Review of the MH Act - considerations for change
A panel was convened with representatives from a wide range of stakeholders.
- Family - Diane Gooch - Supporting Families Christchurch.
- Consumers - Brian Vickers, consumer advisor - Northland DHB.
- Clinical leadership - Margaret Aimer, clinical director - Counties Manukau DHB.
- District Inspectors - John Edwards, district inspector for mental health.
- Responsible clinician - Brian Pickering, nurse manager - Hutt Valley DHB.
Themes from the panel discussion
An opportunity exists for inconsistent interpretation as one of the main issues for families. Improvements in the definitions on mental disorder, particularly with the wording - danger and safety. Family consultation should also be strengthened.
Some said that service users are concerned about how easy it can be to subject someone to the MH Act. Sometimes information given over the phone can be enough. Often people are left on Community Treatment Orders for too long, and questioned how the MH Act fits with recovery. There is a lack of information on the MH Act for service users. People subject to the MH Act and their families need to be afforded enough time during the process. There was also concern expressed about the role conflict of being a ‘caring professional' and the coercive nature of working with the MH Act. One suggestion to alleviate this was the DAO role could sit within justice rather than health.
The MH Act needs to reflect its use being limited to a last resort, not first.
Although acknowledging changes to the MH Act are necessary, there is a need to maintain its positive aspects, such as the focus on community treatment, the ability to treat and the human rights perspective. The ‘competency debate' will shape the legislation - who will assess and how, and what the practical requirements will be. Some possible changes that should be considered are as follows.
- Administration of the MH Act needs to be aligned to service delivery models.
- The criteria for releasing people from the MH Act should be improved.
- Sections 8 (a) & (b) and Section 9 should provide for the DAO to express clinical judgement, rather than continue the process unnecessarily.
The MH Act works well most of the time and the ongoing focus should be on service delivery. Service to the prison population should be improved, as there are lots of people in this ‘community' without treatment, which we shouldn't tolerate.
The review of the MH Act should include consideration of Section 9 (2) (d) and Section 29 (3) - as there is a view that it is ineffective and concerns were raised regarding people's rights in hospital. There is some need for humane confinement for those who won't be rehabilitated. John also raised the issue that under section 11 of the New Zealand Bill of Rights Act 1990 ‘everyone has the right to refuse to undergo any medical treatment', yet the MH Act can override this.
The MH Act could be improved, namely:
- the Protection of Personal and Property Rights Act (1988) needs to work with the MH Act
- there needs to be alignment with the HDC Act processes
- the burden of administration of the MH Act needs to be reduced, and consultation should occur with those who do the paperwork.
Page last updated: 28 May 2009