Posts by Neil
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The discussion on the mental health act has unfortunately gone the way of previous instances where it hits the media.
A brief flurry of somewhat confused debate and then nothing.
The ministry of health never takes the opportunity to lead a more informed discussion. There’s widespread misunderstanding of the MHA which is unhelpful. And the stakes are quite high – friends and family often have unrealistic expectations of how the MHA can be applied and there’s a vocal lobby wanting compulsory treatment and assessment done away with.
Going back to Paul Buchanan’s original statement-
“He could have been, upon his release, immediately committed to an institution under the Mental Health Act in order to undergo that psychiatric examination. And he could have been held indefinitely until psychiatrists determined that he did not pose a threat to society.
This is not how the MHA works but it probably is indicative of how a large proportion of the public believe it works.
In order to be required to have an 8b assessment a person must be thought to mentally disordered. If no one thinks that is the case then a person cannot be required to undergo an assessment.
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Off topic but not on Twitter so have few other outlets to opine.
I’m actually sympathetic to Paul Buchanan’s questioning of whether or not a S8a was considered at any point.
I strongly doubt that the terrorist would have met the criteria for compulsory assessment and treatment - as he did not have a mental disorder - but I’d like to know if it was considered and then rejected as an option.
It would have been no use as some sort of holding pattern as an 8a does not usually entail any form of containment, it’s just a notification that a person is required to attend an assessment by a medical practitioner. That 8b assessment would have found he did not meet both limbs of the act and this would not have proceeded. So any detainment would have been at most 6 hours.
And the act should not be used just because there are no other options.
I find more troubling the never ending expansion of “mental health issues” to include just about anything including straight out antisocial behaviour. Being an angry man with grudges is not a mental health issue.
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A PM claiming they don’t want to influence how people vote might just influence how people vote.
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Who becomes minister responsible for Oranga Tamariki will be very indicative.
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Hard News: Cannabis: legalisation versus…, in reply to Sacha,
Any trade off needs to be explicitly stated by the government so it can be transparently evaluated. Which is not happening.
For example, the continued policy of starving acute mental health of resources has resulted in people with mental health issues spending more time in police cells. That’s a trade off that is most likely to be both financially less efficient and with lower health benefits than funding safe places within mental health.
I bring this up because it’s an issue that gets very little coverage in the harm reduction discussion. Acute mental health needs more funding for harm reduction to be effective for those most in need and at risk..
That would indeed cost money but let’s have that on the table so a choice can be made.
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Hard News: Cannabis: legalisation versus…, in reply to Sacha,
I would have thought though that a policy predicated on harm reduction would pay special attention to those most at risk of harm.
And perhaps one would have good reason to be sceptical of the ability of a health system that scrimps on acute care to deliver on promises for non acute care.
The risk involved with a young person destroying their brain with solvents is not just to themselves but to the broader population who will have to cope with their often anti-social behaviour, fund their on-going increasing health and welfare needs and also deal with the moral responsibility of letting a young person destroy their life.
There’s benefit to all in preventing that.
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I keep getting the impression that with harm reduction the most at risk of harm are being ignored.
The SACAT Act is basically unusable – very long delays in having someone placed under the act and then there won’t be an inpatient bed for them anyway.
And a four month – and growing – waiting list at the Kari Centre doesn’t suggest any urgency on the part of the government to put funding where it is most needed.
So the chances of a young person at very serious of harm from drugs getting the help they need is almost zero.
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In Auckand the child and adolescent community mental health service - the Kari Centre - currently has a 4 month waiting list to be seen.
Harm reduction should include adequate provision of mental health services for those most at risk but the government continues to starve acute care of resources.
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Hard News: An unhelpful column about cannabis, in reply to Simon Armstrong,
Is drug abuse the same as addiction? Synthetic weed didn’t seem that addictive but caused a shed load of mental health issues within my family.
Good point. Synthetics and Meth are unlike most other drugs in that any level of use has high probability of producing dangerous situations for both the user and others.
Addiction should be seen as a quite seperate issue to that of using a drug that produces anti- social behaviours as part of its intrinsic effect.
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Some thoughts on mental health and drugs and alcohol.
- having mental health and addiction lumped together as one service makes no sense and is counter productive. There is some overlap - dual diagnosis - but they are quite different specialties. It’s a bit like having a Diabetes and Asthma Service.
- there is still no well established process for detox from severe meth binges. CMDHB has some dedicated facilities but that’s a rarity. Detoxing from meth often poses major risks to others which health services have not provided resources to deal with safely.
- there’s a huge issue with people who have addiction issues and who for various reasons will not engage with agencies such as CADS and continue to destroy their lives and often the lives of those around them. Parents and friends are increasingly approaching mental health services wanting services to require their loved ones to undergo treatment only to be informed that there is very little option for mental health services to intervene in some ones life if they do not agree to it. The Substance Addiction (Compulsory Assessment and Treatment Act) is very difficult to action and there is only one secure facility available. It is also taken pretty much word for word from the Mental Health Act - which the government wants to replace with a competency based formulation which will make treating people against their will even harder. That change will inevitably flow on to the SAC act . It’s a conversation about risk vs rights that the government is not involving the broader public in - rather they are listening to small, vocal lobby groups.