Chief Psychiatrist Annual Report 2014–15

The Mental Health (Treatment and Care) Act 1994 was implemented in the Australian Capital Territory (ACT) 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 (NSW) during the year in relation to people who have a mental illness.

Emergency apprehension

Table 61 shows the number of emergency apprehensions in 2014–15 by initiator.

Table 61: Emergency apprehension

Initiator

Number of emergency apprehensions

Police officer

723

Mental health officer

158

Medical practitioner

139

Total

1,020

Emergency detention

Table 62 shows the number of emergency detention notifications issued in 2014–15 in comparison to previous years. Applications for an 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).

Table 62: Emergency detention

Year

Number of emergency detentions

July 2011–June 2012

614

July 2012–June 2013

689

July 2013–June 2014

594

July 2014–June 2015

698

 

Outcome of those detained

Table 63 shows the outcomes for those detained in 2014–15 in comparison to previous years.

Table 63: Outcome of those detained

Year

Revocation of 72-hour detention and/or 72-hour detention being allowed to lapse

Applications for extension of involuntary detention

July 2011–June 2012

389

225

July 2012–June 2013

363

326

July 2013–June 2014

295

299

July 2014–June 2015

387

311

 

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. Table 64 shows PTO and Community Care Order (CCO) restriction order statistics for 2014–15 in comparison to previous years.

Table 64: Psychiatric treatment orders

Year

PTOs granted by the Tribunal

PTOs revoked

Breach of PTO

Tribunal restriction orders were all in relation to CCOs

July 2011–June 2012

864

148

76

5

July 2012–June 2013

924

127

82

16

July 2013–June 2014

890

167

80

15

July 2014–June 2015

921

156

90

14

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 the removal of an individual to Canberra Hospital for the purposes of an emergency assessment to determine whether immediate treatment and care are required. Table 65 provides statistics for other matters in 2014–15 in comparison to previous years.

Table 65: Other matters

Year

Application for ECT authorised

Application for emergency ECT authorised

Transfers to/from NSW

Court ordered removal for assessment—s309 of the Crimes Act 1900

July 2011–June 2012

16

1

10

54

July 2012–June 2013

13

1

8

40

July 2013–June 2014

7

0

9

44

July 2014–June 2015

10

1

12

63

Key points arising

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

In 2014–15, 1,020 people were apprehended and brought to Canberra Hospital for assessment. This is an increase of 5 per cent from the previous year, when it was 968.

Emergency detention revocations have increased from 295 to 387, a 31 per cent increase from the previous year. This reflects continuing efforts to move to least restrictive care at an early opportunity if at all possible.

Applications  to extend involuntary detention by up to seven days increased by 4 per cent, 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 1,224 hearings throughout the year and granted 921 PTOs. This is an increase of 3 per cent from 2013–14. On application by a consultant psychiatrist, or of its own motion, ACAT revoked 156 orders, compared to 167 in the previous reporting period.

Ten ECT applications were authorised, which is a marginal increase from the previous year. Two applications for emergency ECT tribunal were made, however only one was authorised.

Twelve cross-border agreements were made between the ACT and NSW. The ACT accepted four transfers from NSW, and eight transfers were made to NSW facilities. One transfer was also made to the ACT from a Queensland facility and two transfers were made to Victorian facilities.

Breaches of PTOs increased from 80 in 2013–2014 to 90 in 2014–15. This amounts to an increase of 9 per cent from 2013–14. Fifty-nine people were brought to the Mental Health Assessment Unit for medication or assessment purposes, and 22 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 63 referrals for assessment pursuant to section 309 of the Crimes Act 1900, a significant increase of 43 per cent from the previous year. Of these, 37 people required admission to the Adult Mental Health Unit for assessment purposes, with 26 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.

With the pending implementation of the new Mental Health Act 2014, a Mental Health Act Strategic Implementation Group has been formed. Implementation 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. The new Act will begin on 12 November 2015.

 

Dr Peter Norrie

Chief Psychiatrist