – 30 June 2021, p. 63. https://www.chiefpsychiatrist.wa.gov.au/wp-content/uploads/2021/09/Chief-Psychiatrists-Annual-Report-2020-21.pdf; Regina Titelius, “Perth mental health experts call for closure of seclusion rooms,” Perth Now, 1 January 2017. https://www.perthnow.com.au/news/wa/perth-mental-health-experts-call-for-closure-of-seclusion-rooms-ng-c17edef5d32366dadd8fe1d79844b27d
  17. “Mental Health Tribunal Annual Report 2020/21,” pages 10,21. https://www.mht.wa.gov.au/documents/annual-reports/
  18. South Australia Mental Health Act 2009, s79, s84. https://www.legislation.sa.gov.au/LZ/C/A/Mental%20Health%20Act%202009.aspx
  19. Annual Report of Chief Psychiatrist of Western Australia, 1 July 2018 – 30 June 2019, p.32. https://www.chiefpsychiatrist.wa.gov.au/about/publications/ ;
    Annual Report of Chief Psychiatrist of Western Australia, 01 July 2019 – 30 June 2020, p.28. https://www.chiefpsychiatrist.wa.gov.au/about/publications/
  20. “WA Mental Health Advocacy Service Annual Report 2018-19,” p.1. https://mhas.wa.gov.au/assets/documents/2018-2019-MHAS-Annual-Report.PDF
  21. “Statutory Review of the Mental Health Act (2014): Discussion Paper,” WA Mental Health Commission, August 2021, p.42. https://www.mhc.wa.gov.au/media/3847/19105-mha-2014-statutory-review-aw_web.pdf ; WA Mental Health Act 2014, s261, s262. https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13717_homepage.html
  22. Northern Territory Mental Health and Related Services Act, Part 9, Division 1. https://legislation.nt.gov.au/en/Legislation/MENTAL-HEALTH-AND-RELATED-SERVICES-ACT-1998 ; NSW Mental Health Act 2007, Clause 83. https://legislation.nsw.gov.au/view/html/inforce/current/act-2007-008 ; Western Australia Mental Health Act 2014, p.153. https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13534_homepage.html ; Queensland Mental Health Act 2016, p.195. https://www.legislation.qld.gov.au/view/pdf/asmade/act-2016-005
  23. Prof. Paul Fitzgerald, Dr Rebecca Segrave, “Deep Brain Stimulation in mental health: review of evidence for clinical efficacy,” NSW Ministry of Health, NSW Government Information (Public Access) request number PA 15/70. Please contact the NSW Ministry of Health (quoting the request number) or CCHR Australian National Office for a copy
  24. Sue Dunlevy, “Experts slam the age of consent,” Weekend Australian, March 31-April 1, 2012. https://www.theaustralian.com.au/news/health-science/experts-slam-age-of-consent/news-story/ea974fa10909d6d13bb1efeeddbefbb6
  25. Annual Report of Chief Psychiatrist of Western Australia, 1 July 2020 – June 2021, p.86. https://www.chiefpsychiatrist.wa.gov.au/chief-psychiatrists-annual-report-2020-21/ OR https://www.chiefpsychiatrist.wa.gov.au/about/publications/
  26. Annual Report of Chief Psychiatrist of Western Australia, 1 July 2019 – 30 June 2020, pages 49,52. https://www.chiefpsychiatrist.wa.gov.au/about/publications/
  27. Annual Report of Chief Psychiatrist of Western Australia, 1 July 2019 – 30 June 2020, p.43. https://www.chiefpsychiatrist.wa.gov.au/about/publications/
  28. Annual Report of Chief Psychiatrist of Western Australia, 1 July 2020 – 30 June 2021, p.68. https://www.chiefpsychiatrist.wa.gov.au/chief-psychiatrists-annual-report-2020-21/ OR https://www.chiefpsychiatrist.wa.gov.au/about/publications/
  29. Annual Report of Chief Psychiatrist of Western Australia, 1 July 2019 – 30 June 2020, p.49. https://www.chiefpsychiatrist.wa.gov.au/about/publications/
  30. Annual Report of Chief Psychiatrist of Western Australia, 1 July 2020 – 30 June 2021, p.68. https://www.chiefpsychiatrist.wa.gov.au/chief-psychiatrists-annual-report-2020-21/ OR https://www.chiefpsychiatrist.wa.gov.au/about/publications/
  31. Fully referenced layman’s summary of all psychiatric drug warnings issued by the Therapeutic Goods Administration, https://cchr.org.au/wp-content/uploads/2022/03/Australian-government-warnings-other-actions-on-psychotropic-drugs-2022-06-05.pdf
  32. Therapeutic Goods Administration Database of Adverse Event Notifications: Generate reports for each antidepressant, antipsychotic by chemical name sold in Australia and add statistics manually. http://www.tga.gov.au/safety/daen.htm
  33. “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 14 October 2021. https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/mental-health-related-prescriptions
  34. “Health and Disability Services Complaints Office 2019-20 Annual Report,” p.55, https://www.hadsco.wa.gov.au/-/media/HaDSCO/Documents/Annual-Reports/2019-20-Annual-Report/HaDSCO-Annual-Report-2019-20-Full-Print-Version.pdf
  35. $533,571,000 in 2013/14 and $763,453,000 in 2019/20. “2015-16 Budget Paper No. 2, Volume 1, Budget Statements Volume1,” p. 139. https://www.ourstatebudget.wa.gov.au/2015-16/budget-papers/bp2/2015-16-wa-state-budget_bp2_vol1.pdf ; “Western Australia State Budget 2020-21, Budget Paper No.2, Budget Statements Volume 1,” 8 October 2020, p.318. https://www.ourstatebudget.wa.gov.au/2020-21/budget-papers/bp2/2020-21-wa-state-budget-bp2-vol1.pdf
  36. “People who received mental health care provided by State and Territory public mental health services and who significantly improved, by service type and age group,” Productivity Commission Report on Government Services 2021, Part E, Section 13, 28 January 2021, Table 13A.62. https://www.pc.gov.au/research/ongoing/report-on-government-services/2021/health/services-for-mental-health
  37. “Readmissions to hospital within 28 days of discharge, by selected characteristics,” Productivity Commission Report on Government Services 2021, Part E, Section 13, 28 January 2021, Table 13A.33. https://www.pc.gov.au/research/ongoing/report-on-government-services/2021/health/services-for-mental-health
  38. “Western Australian Auditor General’s Report Access to State-Managed Adult Mental Health Services,” Report 4: 2019-20, 14 August 2019, p.9. https://audit.wa.gov.au/wp-content/uploads/2019/08/Access-to-State-Managed-Adult-Mental-Health-Services.pdf
  39. Hon. Stephen Dawson, “Mental Health ─ Long stay admitted patients,” Legislative Council WA Parliament Hansard, 4 August 2021. https://www.parliament.wa.gov.au/Hansard/hansard.nsf/0/a4987ae0dfc967f54825873c001a1f94/$FILE/C41+S1+20210804+p2301b-2301b.pdf
  40. “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
  41. Examples of no tests include: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, DSM-IV-TR, American Psychiatric Association, pages 88,89,305 ; Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5, American Psychiatric Association, pages 61,101.
  42. WA Mental Health Act 2014, s6(4). https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13534_homepage.html ; WA Mental Health Regulations 2015, p.2. https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13717_homepage.html ; Arlin Cuncic, “What is the ICD-11?” 17 September 2020. https://www.verywellmind.com/overview-of-the-icd-11-4589392
  43. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5, American Psychiatric Association, pages 506,707 ; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, DSM-IV-TR, American Psychiatric Association, pages 53,739.

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