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Legislative Assembly for the ACT: 2004 Week 08 Hansard (Tuesday, 3 August 2004) . . Page.. 3301 ..

MS TUCKER (11.22): The Greens will be supporting this bill, the only condition being that when the act is reviewed over the next year, the impact of the specific provisions of this bill, both in effect and in human rights, be assessed and reported on. That is a reasonable request and I understand from the department and the minister’s office it is a commitment that they have already made. However, I would like to hear that on the record as well.

The key purpose of this bill is to give the Mental Health Tribunal the power to order a person found to have a mental dysfunction and to be at high risk of harm to themselves or others to live in a particular place or be detained in a particular facility. It also authorises the involuntary use of medication. There are safeguards in regards to scrutiny in the exercise of that power, such as the requirement for the Community Advocate to be advised within 24 hours of any involuntary restraint or medication and for comprehensive reporting and recording requirements.

It is increasingly the case that people who do the work or who care for affected people use the law to guide them. It is important that such legislation is clear. This bill more clearly separates the psychiatric treatment orders and the community care orders as they apply to people living with mental illness and with mental dysfunction. The argument as to the need for the Mental Health Tribunal to have the power to make these orders and to require the community care co-ordinator to ensure they are followed has been clearly made in the presentation speech, so I will not recap on what has already been said.

We are all aware that a small number of members of our community do not have a mental illness but rather have disturbed thinking, behaviour or moods to a disabling extent and are or can be at high risk of harming others or themselves and have been incredibly disruptive. Clearly, it is not acceptable to treat such people for illnesses they do not have, or to charge them with crimes that they cannot be held accountable for. However, we cannot leave them unsupported or unhindered. While the act has been able to support and help in the management of most people living with mental dysfunction, it has not given the tribunal or the care co-ordinators sufficient authority to deal with these most difficult situations.

However, there are some ongoing concerns, no matter how carefully the legislation is written. Some say mental dysfunction is not an illness. It is often congenital or the permanent consequence of head injuries. Ordering someone with such a condition to undergo involuntary medication does not always offer the same promise of recovery or remission. I am aware that there is no generally accepted model for managing the high-risk end of mental dysfunction, and that other states will be watching this regime. It is for these reasons that a close assessment of the impact and effectiveness of this approach will be important.

The other point I want to make is that the most consistent thing said to me by people who work with these sorts of people who have this mental distress or dysfunction, as it is called, and who are part of our community, is that rather than go to these kinds of lengths, we should be putting much more focus on ongoing therapeutic relationships with them. While the Greens are supporting this bill, it is qualified with that concern. It is still easier to have this kind of response than it is to invest in the ongoing support for people who suffer this distress and mental dysfunction. It comes up in our debates on health and

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