Mental health laws delayed to take into account public opinion

By Dr. Ananya Mandal, MDJan 26 2011

The Victorian government has extended the closing date for public comment on changes to the state’s Mental Health Act. The deadline has been extended to February 28. Submissions on the Exposure Draft Mental Health Bill 2010 can be lodged online at https://www.health.vic.gov.au/.

According to Minister for Mental Health Mary Wooldridge, this feedback would help frame the draft of the Mental Health Bill. Now more individuals, families and other stakeholders would be able to speak up she said.

This would also mean that the changes in the laws would take another year to come into play. Ms Wooldridge said Victoria’s mental health laws needed to be overhauled, but the former Labor government had not allowed sufficient time for feedback and a number of areas of contention had emerged from submissions on its draft bill received last month.

According to her some key areas need to be talked upon. These include a move towards supported decision-making and requiring a tribunal to approve electroconvulsive therapy (ECT) treatment for involuntary patients. At present Victoria is the only jurisdiction in Australia that allows ECT to be given without the consent of the patient and without either external review from a tribunal or a second psychiatrist.

In a feedback from St Vincent’s Hospital it was argued that waiting for tribunal approval for ECT could delay treatment and “acute patients whose lives are not in immediate danger may remain unwell for longer than necessary.” It added that an emphasis on supported decision-making would result in clinicians spending more time liaising with family and carers, possibly leading to greater lengths of stay and blockage of mental health beds. The submission read, “It is predicted that the retention of senior psychiatrists in the public sector may be affected due to increased administrative responsibilities impacting on clinical time…Possible imprisonment for infringement of ECT regulations and patient-consent protocols adds a further disincentive to remain in the public system.”

There was another submission from the Royal Australian and New Zealand College of Psychiatrists which said ECT’s effectiveness had been established beyond doubt for conditions including major depression, particularly for patients who had not responded to medication. Their submission read, “The bill introduces harsh and unrealistic penalties for the failure to meet requirements at the same time as imposing highly restrictive requirements on clinical practice.”

Ms Wooldridge in response to these arguments said that a balance needs to be maintained “between respecting the privacy of the individual versus the involvement of families and carers.” She said there were strong community support for certain elements of the draft bill, including a new mental health commissioner and improved Mental Health Tribunal. For example acting Health Services Commissioner Dr Grant Davies approved of the appointment of a mental health commissioner, which he feels “should greatly assist the management and resolution of mental health complaints.”