Mental Health, Forensic Services

20 Sep 2006 questionsarchive

I seek leave to make an explanation before asking the Minister for Mental Health and Substance Abuse a question about forensic mental health services

The Hon. J.M.A. LENSINK: A number of items have been reported in the newspapers following the inquests into deaths in custody and other deaths of people within our mental health and correctional systems, and I wish to quote from some of those articles. On 23 August, it was reported in The Advertiser that a Ms Hodder had said that a Glenside psychiatrist, Dr John Clayer, had told police investigators that he had wanted to keep a particular person at Brentwood North but was overruled by the clinical director, because he allegedly wanted to clear beds in the unit. There also have been citations from Dr Ken O’Brien, the distinguished provider of psychiatric services within the forensic system, who said:

I think it is scandalous that there aren’t an adequate number of funded mental health nursing positions in South Australian gaols, and it is scandalous that most gaols do not have a psychologist and there is nothing resembling an adequate mental health service in our prisons.

On 5 September, a report appeared in The Advertiser in which the senior psychiatrist at the Glenside Hospital, Harry Hustig, gave evidence and, in doing so, criticised funding for the mental health system. A former medical officer at Glenside Hospital, Marion Drennan, highlighted problems in the mental health system. She said that the hospital was understaffed and her duties were ‘beyond the work of one person’.

She also said that more medical practitioners were needed in the wards, and she described social workers as being very stretched at times in meeting the demand. It was stated that the court heard that a review of the Mental Health Act was under way, which I am sure will give people much comfort.

In an article on 7 September in relation to one of the deaths, Dr Goh said that, if he had been given information about a particular client which included details of his hostile behaviour, it was likely that he would have requested a review of the detention order.

In today’s Advertiser there is a reference to that particular case, and Professor Robert Goldney, who compiled a report for the state government, was reported as saying that psychiatrists in the public health system were overworked, lacked time to assess properly patients who had committed crimes and ‘as soon as a patient’s case notes get to 15 centimetres in height, they should be reviewed and summarised by someone with sufficient experience’. What actions is the minister taking in relation to the disastrous system we have in this state?

The Hon. G.E. GAGO(Minister for Mental Health and Substance Abuse): Our Prison Health Service and the Forensic Mental Health Service are managed by the Central Northern Adelaide Health Service. Both these services continue to work together to develop better ways in which to manage prisoners with mental health problems. For example, the Prison Health Service and the Department for Correctional Services recently developed a joint high risk assessment team process whereby information is freely shared regarding prisoners at high risk. I understand that since the inception of the high risk assessment team the incidence of self-harm has reduced and communication between both services has improved. I have been advised that the Prison Health Service is currently working with the Department of Health to develop an integrated electronic health record, which will have connectivity with both the Department for Correctional Services and hospital patient record systems;

and, of course, we know how important it is to have better communication between the services.

Planning is also under way for a court liaison assessment process to provide early intervention for people identified with mental health problems during court processes; and also an emergency assessment and crisis intervention response for the watch-house and the Adelaide Remand Centre. An additional four forensic liaison mental health workers have been appointed recently by the Central Northern Adelaide Health Service. These workers will provide some prison inreach and outreach services. This is in addition to four forensic mental health nurses who perform community outreach work and work within the metropolitan prisons. I understand further work will be undertaken to look at the inreach needs for regional prisoners. As part of the COAG discussions on mental health initiatives, the needs of prisoners and parolees have been referred to specifically.

I also point out that there are now more psychiatrists employed in the system than ever before. There are now more employed than was the case a couple of years ago. In 2005 we were undergoing severe shortages of psychiatrists throughout the state. We have been able to successfully recruit a number, and the last report I received on the matter indicated that all positions were now filled. I also understand that we have more mental health workers employed than we had a couple of years ago. This government has put forward extra funding and employed a number of additional mental health workers, including workers to deal with co-morbidity issues; and we know how important that is.

A current analysis of our risk alerts has been completed, and we are about to introduce a new risk alert system that will go into the mental health record of all mental health patients.

It will be readily available for other mental health workers to easily access in order to determine the level of risk of that person and make responses more appropriate. A great deal has been done on this issue. It is a difficult and challenging area, but this government is committed to implementing improvements in our mental health services. Of course, we are also looking at transforming the whole of our mental health services, given the recent term of reference that has been given to the Social Inclusion Board. A great deal of work has been done there and we can expect further developments as well.

The Hon. J.M.A. LENSINK: By way of a supplementary question, from the strategies the minister has referred to, can she advise the council how many psychiatrists have been recruited since that incidence referred to in the Corner’s reports into Glenside and/or the forensic mental health system?

The Hon. G.E. GAGO: I am happy to bring those figures back to the council, as I do not have them in front of me at the moment.