19 May 2017

The NSW Mental Health Commission should be granted complete access to mental health system data so that it can increase the accountability of services provided to people who experience mental illness, the NSW Mental Health Commissioner Mr John Feneley said today.

Mr Feneley’s comments come as the NSW Government prepares to review seclusion, restraint and observations practices across the NSW mental health system. The terms of reference for the review are expected to be released soon.

Mr Feneley said he welcomed the inclusion of a Commission representative, Deputy Commissioner Dr Robyn Shields AM, in a panel of experts appointed by the Government to conduct the review, which follows the release of disturbing video footage of events leading to the death of Ms Miriam Merten at Lismore Hospital in 2014, after an episode of seclusion.

However, he said, “I am disappointed that in announcing the review the Ministers for Health and Mental Health did not meet with the Commission or seek its advice. Our mandate is to act as an independent authority working to get the best outcomes for people affected by mental illness.

‘Since the review was announced the Commission has worked behind the scenes to influence its scope and terms of reference. It is now essential that the Commission speaks publicly on this issue, which is central to the quality and safety of our mental health system and the confidence that people requiring care, their loved ones and the community can have in it. ”

The Commission was established as an independent statutory agency by an Act of Parliament in 2012, following an election commitment by the Coalition Government. Its creation recognises the particular vulnerabilities of people who have a mental illness and the need to ensure the mental health system responds respectfully to them. The Commission has a statutory function to monitor, review and improve mental health services in NSW and is able to report to Parliament.

“If not satisfied with the outcomes of the announced review, the Commission can prepare its own report to Parliament on the issue,” Mr Feneley said. “However, currently it has no statutory powers to intervene or require Government agencies to produce information

“In the aftermath of Ms Merten’s death, the Government should ensure that the Commission has full access to NSW mental health system data and critical incident reports to enable it to perform its statutory functions. This issue, and that of the Commission’s power to act, need to be addressed in the forthcoming five year review of the Commission’s legislation.”

In addition the Government should consider immediate steps to strengthen the role of the Chief Psychiatrist, by giving this office additional responsibility for the quality and safety of mental health services, said Mr Feneley. “This would bring the office into alignment with other states and give the community greater confidence that appropriate clinical quality and safety standards will be established and maintained across the mental health system,” he said.

Mr Feneley said use of seclusion, restraint, and other coercive and restrictive practices in mental health units was recognised as traumatising and counter-therapeutic. “These practices may be partly a result of inadequate resourcing, if nurses are not able to give appropriate attention to a person to help them feel safe and to reduce their distress,” he said. “They may also be a result of poor culture, in which people's distress is ignored or discounted. Neither explanation is acceptable, and the Government must firmly commit first to reduce and then as far as possible to eliminate these practices.”

“As this review takes shape I keep in mind Ms Merten, whose privacy and dignity were further compromised after her death by the broadcast of the shocking images of her final hours. This can only be justified if it is a catalyst for real improvement in the quality, safety and accountability of mental health services and I will do everything in my power to ensure the outcome of this review honours her memory,” Mr Feneley said.

Mr Feneley noted that the footage of Ms Merten would inevitably cause distress for people who themselves had undergone seclusion or other traumatic mental health treatments. “I hope people with a lived experience of mental health problems, and others who have been distressed by these devastating images, will seek support and be respectfully heard by the services they approach,” he said.

Dr Shields is a registrar in psychiatry, who was appointed in 2012 as a Deputy Commissioner. She has a distinguished history of advocating for and on behalf of disadvantaged groups within the mental health system, in particular Aboriginal people and people in contact with the criminal justice system.

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Last updated: 28 June 2017