Page 735 - Week 03 - Wednesday, 24 March 1993
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The patient detained on an immediate treatment order must be examined as soon as practicable by a qualified psychiatrist, and if possible within 24 hours of admission. The psychiatrist may make an initial treatment order of up to 21 days. The psychiatrist or the Director of Mental Health may vary or discharge this order if the continued detention is no longer justified. Unless otherwise determined, the order is automatically discharged at the end of a 21 day period. The patient has the right to appeal against the order at any stage.
The Government, quite rightly on my reading of the response, has decided that the Mental Health Tribunal will make orders for detention, not the examining psychiatrist, although they must take his or her advice into account. This allows consideration of other information, which will give a better result for the people who are brought to the tribunal. I also agree that the advocate should not take a role in applying for orders, as outlined at recommendation 17. It is proper that the roles of the advocate and the tribunal and other authorities under the proposed legislation be clearly defined, as this removes any conflict of interest when dealing with people with mental dysfunction.
I also agree with the Government that there are adequate emergency detention provisions, and police powers in this area should not be expanded, as was recommended at point 19. Recommendation 20, which seeks to make the Magistrates Court a forum for community care and mental health functions, is not appropriate. At present we have the situation where many people with mental dysfunction appear before the courts because there is no other forum for dealing with their circumstances. Madam Speaker, it is not enough to use the inadequate resources that we now use. We must put the issue of mental dysfunction where it belongs - in the community and not the courts.
I have some concerns that the Government wishes to have relatives and carers apply to be heard before the tribunal, as detailed in its response to recommendation 25. I hope that the Government will further make known its reasons for feeling that an application to appear, not a right to appear, should be the norm; or could the Government outline what directions or procedural guidelines will be given to the tribunal to direct them in their consideration as to who will have a right to appear before the tribunal? Recommendation 28 states that the Community Advocate will fulfil the role of official visitors and a psychiatric services board. I hope that the Government will further liaise with the Community Advocate on the resources that that office will need to fulfil these roles.
Madam Speaker, I welcome the response to recommendation 34, which states that police need to show cause why a person should be dealt with by the Mental Health Tribunal. This will leave under the control of that tribunal all psychiatric examinations for the purposes of detention orders. This avoids unnecessary duplication within the system and ensures that correct procedures are followed in all cases. This also ties in with the response to recommendation 39. Madam Speaker, in the light of the passing of the Health Bill 1993 I hope that the Government will soon make known which body will be taking on the review of recommendations 40 and 41. With recommendation 43, it is important that the Mental Health Tribunal have clear lines of operation and that no other body be allowed to cut across this line of responsibility. Therefore, it is appropriate that this recommendation be considered in conjunction with the tribunal's functions.
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