Page 3655 - Week 12 - Tuesday, 28 October 2014
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to build. In the time it took to prepare the numerous amendments, we have doubled the size of the dam, built and rebuilt the Gungahlin Drive extension, planned and built the adult mental health unit, and the arboretum. They say that Rome was not built in a day. Seven years is a long time for consulting on the update of a bill.
The question now is how it will be implemented and how it will be different to what we have. It is an adaption, a modernisation, and many of its tenets are very good. How will the management of ACT Mental Health implement the changes to this legislation? The main elements are, in my view, changes to allow ACAT to clarify the role of guardians in decision-making, to create binding, advanced care directives, advanced agreements to assist mostly in second and subsequent episodes of illness, to clarify the aims of the bill, to enable meeting, in the bill’s words, “the necessity for timely, evidence-based treatment of people’s mental illness”, to allow ambulance officers to have a few key phrases they are permitted to use to try to convince patients to come with them to hospital when they believe that safety would not be compromised by phrases such as, “I have the authority to tell you that you are required to come with us to the hospital.”
There is a requirement in the bill to consult with the patient and to record that the patient was consulted when the determination of their care is made; that ACAT’s involuntary detention orders will be made, under the act initially being as long as 11 days after an initial three-day emergency order that authorised mental health personnel are allowed to initiate under certain circumstances; making the period of a primary initial detention up to two weeks, somewhat less than some other jurisdictions which allow up to 28 days.
The bill prepares the system for the opening of the secure mental health facility and the transfer of inmates from the Alexander Maconochie Centre to be put 100 per cent in the custody of the health system, a concept which, no doubt, will experience some trial and error at the very least initially; increased measures for ACAT to use forensic mental health orders in the case of people who have been considered unfit for trial and for ACAT to use these orders in determining how they will be monitored and treated outside the criminal justice system or, indeed, inside it, in essence, giving ACAT the opportunity to create a set of rules and a system for managing a person who is unfit for trial and who otherwise may have been imprisoned, including in these options detention in a correctional facility or serving a community-based sentence; and for information on their release into the community to be available as per the Victims of Crime Act, which would allow, in the case of someone who had been normally convicted and imprisoned, some victims to be notified when the client is released from a facility.
This bill’s most significant element by far is the transfer of the hosting of people who may have previously displayed criminal behaviours from the justice system to the health system. It is an area that many want to see an improvement in. I do not think many in the community think that it is a good thing that people suffering severe mental health disorders are housed in our prisons. However, in making this change, we change a purely therapeutic nature of the health system into a partially custodial system as well. My concerns are for how the new secure mental health facility will be staffed and how safety will be maintained for staff and other clients of the service.
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