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Legislative Assembly for the ACT: 2004 Week 03 Hansard (Thursday, 11 March 2004) . . Page.. 1094 ..

In respect of the more acute aspect of mental illness, some of us have had loved ones die while we thought they were in the care and protection of the mental health service. Key recommendations have come out of a number of coronial reports. I will talk in particular about the coronial report of my friend Bob Beatty. I will comment on not only the coronial recommendations but also the general feedback I am getting from the community about how well those recommendations have been dealt with.

I will briefly summarise the recommendations of the coroner. I probably need to say—I note that the coroner has written this—that I am not attempting to blame; I am attempting to be constructive in raising these points. I hope that the government is learning from these tragedies and the recommendations that come out of the inquiries that look into them.

The key issues identified by the coroner were, firstly, that there was the absence of therapeutic interaction between staff and patients in PSU. The feedback I am getting generally is that, while it is generally changing, it is still a problem. Some of that relates to the physical structure of PSU and the well understood problems now—and I know the government understands this—about the position of the nurses’ station. I know from the last response that I saw, which was December, that it is being looked at. I do not think we have got a March response from the government, so we are due for one quite soon. But work was being done, architects were being consulted, et cetera. I am hoping that in the March response to these reports we are going to be told that work has started.

There are also questions of therapeutic relationships between staff and consumers. There are questions about the number of staff members in the unit, and obviously that can aggravate that situation. Some members of the staff have an unhelpful cultural attitude, and that has been highlighted by consumers many times. I am sure the government is already aware of that. There are certainly opportunities for professional development and support for staff who are not helpful. This can, as much as anything, be a result of all the other things that I mentioned—unacceptable working conditions; a bureaucracy or a culture within the bureaucracy which is not affirming of the extremely stressful work that people are doing on the ground.

The health committee is certainly interested in looking at how the cultural attitude within the bureaucracy meets the needs of workers right through the system and particularly those people on the ground who are quite often dealing with, as I said, quite stressful situations. The expert evidence also talked about the notion of a low stimulus environment, which they criticised. They made it quite clear that the only way to have a low stimulus environment is to have ongoing involvement of staff with patients who are at the peak or trough of their illnesses, and that is part of the therapeutic engagement.

The observation regimes and poor note taking in the recording of the observations were also issues. As I understand it, there are still serious issues in respect of continuity of patients’ records, whether those records are in paper form or computer form, and how they relate to each other. Maybe that has been fixed up, but I am looking forward to hearing about what has been done. Another question that has recently been raised again publicly—and this was certainly in the coroner’s report—is the implications for the management of the psyche unit when a patient is very disturbed and dangerous. This was one of the quite significant issues that came up in the coronial report on Bob’s death.

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