Chief Psychiatrist Annual Report 2013-14
The Mental Health (Treatment and Care) Act 1994 was implemented in the Australian Capital Territory (ACT) on 6 February 1995.
A report prepared by the Chief Psychiatrist under the Annual Reports (Government Agencies) Act 2004 for a financial year must include:
a. statistics in relation to people who have a mental illness during the year
b. details of any arrangements with New South Wales (NSW) during the year in relation to people who have a mental illness.
The following table shows the number of emergency apprehensions in 2013-14, with a breakdown of who initiated them.
The following table shows the number of emergency detention notifications issued in 2013-14 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 (ACAT).
Outcome of those detained
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.
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.
Key points arising
The following trends in key areas of activity related to the Office of the Chief Psychiatrist are noteworthy.
In 2013-14, 968 people were apprehended and brought to the Canberra Hospital for assessment. This is an increase of 10 per cent from the previous year, when it was 876. Emergency detention revocations have decreased from 363 to 295, an 18 per cent decrease from the previous year and a 27 per cent decrease over the last two reporting periods. This reflects continuing efforts to move to least restrictive care at an early opportunity if at all possible. There was also an 8 per cent decrease in the 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.
As previously reported, an increased stability during an admission provides a greater chance of successful ongoing management when a person is discharged to the community. ACAT held 1265 hearings throughout the year and granted 890 PTOs.
This is a decrease of 3 per cent from 2012-13. Upon application by a consultant psychiatrist, or of its own motion, ACAT revoked 167 orders, compared to 127 in the previous reporting period.
There were seven electro-convulsive therapy applications authorised, a significant decrease from the previous year. There were no applications for emergency ECT made to the tribunal.
Eight cross-border agreements were made between the ACT and NSW. The ACT accepted six transfers from NSW, and two transfers were made to NSW facilities. One transfer was also made to a Queensland facility.
Breaches of PTOs decreased from 82 to 80 in 2013-14. This amounts to a decrease of 2.5 per cent from 2012-13. Thirty-eight people were brought to the Mental Health Assessment Unit for medication or assessment purposes, and nine were admitted to hospital as a result. 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 44 referrals for assessment pursuant to section 309 of the Crimes Act 1900, an increase of 10 per cent from the previous year. Of these, 27 people required admission to the Adult Mental Health Unit for assessment purposes, with 17 being returned to court on the same day. The Court Assessment Liaison Service continues to provide assessment and advice to the courts at the time of the hearing, which in many 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 was presented to cabinet during the first half of 2014.
Plans are in place for the anticipated requirements for training for the revised Act, particularly to support, educate and familiarise clinicians with accompanying changes in assessment and practice.
Dr Peter Norrie