A Week Can be a Long Time in Mental Illness

Abstract

An erosion of the Mental Health Act is worrying. The safeguards on our human rights hang by a slender thread. In July last year, everyone in NSW had one such safeguard cut away. Its removal, by a simple bureaucratic manoeuvre, will be hard felt by anyone unfortunate enough to become severely mentally ill. Mental illness can happen to anyone. Severe depression, for example, affects one person in 10 and can strike at any age. The NSW Mental Health Act gives psychiatrists extraordinary powers to lock up and medicate people with severe mental illness, even when the affected person refuses all treatment. These powers are important. They can and do save lives. But, like any extraordinary power, there is always a risk that they might be abused. To make abuse less likely the Mental Health Act only allows a person to be held on a psychiatrist's order for a very short time and demands that the order be quickly and automatically reviewed by an independent tribunal. How quickly? The phrase in the Act is "as soon as practicable". Until July last year "as soon as practicable" was interpreted as within about a week - usually within a few days. Of course, many felt that even a few days was a long time, if you were in a psychiatric hospital and believed you shouldn't be there. However, most people accepted that within about a week was a pretty reasonable definition for "as soon as practicable". It was the definition used for more than 50 years and the system seemed to work very well. In July last year though, everything changed. The Mental Health Review Tribunal took over the independent reviews from magistrates, and the president of the Tribunal, Greg James, advised hospitals that although the Act said that these reviews should happen "as soon as practicable", in some cases people should be made to wait in detention for at least two weeks before their automatic review