Mental Health ReviewPosted: February 20, 2011 at 9:34 pm | Tags: exclusion, mental health, politics, violence
**Trigger warning – this post discusses suicide attempts, police violence, PTSD and rape flashbacks**
I think it’s beyond time to review the Victoria Mental Health Act (1986)*. The way the system treats those with mental illnesses is horrifying, and the other day this was brought home to me again as I chatted to a woman I know and her very recent experience with the Mental Health Act and the whole medical/police system. I’m going to summarise her story, and leave out anything that will identify her. That said, I don’t know every step of her story, I know what she told me the other night, and that in itself is horrifying without knowing all the rest of the story.
A little bit over a week ago, someone I know (and for the sake of this story I will call her Brenda) attempted suicide via ODing on the drugs that she is prescribed. The next day the police kicked her door in (I’m guessing she called triple zero and asked for assistance) and during offering their “assistance” several police crash tackled her to the floor and she had capsicum spray, sprayed in her face. She was handcuffed (very tightly) and forced to lie on her handcuffs in the ambulance where she was taken to hospital. Once there she was told she was to have a blood test, which she refused. This resulted in several guards holding her down and strapping her to the table and her blood being forcibly taken. Unsurprisingly, this brought gave her rape flashbacks and deeply traumatised her.
Eventually from emergency she was transferred to the psych unit of the hospital, where she was given very little information about her stay, where she could shower, and she was barely fed during her ordeal. She was there for 6 days and told me that she’d been fed three meals, and that it had taken them three days to tell her where she could shower. The hospital provided her brother with more information than they provided to her.
Eventually Brenda found out that she’d been detained under Section 10 of the Mental Health Act (1986):
Apprehension of mentally ill persons in certain circumstances 10. Apprehension of mentally ill persons in certain circumstances (1) A member of the police force may apprehend a person who appears to be mentally ill if the member of the police force has reasonable grounds for believing that- (a) the person has recently attempted suicide or attempted to cause serious bodily harm to herself or himself or to some other person; or (b) the person is likely by act or neglect to attempt suicide or to cause serious bodily harm to herself or himself or to some other person. (1A) A member of the police force is not required for the purposes of subsection (1) to exercise any clinical judgment as to whether a person is mentally ill but may exercise the powers conferred by this section if, having regard to the behaviour and appearance of the person, the person appears to the member of the police force to be mentally ill. (2) For the purpose of apprehending a person under subsection (1) a member of the police force may with such assistance as is required- (a) enter any premises; and (b) use such force as may be reasonably necessary. (3) A member of the police force exercising the powers conferred by this section may be accompanied by a registered medical practitioner or a mental health practitioner. (4) A member of the police force must, as soon as practicable after apprehending a person under subsection (1), arrange for- (a) an examination of the person by a registered medical practitioner; or (b) an assessment of the person by a mental health practitioner. (5) The mental health practitioner may assess the person, having regard to the criteria in section 8(1) and- (a) advise the member of the police force to- (i) arrange for an examination of the person by a registered medical practitioner; or (ii) release the person from apprehension under this section; or (b) complete an authority to transport the person to an approved mental health service in accordance with section 9A(1). (6) If the mental health practitioner assesses the person and advises the member of the police force to arrange for an examination of the person by a registered medical practitioner the member of the police force must do so as soon as practicable. (7) If the mental health practitioner assesses the person and advises the member of the police force to release the person from apprehension under this section the member must do so unless the member arranges for a personal examination of the person by a registered medical practitioner. (8) If an arrangement is made under this section to have a person examined by a registered medical practitioner, a registered medical practitioner may examine the person for the purposes of section 9. (9) Nothing in this section limits- (a) any other powers of a registered medical practitioner or mental health practitioner in relation to that person under this Act; or (b) any other powers of a member of the police force in relation to that person.
and hospitalised under Section 8 of the same Act:
Criteria for involuntary treatment 8. Criteria for involuntary treatment (1) The criteria for the involuntary treatment of a person under this Act are that- (a) the person appears to be mentally ill; and (b) the person's mental illness requires immediate treatment and that treatment can be obtained by the person being subject to an involuntary treatment order; and (c) because of the person's mental illness, involuntary treatment of the person is necessary for his or her health or safety (whether to prevent a deterioration in the person's physical or mental condition or otherwise) or for the protection of members of the public; and (d) the person has refused or is unable to consent to the necessary treatment for the mental illness; and (e) the person cannot receive adequate treatment for the mental illness in a manner less restrictive of his or her freedom of decision and action. Note In considering whether a person has refused or is unable to consent to treatment, see section 3A. (1A) Subject to subsection (2), a person is mentally ill if he or she has a mental illness, being a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory.
(There is a subsection 2 of this section of the Act, but it isn’t relevant for this blog post).
So it’s a nice twisted road – the police can arrest you for attempting, or them believing that you may attempt, suicide, and then if you refuse to be treated, you will be involuntarily committed and kept against your will. Another friend of mine recently voluntarily admitted himself to a hospital for treatment, and then was told when he considered leaving that if he did he’d be involuntarily committed and not allowed to leave if he attempted to leave at that point.
I also think that’s it’s a REALLY bad idea to allow the police to use “force as may be reasonably necessary” in dealing with any person with mental illness/es. It’s turned out really bad so far, with a large number of people with mental illnesses being shot by police, and I’m sure that those people who are traumatised by authority figures are additionally traumatised by the police using force against them when they’re at their lowest point.
There really has to be a better way of treating people with mental illnesses, and I’d start by treating them as people who are aware of their conditions, or who may need information and diagnosis about their conditions (someone who is undiagnosed wouldn’t be educated about their condition clearly). To make the any treatment options an informed decision of the individual who is likely to receive it. To work with the individual and not against them. To listen to their fears, concerns, needs and work through and with those. Proper partnered care has to be a better option than forced care, in the long term.
The upshot of Brenda’s experience is that she’s more traumatised than before she was admitted to hospital, she was released with no support networks in place (she lied to get out of hospital because that environment was adding to her trauma), she doesn’t feel heard by her friends of family, and she wants care but on her terms and not through force.
Charities such as SANE which try to reduce the stigma of mental illness are let down by the legislation governing mental health, which clearly treats mental illness differently than any other public health issue. When governments treat one group of citizens differently because of a real or perceived difference, then everyone else will treat them differently. To improve the situation of people with mental illnesses, they have to be treated the same way everyone else is. Not everyone with cancer wants chemotherapy, and not everyone with mental illness wants to take medication to treat it. If someone is educated about their health condition, they can make an educated decision about the treatment they wish to receive to deal with it. And surely, if they are not likely to harm someone else, their choices should be respected.
I’m not a mental health expert, and cannot comment authoritatively on mental health, but I am certainly looking at it and from where I’m sitting right now, it sucks.
If you are considering suicide you might want to read this page.
If you are in Australia, you might also want to call:
Lifeline Australia at telephone: 13 11 14
* I think it’s really telling that the date of this Act is over 20 years ago – which indicates that the legislation has not been significantly revised since that date – either to address changes in treatment options of people with mental illnesses or to address the human rights of people with mental illnesses.