Saturday, July 16, 2005

Time to get mentally ill out of jails

"The process had gone too far" Professor Paul Mullen

LEADING psychiatrists have admitted that a 20-year policy of treating mental patients in the community has failed.

The psychiatrists are demanding a radical review of mental healthcare, claiming prisons have replaced asylums as holding centres for the mentally ill.

Those calling for a new approach include many of the architects of the current policy of deinstitutionalisation, which led to the closure of psychiatric wards and institutions around the country.

High on their list of priorities is the reopening of secure psychiatric wards and an increase in the number of medium and long-term beds for the mentally ill to take the pressure off prisons, which are ill-equipped to deal with the number of mentally ill inmates.

In the two decades since the influential Richmond Report recommended deinstitutionalising mental healthcare, the number of patients in psychiatric institutions has more than halved, from about 15,000 to 6000. The prison population more than doubled between 1986 and 2001 to more than 24,000 and now includes a high proportion of mentally ill prisoners.

A recent study by Corrections Health Service found that 74per cent of prisoners in NSW suffered from a psychiatric disorder, with almost 10 per cent suffering symptoms of psychosis.

Former NSW corrective services commissioner Tony Vinson said, "The consistent testimony of frontline workers in corrections is that, increasingly, court proceedings and jail cells have replaced the longer-term mental healthcare of 30 years ago."

David Richmond, the author of the 1983 Richmond Report said, "that a new model" was needed.

"Fundamentally the planning and precepts of the 1980s were for a different kind of community," Professor Richmond said.

He called for more acute beds and supported accommodation, because his report had not taken into account radical changes in population growth, housing and employment structures in Australia, or the impact of illicit drugs.

A damning report from the Mental Health Council of Australia and the Human Rights and Equal Opportunity Commission, to be released in coming months, will expose "serious problems" and "failures of care" in facilities around the country.

In the past six years there have been at least 30 murders committed by mentally ill people and between 1999 and 2002 at least 20 people charged with murder were found not guilty in the Supreme Court on the grounds of mental illness.

In a Senate inquiry submission that pre-empts the report, the council says underfunding "undermined the (deinstitutionalisation) strategy from the beginning".

"(There are) serious concerns that, while the (psychiatric) institutions themselves have closed, institutionalisation of people with a mental illness has in fact been transferred to prison and detention systems or replaced with isolation within the community, for example through homelessness," the council says.

According to one NSW Health report, 12 per cent of prisoners are psychotic, 30 times the rate in the general community.

University of NSW head of psychiatry Philip Mitchell is planning NSW's response to the call for reform. He said a new secure hospital being built alongside Long Bay jail would take some seriously ill psychiatric patients out of the prison system.

"In NSW there is a process to open up more acute beds and sub-acute beds," he said.

"We're now recognising we've created some new problems with deinstitutionalisation."

One of Australia's foremost defenders of deinstitutionalisation, Monash University psychiatry professor Paul Mullen, said the process had gone too far.

"It was a well-meaning enthusiasm, an overenthusiasm, which shoved the whole thing to an extreme point," Professor Mullen said. "It's not a good thing that there are no locks and bolts now."

The push for reform of mental healthcare in Australia has been given added weight by the findings of the Palmer Inquiry into the wrongful detention of mentally ill Australian resident Cornelia Rau, which was released on Thursday. The report found the prisons system, the South Australian Health system and immigration detention centres failed to deal properly with psychiatric patients such as Ms Rau.

The calls for reform follow recent moves in the US to open new mental facilities after decades of deinstitutionalisation.

NSW chairwoman of the Royal Australian and New Zealand College of Psychiatrists Louise Newman said there was consensus among mental health experts there needed to be a limited reopening of new psychiatric institutions, but not a return to traditional asylums.

"We're seeing more drug-affected and mentally ill people presenting at hospitals. There's a real need for a place to keep them secure and safe and protect the community," she said.

Both Dr Newman and Professor Mullen said bed shortages for psychiatric patients were chronic.

Australian Bureau of Statistics census data shows a rapid drop in institutionalisation from the mid-1980s. On census night in 1986 there were 14,855 patients in psychiatric hospitals or institutions, by 1996 this had dropped to 11,745 and by 2001 to 6092.

"Some people simply need long-term stable and supportive living arrangements if they are to keep out of harm's way and avoid being pushed, for want of other options, into lock-ups and jails."

The NSW Justice Health Service's latest figures on prison admissions show that more than one-third (38 per cent) of inmates sentenced suffer a mental disorder.

An Australian-first study by Professor Mullen, published in the American Journal of Psychiatry last year, found sufferers of schizophrenia were more than twice as likely to be convicted of violent crime than the general population.

The Mental Health Council's unpublished report found 1000 NSW prisoners had a serious mental illness.

"We have all the indications of a serious crisis in this area," council chief executive John Mendoza said. "There is a case for clinical care in long-term residential settings for those with a chronic mental illness."

States such as Victoria and Western Australia are leading the way by building residential care facilities.

By Simon Kearney and Adam Cresswell 16 July 05


The New Asylums
US: Fewer than 55,000 Americans currently receive treatment in psychiatric hospitals. Meanwhile, almost 10 times that number -- nearly 500,000 -- mentally ill men and women are serving time in U.S. jails and prisons.

Nearly 500,000 mentally ill men and women are now locked up in America's jails and prisons. That's 10 times the number who remain in its psychiatric hospitals.

Submission to Senate: Inquiry into Mental Health 2005
We appreciate that the urgent issues of Human Rights and other abuses including institutionalisation and the use of force, and the lack of progress on Burdekin are being examined by the Committee.

Mental Treatment and Pharmacy Profit $$$$$
Mentally ill patients are being kept in solitary confinement within maximum security NSW prisons as punishment, against the most basic principles of human rights law.

'Killing Rational' and Prisoner Control in NSW
Dear Justice Action, I'm writing to you regarding xxxx, he has rung me a few times in the past weeks and has been drugged to the max, he rang today twice and could hardly speak to me, he said he was going to ring you and talk to you about it but he couldn't so I told him I would get in contact with you and see what you could do! He has told them he doesn't want the sedatives but they hold him down and give it to him anyway, they have drugged him 4 times in the last 2 days he said.

Mental Health Tribunal recommendations on forensic inmates
Below is the answer we have received from the Minister for Health regarding prisoners recommended for parole or release by the Mental Health Tribunal FYI

Death in custody: In memory of Scott Simpson
Scott Simpson 34 died in custody on 7 June 2004 leaving behind a child. It is alleged that he hanged himself in a segregation yard at Long Bay Prison Complex. Justice Action has reasons to believe that Scott had been mistreated from the time he was taken into custody and the subsequent events that ensued that led to his sad death. We think that his treatment may well have caused his death.

Doctor Ron Woodham I presume?
"Corrections Health staff provide medical care. However, its staff's authority is essentially limited to making recommendations to corrective services on treatment. Corrective services staff can then decide what treatment can be given."

Isolation, psychiatric treatment and prisoner' control
The 2003 NSW Corrections Health Service (now Justice Health) Report on Mental Illness Among NSW Prisoners states that the 12 month prevalence of any psychiatric disorder in prison is 74%, compared to 22% in the general community, and while this includes substance disorder the high rate cannot be attributed to that alone.

Call for royal commission into NSW prison health system
Mr Tony Ross a social justice activist said yesterday that a royal commission into the health system in NSW should be wide reaching to ensure that the Corrections Health Service is also exposed because of reported widespread cover ups in the prisons health system.

Watchdogs slaughtered in NSW
On Tuesday the Carr Government reduced transparency and accountability yet again and New South Wales is in danger of becoming entrenched with cronyism and intimidations with the Carr Labor Government that continues to slaughter the watchdogs.

Escape proof but not so the prisoners mind
Fewer prisoners escape from prison these days because they're "cemented in" by materials that do not break and by legislation that can keep prisoners in jail until they die.

Carr's Castle the real story H.R.M.U.The High Risk Management Unit Goulburn Correctional Centre. A prisoner writes, " I was unsuccessful in my letters to Dr Matthews CEO of the Corrections Health Service on my problem regarding air - claustrophobic effect the cells have on me. Just recently the management decided my injuries are not seriously affecting me so no further discussions are necessary.

Risdon prisoners' seize prison to protest mistreatment
Apparently one prisoner had been mistreated and held in isolation in an SHU (Segregation Housing Unit) [Solitary Confinement] because, he'd had and altercation with a screw. SHUs cause severe mental harm - regarded as torture - and are a cruel, inhumane and degrading way to keep prisoners.

No Safe Place
In a brief four month span from August 1999, five men died in Tasmania's Risdon prison. Their deaths have put the state's corrections system in the dock and led to the planned demolition of a jail which even the State's Attorney-General now calls an "appalling facility".

Association for the Prevention of Torture
The Optional Protocol requires 20 ratifications to enter into force. All States Parties to the UN Convention against Torture should seriously consider ratifying the OPCAT as soon as possible. National Institutions and others promoting the human rights of people deprived of their liberty need to be informed of their potential role as national preventive mechanisms under the OPCAT.

Corrected or Corrupted
A psychiatrist from the prison Mental Health Team attached to Queensland Health made the comment that 25 per cent of inmates suffer from a diagnosed mental illness.

ICOPA XI International Conference on Penal Abolition
We are excited to announce that ICOPA X1, the eleventh International Conference on Penal Abolition will happen in Tasmania, Australia from February 9 - 11,2006. Please pass this onto all networks.

Ex-Prisoner Locked Out of Prison
The NSW Department of Corrective Services (DCS) has revealed a policy which bans ex-prisoners from entering prisons.

Justice Action: Access to our community
NSW: Justice Action went to the NSW Supreme Court before the last Federal election on the constitutional right for prisoners to receive information for their vote. The government avoided the hearing by bringing prisoners' mobile polling booths forward. We pursued it after the election. This is the report.

Overhaul Department of Justice: Reform Group
WA: The Prison Reform Group of WA is calling for a complete overhaul of the Department of Justice following recent events which have compromised its integrity, placing prison staff, prisoners, their families and the community, at risk. We call for the Minister to publicly apologise for last week's debacle which has seen the public badly let down by the Department of Justice yet again.

Detention Centres, Solitary Confinement
On Friday night the NSW Council for Civil Liberties awarded Sydney solicitor John Marsden honorary life membership. Julian Burnside was invited to make the speech in Marsden's honour. In the course of his speech, Burnside referred to the unregulated use of solitary confinement in Australia's immigration detention centres, criticising it as inhumane and also as unlawful.

2nd Renaissance - Beyond Industrial Capitalism and Nation States Some Practicalities Of Emptying The Prisons [287] Given the importance that prisons and punishment have in maintaining control of increasingly restless populations, the task of achieving the release of the people in the jails and the closure of those institutions, seems daunting. But it is so vital to the 2nd Renaissance that we must find ways to do it.