Mental Health Patient

01 Aug 2007 questionsarchive

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

The Hon. J.M.A. LENSINK: I received an email on 18 July from a constituent who is understandably frustrated with his dealings with the mental health system, and I subsequently wrote to the minister on 24 July, and I appreciate the acknowledgment. The details of this case are as follows, and I quote from his email:

On the 11th of July my brother was detained by his doctor and put in the Adelaide hospital. He was detained till Friday the 13th of July and then released to go home. On Saturday the 14th of July I visited my brother and I found him not that well but put it down to medication still to kick in. . . Sunday the 15th I had my brother help me with some work I was doing and found him to be very aggressive and threatening, he made threats against myself and others that were in the area, at that time I rang the eastern MAC number and had a recorded message, stating to leave a message and they will get back to me, but if it is urgent ring the ACIS number, which I did and was told that he was a client of eastern MAC, there was nothing the ACIS team can do for me and they will try to get someone from the eastern MAC team to call me back.

He then received a call from the eastern MAC team and had some disagreements about medication and his assessment of potential threats of violence as opposed to that of the person from the MAC team. He continues:

. . . normally when he gets to this point, he is not far from causing some damage or hurting people. . . when he threatens me he is well and truly off the rails and he had threatened to come and break my door at home and cause damage. She [that is, the person from Eastern MAC] asked if I called the police and I told her that they suggested that I call Eastern MAC. I then asked that they acknowledge my concerns and she told me that she would talk to the doctor on Monday. I then left it with [the person] and hoped that there would be some action taken by the Eastern MAC team. Well, there was no action taken at all, as I discovered this morning when I rang for some answers.

On Tuesday night 17 July my brother made good on his threats and broke into my home while we were not home at the time. Using a pick axe he broke through the door and caused approximately $5 000 damage to my property. I then was alerted by the police that my brother presented himself to James Nash House that day and asked to be committed and he was sent away.

The Hon. R.D. Lawson interjecting:

The Hon. J.M.A. LENSINK: Indeed. He went on saying that he spoke to a person at James Nash House, who did not know about the calls to the MAC team. He continues:

I also was told that they were going to see him today because there was a doctor available. My concerns are that if I was home with my wife and 14 month old son there could [have] been an injury or death to any one of my family and if the Eastern MAC team had acted on my concerns on Sunday and got my brother help or even on Tuesday morning when he presented himself to James Nash House there would be no damage to my house or there would be no other victim in the city as well as my brother now having to face charges.

He continues on. My questions for the minister are:

1. How is a situation like this allowed to happen?

2. Are the agencies actually talking to each other so that these sorts of events do not happen (because I get at least one of these serious issues a week)?

The Hon. G.E. GAGO(Minister for Mental Health and Substance Abuse): I thank the honourable member for her question. The honourable member is well aware that I will not discuss individual cases here in this chamber. These people are often our most vulnerable, and I have said on many previous occasions that I will not discuss individual cases in this chamber. The honourable member has, in the past, cooperated with that. She writes to me regularly on a number of matters, and she would also be well aware that I respond in a timely and comprehensive manner to any of her inquiries in terms of requesting information or regarding explanations or complaints about services. The honourable member also knows that I regularly brief her on a range of mental health cases—in particular on cases that pertain to individuals—and in the past have provided, and will continue to provide, briefings to ensure that any concerns she or her constituents may have are responded to and acted upon. I have done that, as I said, in a very timely way in the past, and the honourable member would have to acknowledge that.

In this particular case the honourable member says she wrote to me on 24 July. I am not absolutely sure of this. The honourable member says we have acknowledged this correspondence but, obviously, she has not received our reply as yet. As always, any individual case or concern raised requires a full investigation and response, and that will occur.

I do not know the details of this particular case; there is an incident we are investigating at the moment but I am not sure whether or not it is the same one. Given that the honourable member only wrote to me on 24 July, and it is 1 August today, I believe that it is reasonable that she allows us, as we have in the past, to investigate fully and thoroughly any concerns that she raises and to respond appropriately.

The Hon. J.M.A. LENSINK: What assurances can the minister give me that James Nash House, ACIS, MAC and the police have any systems that talk to each other which might reassure constituents who keep ringing me and telling me about these problems?

The Hon. G.E. GAGO: That is a separate question again.

The honourable member knows that we do operate a memorandum of understanding, which involves both our police and also our ambulance services. We know that the government is indeed very much committed to affirming the rights of those with mental illness, as well as upholding the community’s expectation in terms of services and care. We are planning to introduce legislation to reform arrangements involving transportation and a response to the mentally ill who are involved in an incident or public disturbance, and that legislation is well under way.

In 2006, there was a review of the previous 2000 emergency services memorandum of understanding in regard to transportation of people with mental illness, including those who displayed behaviours of concern requiring health assessment. In February 2006, a steering committee, representing mental health services, SAPOL, SA Ambulance and also the Royal Flying Doctor Service, was convened and undertook a review process, and from that process a further memorandum of understanding was developed to reflect current practices.

The new MOU was signed by the chief executives of the four partner agencies in June 2006. This current MOU includes agreed communication processes that reduces the risks and improves safety for the individuals and the workers involved, and also for the broader community. There is an agreement regarding the use of standard documentation and communication processes to facilitate transfer of care between agencies that will help provide consistencies and, again, further streamline procedures. That was identified by the partners. The means of communication was considered a major issue, so that has all been redesigned.

The memorandum took effect on September 2006 and has been supported by ongoing training, monitoring and evaluation.

It has also been supported by the establishment of local liaison groups across the state: police, ambulance, mental health and emergency department staff all meet together on a regular basis. Additionally, there is the provision of other key stakeholders who participate in these meetings, involving, for instance, GPs, some consumers, carers and other agencies, such as Disability SA and Drug and Alcohol Services SA. The aim is to assist consumers and partners in working together to resolve issues in an efficient way.

Additionally, the local liaison groups have the provision to develop case management plans for working with persons who have complex needs.

So, as you can see, quite a deal of work has been done in bringing those partners together—the police, Flying Doctor, ambulance services—and they continue to work together to refine those practices so that they are able to reduce duplication, streamline communication and provide efficient and effective services in a timely way.

The Hon. J.M.A. LENSINK: I have a supplementary question. Is the minister confident that the MOU is working?

The Hon. G.E. GAGO: Those relationships continue to evolve and are refined, and they continue to develop and improve. I think it is a continuum of improvement. It is continually being evaluated and updated. Where improvements are identified, they are incorporated and adapted, as they should be.