Chief Psychiatrist Annual Report 2012‑13

The Mental Health (Treatment and Care) Act 1994 was implemented in the Australian Capital Territory on 6 February 1995.

Section 120

A report prepared by the Chief Psychiatrist under the Annual Reports (Government Agencies) Act 2004 for a financial year must include:

statistics in relation to people who have a mental illness during the year

details of any arrangements with New South Wales during the year in relation to people who have a mental illness.

Emergency apprehension

The following table shows the number of emergency apprehensions in 2012‑13, with a breakdown of who initiated them.

 

  Emergency action Police officer Mental health officer Medical practitioner
Total 876 617 165 94

 

Emergency detention

The following table shows the number of emergency detention notifications issued in 2012‑13 in comparison to previous years. Applications for extension of emergency detention (for a further period of up to seven days) and applications for mental health orders and variations of mental health orders are made to the ACT Civil and Administrative Tribunal.

 

Emergency detentions July 09–June 10 July 10–June 11 July 11–June 12 July 12–June 13
Total 505 596 614 689

 

Outcome of those detained

 

  July 09–June 10 July 10–June 11 July 11–June 12 July 12–June 13
Revocation of 72-hr detention and/or 72-hr detention being allowed to lapse 302 322 389 363
Applications for extension of involuntary detention 204 274 225 326

 

Psychiatric treatment orders

Under the Mental Health (Treatment and Care) Act 1994, the Chief Psychiatrist is responsible for the treatment and care of a person to whom a psychiatric treatment order (PTO) applies. The maximum duration of a PTO is

six months.

 

  July 09–June 10 July 10–June 11 July 11–June 12 July 12–June 13
PTOs granted by the tribunal 790 884 864 924
PTOs revoked 69 119 148 127
Breach of PTO 68 59 76 82
Restriction orders 3 3 5 16

 

Other matters

The Mental Health (Treatment and Care) Act 1994 provides for the authorisation of involuntary electro-convulsive therapy (ECT), including emergency ECT. It also has provisions for the interstate application of mental health laws, including for the transfer of people to and from the ACT.

The Crimes Act 1900 provides for the court to order removal of an individual to the Canberra Hospital for the purposes of an emergency assessment to determine whether immediate treatment and care are required.

 

  July 09–June 10 July 10–June 11 July 11–June 12 July 12–June 13
Application for ECT authorised 19 17 16 13
Application for emergency
ECT authorised
0 2 0 1
Transfers to/from NSW 12 4 10 8
Court ordered removal for assessment—s309 of the Crimes Act 1900 25 26 54 40

 

Key points arising

The following trends in key areas of activity related to the Office of the Chief Psychiatrist are noteworthy.

In 2012‑13, 876 people were apprehended and brought to the Canberra Hospital for assessment. This is a decrease of 7 per cent from the previous year, when it was 942. This likely reflects the increasing level of mental health education provided to the police and other stakeholders. Emergency detention revocations have decreased from 389 to 363, a 7 per cent decrease in comparison to the same reporting period last year. This reflects efforts to move to least restrictive care at an early opportunity if at all possible. Notwithstanding this, there was a greater number of applications for extension of further involuntary detention (of up to seven days), indicating the treating team’s efforts to continue to appropriately stabilise an acute episode of illness. Increased stability during an admission provides a greater chance of successful ongoing management when a person is discharged to the community.

The ACT Civil and Administrative Tribunal (ACAT) granted 924 psychiatric treatment orders (PTO). This is an increase of 6 per cent from 2011‑12. Upon application by a consultant psychiatrist, or of its own motion, ACAT revoked 127 orders, compared to 148 in the previous reporting period. Community psychiatry is proactive in management without orders where possible.

There were 14 electro-convulsive therapy applications authorised, a negligible decrease from the previous year. There was only one application for emergency ECT made to the tribunal and after a full hearing and review this application was able to be revoked. Thus, for the 2012‑13 year, no emergency ECT needed to be authorised by the tribunal under the provisions in Part 7 of the Act, introduced in 2005.

Eight cross-border agreements were made between the ACT and New South Wales. The ACT accepted four transfers from New South Wales and four transfers were made to New South Wales facilities. Breach of PTOs increased from 76 to 82. This amounts to an increase of 7 per cent from 2011‑12. Thirty-five people were brought to the Mental Health Assessment Unit for medication or assessment purposes. Community teams make every effort to anticipate and manage crises early. Often, if this is successful, a breach is not required.

The ACT Magistrates Court made 40 referrals for assessment pursuant to section 309 of the Crimes Act 1900,

a decrease of 25 per cent from the previous year. Of these, 24 people required admission to the Adult Mental Health Unit for assessment purposes, with 16 being returned to court on the same day. The Court Liaison Service is often able to provide assessment and advice to the courts at the time of the hearing, which in some circumstances means that a section 309 referral is not required.

The review of the current Mental Health (Treatment and Care) Act 1994 continues, and a revised amendment bill is expected to be presented to cabinet before the end of 2013.

 

Dr Peter Norrie signature

Dr Peter Norrie
Chief Psychiatrist