Hard News: Dirty Politics
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Neil, in reply to
What you said is that the police can arrest someone who commits a crime. And they don’t have to follow thru with prosecuting them. That wouldn’t change under the proposals.
At present though the Police do not have to charge some one with an offense in order to detain them and have them assessed by mental health services if they believe there is a mental health issue involved.
Possible changes to the Act could remove that option leaving the police to deal with it as a legal issue not a mental health issue.
The next problem would be if some one was charged for an offence committed because of mental illness and they refused treatment - what should happen? They continue through the criminal justice system possibly to prison?
I don’t think there’s any non- controversial solution to these sorts of dilemmas but at present I’m seeing quite a lot of “mental health act takes away peoples’ rights” without any discussion of the possible consequences of not having the act.
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Neil,
Also, if the police cannot have someone assessed by a mental health team they then have no basis on which to drop charges as they themselves are not able to undertake a mental health assessment to determine if a mental health issue was involved or not. That they can’t is of course a deliberate safeguard.
At present someone can only be placed under the act if they have a mental disorder AND they are either a risk to themselves or to others or both. Treatment has to be provided in the least restrictive manner possible.
A very small percentage of people with mental health issues are placed under the act and most often for short periods of time. The high risks that a small number of people face will not go away if there is no compulsory assessment and treatment and could very well be exacerbated by such a move.
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steven crawford, in reply to
Also, if the police cannot have someone assessed by a mental health team they then have no basis on which to drop charges as they themselves are not able to undertake a mental health assessment to determine if a mental health issue was involved or not. That they can’t is of course a deliberate safeguard.
The police can drop charges by just dropping the charges! whats so hard to understand about that? If someone commits a criminal offence the police can arrest them, they can detain them, they can get an approval from the courts to remand them to a hospital. They do not have to follow thru with a prosecution! That will not change.
What will change is the police will not be allowed to pull someone up who is known to have a mental illness, and detain them just because. Can you see how that might help someone with a history of mental illness to not feel picked on? and how they might try even harder not to commit any criminal offence? How they might feel more inclined to take more responsibility for their own mental health? It might even help them to feel less anxious about asking for help.
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Moz, in reply to
the police will not be allowed to pull someone up who is known to have a mental illness, and detain them just because.
So the mental illness is a get out of custody free card that the rest of us don't have? The legal system is full of pretexts that allow the plod to arrest almost anyone any time they like. The fact they don't is "discretion" and allows things like the hugely disproportionate rate at which Maori and poor are arrested compared to, say, all the dope smokers in suits along Lampton Quay.
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steven crawford, in reply to
So the mental illness is a get out of custody free card that the rest of us don’t have?
No of coarse it’s not..
But mental illness alone, should not be used as the reason to deny someone the same liberty as the rest of us do. Thats the crux of the argument here. It’s got nothing to do with your rights, or mine. Unless you are subject to forced treatment under the relevant parts of the mental heath act thats in dispute.
I don't know how it all overlaps with insanity as in the criminal justice system.
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Moz, in reply to
I don’t know how it all overlaps with insanity as in the criminal justice system.
It doesn't, the legal system is inherently incapable of recognising its own insanity.
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steven crawford, in reply to
Yep, I’m going to go and do some proper old fashioned reading about these things. It’s a significant issue no mater what the personal stance. I have an extended family member who has been on a constant cycle of needing to be taken to hospital by the police for treatment, then when he gets well he starts fighting for his autonomy again, until the next major episode. There must be some middle ground somewhere.
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Neil, in reply to
The police can drop charges by just dropping the charges! whats so hard to understand about that? If someone commits a criminal offence the police can arrest them, they can detain them, they can get an approval from the courts to remand them to a hospital. They do not have to follow thru with a prosecution! That will not change.
There would have to be some new legal provision for a court to remand someone to a mental health unit without any form of assessment by a mental health team. I think most would agree the justice system shouldn’t have such power.
Perhaps I’m not making myself clear. I’m supposing a possible repeal of the Act and consequent loss of compulsory assessment and treatment. The consequences of that would be the justice system would have no ability to detain someone for the purpose of having mental health assessment or treatment. A person with a mental health issue may just get stuck in the criminal justice system.
The UK mental health act has just recently been reviewed and has some worthwhile consideration of such issues:
We considered carefully whether we should rule out the use of detention where a person has capacity to consent to their admission, but does not consent. We recognise that there are human rights arguments in favour of this, but we do not think that those arguments are strong enough for such a large change at this stage. We think that a much greater debate is needed, involving service users, to see whether society is willing to accept the consequences of someone’s refusal to be admitted, especially where the consequence is the person’s death. The debate also needs to consider whether a person’s right to refuse to be admitted is given greater weight than the risk that the person might pose to other people.
(pg 112)
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Neil, in reply to
I have an extended family member who has been on a constant cycle of needing to be taken to hospital by the police for treatment, then when he gets well he starts fighting for his autonomy again, until the next major episode. There must be some middle ground somewhere.
Not uncommon. I’ve seen it quite a few times. People come into hospital, get well, go home, stop taking medication, get unwell, back into hospital. With illnesses such as psychosis every episode of unwellness reduces future functionality and reduces the effectiveness of medication so repeated cycles are very damaging over and above immediate consequences.
More funding to community mental health teams to resource more active outreach and crisis intervention is much needed. That’s essentially what the UK review concluded – the way to reduce compulsory treatment isn’t to change the law but to properly fund acute community mental health teams. Something our government isn’t currently proposing.
There’s a community team called ACOS – which is an assertive outreach team that can check in on people every day and spend decent periods of time with them. That service could easily be expanded to cover not just the most difficult cases they presently deal with.
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Neil,
Overall I tend to suspect the the govt may be replicating the Kiwibuild debacle with mental health – trying to throw $2b at a sector in desperate need but which they know little about.
The inquiry skipped along the surface of the most fundamental issues such as risk vs autonomy and ignored those who urgently need more resources – those with the most severe mental health issues who are the most vulnerable.
From the UK review:
We have heard many anecdotal reports that, over time, there has been a shift in the perception of what is ‘acceptable risk’ among professionals, which may have contributed to the rise in the use of the MHA. This appears to have been driven by professionals’ fears – often arising from court cases – that a decision not to detain someone, or to allow them out from hospital whilst under their care, may lead to serious incidents and, at the most extreme, deaths, resulting in a subsequent summons to a coroner’s court to defend their decision.
This probably is true for Orange Tamariki as well – people at the coal face are petrified of legal consequences of making the wrong judgment call.
The UK review is very good but I feel the big problem with it will be it gives two types of solutions – one expensive and try other not so. I doubt any government will opt for the most expensive.
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John Farrell, in reply to
"Kiwibuild debacle" - sounds like you have swallowed the National party line on this........what is wrong with trying to increase the number of houses available?
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Sacha, in reply to
those who urgently need more resources – those with the most severe mental health issues
And that is exactly the belief the govt has had to work around to get funding into supporting people in more widespread mental distress. You asked earlier why they weren't just channelling funds into existing organisations and networks.
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I'm confused. Is the government "ignoring those in most need", or is it "throwing money at" mental health? It seems a difficult combination to pull off.
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Moz, in reply to
“Kiwibuild debacle” – sounds like you have swallowed the National party line on this
The rule is that any government programme that succeeds is obvious and what the opposition would have done were they accorded the respect they desrve; and any programme that fails is a complete debacle, entirely the fault of the relevant minister (who should resign) and also symptomatic of the failings of the government in general.
(insert National, Labour or whatever as appropriate).
The above pretty much summarises what is wrong with modern parliamentary politics. It doesn't matter how good an idea is, or even if it was longstanding policy of the opposition when they formed the previous government and all that remains is to pass the bill they introduced to implement it, now that it is those morons in charge the bill will be opposed and if possible voted down.
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