Debates Day 3 - Thursday 21 October 2010
Parliamentary Record 15
Debates for 11th Assembly 2008 - 2012; ParliamentNT; Parliamentary Record; 11th Assembly 2008 - 2012
2010-10-21
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Debates
Legislative Assembly of the Northern Territory
Darwin
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DEBATES - Thursday 21 October 2010 would like the minister to table that advice in its entirety. If he has legal advice to suggest there is an implied power in the legislation of a right to detain I would like to see that evidence and it be tabled today. Madam Speaker, I am attempting to deal with this matter in a sober and upright fashion. It is an important issue, as the liberty of Territorians should be an important issue to every member in this House. I am concerned the Territory Health department, which has a prior history of operating with policies outside the law, is continuing the practice. I look forward to the ministers response. Mr VATSKALIS (Health): Madam Speaker, the member for Port Darwin has brought up a very serious issue because I also believe the right of the individual to freedom and liberty is paramount. However, in this situation we sometimes deal with individuals who, in some cases, are not in a position to understand their condition. I believe and say that from my own personal family experience. In some cases, their liberty has to be curtailed; it has to be held back involuntarily. Again, we are dealing with people with mental illness. I appreciate the members concern about the state of mental health patients. A person is admitted to a mental health institution or a unit for psychiatric treatment and care. The John Ridley Unit treats our sickest involuntary patients who are at high risk to harm themselves or other. The Cowdy Ward is an acute unit which treats both involuntary and voluntary patients. Due to a number of serious critical incidents, a decision was made in February 2010 to close the unit to provide better monitoring and treatment of patients. A young girl had admitted herself voluntarily and committed suicide, and another person went out for a cigarette, jumped off the balcony and is now a quadriplegic. As a result, a decision was made for the front door of the ward to be locked. Closure of acute mental health inpatient units is practiced in other jurisdictions, both in Australia and overseas, where it has become an increasingly difficult task to appropriately balance the services duty of care and the right of the patient to self-determination. Our mental health services support the fundamental principle of least restrictive care possible, and there has been significant effort in ensuring clients have ready access and egress from acute mental health inpatient units. To admit someone to an acute mental health inpatient facility is purposeful in the immediate and long-term management of the person. Thorough and comprehensive assessment is a critical phase of good planning and effective management of client care. As a consequence, it is important for this reason as well as patient safety, to identify where patients are located. Before I respond to the allegation, I would like to highlight the Community Visitor Program report on page 9 stated: Panel members spoke to consumers about their experience of the locked ward, finding that on the whole, most consumers did not have a problem with it. In relation to the concerns about leaving arrangements and rights of people admitted voluntarily to Cowdy Ward, I can advise, as per section 29(2) of the Mental Health and Related Services Act: A person must be informed of his or her right to leave the approved treatment facility on being admitted as a voluntary patient. This has been adhered to. Voluntary admission to the ward requires acceptance of ward policy whilst maintaining the ability to withdraw from treatment at any time. The current policy on wards is people are informed that, for best treatment outcomes, it is preferred they remain in the ward for the first 48 hours. Patients are assessed daily to monitor their condition. If a patient decides to discontinue treatment and wants to leave the facility, the patient is advised to wait until a doctor has seen them - like any hospital ward. If a patient wants to leave anyway, they are free to leave and are required to sign a Discharged Against Medical Advice Form. I will make it very clear. Voluntary patients can withdraw their consent to be in the ward at any time. If the patient has deteriorated and is understood to be at increased risk, staff may determine they meet the requirements for involuntary admission and other action is taken. The majority of patients 78% - admitted to Cowdy Ward are involuntary patients, the rest voluntary. Upon admission, the voluntary patients are provided with a form to fill in. They tick a number of boxes which identify they have been provided with information which has been explained to them, it is signed by them or, in the case of minors or people who cannot understand, by their guardian. Mr ELFERINK: A point of order, Madam Speaker! Could he table those documents? Mr VATSKALIS: Yes, I am happy to table them. Mr Elferink: Thanks, I appreciate it. 6539