Doubts on patients’ rights

Press, 14 May 1985, Page 23

Doubts on patients’ rights

PA Wellington Health Department proposals for a new Mental Health Act do not go far enough in guaranteeing psychiatric patients’ rights, according to the task force on revision of mental health legislation. In a submission on the department’s December, 1984, discussion paper reviewing the act, the task force says the proposals contain a number of important and long-overdue advances.” ‘‘But they do not go far enough in redressing the extraordinary powerlessness of mentally disordered persons committed to psychiatric hospitals.” The seven-member iasK force includes the director of the Mental Health Foundation, Dr Max Abbott, a Justice D € P ar^ n ? n }. P s 7" chiatrist, Dr Rachel Maule and an Auckland University law lecturer, Mr Warren Brookbanks. The task force was the author of the 400iflge report tal Health Law Reform,

published in February, 1984, advocating a complete overhaul of New Zealand’s mental health laws.

In its submission, the task force says: “Patients must be guaranteed representation and advocacy services, and automatic access to independent review processes which will ensure a fair hearing. The department’s proposals fall short of these aims.”

Changes advocated in the department’s discussion paper include: • Establishing regionally based tribunals to review the legal status of detained patients who apply to them. . Introducing a system of community treatment orders to replace the unregulated process by which persons receive compulsory psychiatric treatment in the community as committed patients on long leave. • A staggered approach to the use of compulsory powers, where all orders would be for limited periods and patients would be entitled to a hearing b&ore they were renewed. "

“While these are important advances, many concerns remain,” said a task force member, and Mental Health Foundation legal officer, Mr John Dawson, in a statement covering the submission. “Review will not be automatic. Persons who are detained because they are mentally disordered will bear the burden of coming forward to apply for a review. Under this system in England only about 10 per cent of patients have applied. “Those who are silent, withdrawn or fearful of the implication of applying for review may often be those who are most in need of it.”

The proposals placed great emphasis on the use of guidelines for standards of care, Mr Dawson said. “Too many important issues are to be relegated to guidelines not included in the act, thereby depriving patients’ rights of the status of law.”

Rights were not established by guidelines because they could not be enforced

by either the patient or the department which promulgated them, he said. Other proposals would give the police greater powers to arrest mentally disordered people without adequate judicial oversight, would define standards governing orders in broad and vague terms, and might reduce family involvement in compulsory admission, Mr Dawson said.

“This last proposal has important cultural implications. Greater police and professional involvement in compulsory admissions means in reality greater pakeha involvement, when considerable numbers of patients are Maori and Pacific Islanders.

“The families of patients in these ethnic groups will have even less control over the fate of their family members. This cannot be justified,” Mr Dawson said. The Health Department’s working party on the new act began meeting interest groups last month, and the hearings will continue throughout this month.