The reason the Richmond recommendations failed

Callan Park NSW

The reason the Richmond recommendations failed is because the supported community accommodation and therapeutic programs that were envisaged as replacing the nut houses were never funded, unlike in the Scandinavian countries Richmond studied during his inquiry and which have had a very successful experience of psychiatric deinstitutionalisation.

Whether you keep people designated 'mentally ill' bombed out on zombie pills in prisons, locked hospital wards, secure psychiatric institutions or immigration detention centres you are writing a blank cheque for their abuse.

I suspect that most victims don't particularly distinguish between the type of institutions that abuse them or whether they should be calling their abusers 'doctor' or 'warden'.

Philip Mitchell's suggestion that moving the Long Bay loonie bin less than 100 metres will somehow make a difference to the treatment of forensic prisoners is ludicrous.

As Mark Brown of Melbourne Uni points out in 'We are neutral therapists', prison psychiatrists and psychologists are at least as abusive towards their charges as are prison officers.

If "the 1980s were ... a different kind of community" its because now Big Pharma is a much more powerful and organised lobby group than it was then. Because antipsychotics are used primarily to control patients - not treat mental illness - the drug companies have a major interest in keeping as many people in institutions and 'managed' with their pills as possible.

Those companies also fund the organisations and research projects.

Drug company funding is also behind the resurgence in the utterly debunked tabloid portrayal of the mentally ill as dangerous that is exploited them.

There are about 2000 murders in Australia over six years so if only 30 (1.5%) are committed by the mentally ill - who make up at least 5% of the population - that suggests that the mentally ill are less than one third as likely as the healthy to kill someone.

Studies on schizophrenia and violent offending fail to control for the way the legal culture interacts with these sorts of offences.

If you are up on charges and mentally ill you are less likely to mount a competent defence and more likely to be convicted.

If you do *not* have a pre-existing diagnosis of mental illness you are more likely to end up with one if you are up on violent offence charges - especially if you let your lawyer run your case.

Lets not forget that it was a NSW psychiatric hospital that Cornelia Rau was running from when she ended up in Baxter.

To the psychiatric industry, the problem isn't that Ms Rau found it so abusive that she needed to run from it, but rather that she was able to escape.

She must be very grateful to Bob Ellis for busting her out of Glenside instead of just exploiting her situation for his own narrow agenda as everyone else seems determined to do.

More emergency mental health beds? Sure. We need more emergency beds of all kinds in our health system.

What we *don't* need is an extension of the mental health gulag that already keeps far too many Australians out of sight and bombed out of their minds.

Some people want to remain anonymous

The federal attorney-general has suggested that two women wrongfully detained by the Immigration Department could have avoided being locked up if they had cooperated more with authorities.

By Reader Posted 18 July 05

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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.

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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."

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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.

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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.

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Detention Centres, Solitary Confinement
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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.

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

Related:

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.

JAILS AND PRISONS - THE NEW ASYLUMS:
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.

Fiona Stanley, the children's crusader

It is all about prevention. As Fiona Stanley sees it, with one in five Australian teenagers experiencing significant mental health problems, there are just not enough treatment services to cope with the demand.

Instead, resources must be focused on preventing these illnesses from developing, intervening in a child's life before they sink into mental illness or become lost in a life of crime.

In the tried and true tradition of seatbelt education campaigns, HIV/AIDS awareness and Slip, Slop, Slap skin cancer prevention, Professor Stanley, the new Australian of the Year, wants mental health firmly on the preventative public health agenda.

It is a campaign she'll begin from an almost standing start, despite the quality research her Perth-based Telethon Institute for Child Health Research has produced over the past decade.

Public health spending on mental health in Australia is stuck at 6 per cent - less than half the rate of governments in Britain, Canada and New Zealand.

And in NSW, 20 years after the Richmond report into mental health services in NSW recommended "deinstitutionalisation", the state still lacks adequate community and family support services to care for those with mental illnesses outside institutions.

"I don't think we are overstating the point," Stanley says. "Children and adolescents are experiencing significant psychosis, schizophrenia, depression, anxiety - the rates in Australia are rising the same as they are in every country in the Western world."

Stanley says, with some incredulity, that it has only been in the past 20 years that we stopped relying on death certificates as a measure of our health. Take attempted and completed suicide as an example: more males commit suicide, more females attempt it. "Death certificates don't measure that," Stanley says.

What they do measure is falling children's death rates, but this alone is a poor indicator of health. "When we start to look at mental health, we have been shattered by the high levels."

Stanley is an epidemiologist - she measures, describes and explains the occurrence of disease in populations, using the data to argue for the enhancement of health and wellbeing in the community.

She points to several key, marked changes in our society over the past 50 years that have influenced the mental wellbeing of children. Divorce is an obvious one. In the 1950s, less than 10 per cent of marriages involving children ended in divorce - now that rate is nearly half. "At any age that has a major impact on children, because of the kinds of things that lead to divorce ... and the aftermath, the blended families," she says.

Stanley also highlights the significant changes in the distribution of wealth, education opportunities, access to technology, living conditions, and employment opportunities.

There has also been the "rise of the individual and the downgrading of children", she says. There is less community support, less social capital. "Government services and non-government organisations are struggling to handle the numbers of children who are in crisis. That is what I will be preaching this year - we have to put some emphasis on preventing these problems in our society."

You won't find many who disagree with Stanley. From pediatricians to mental health experts, the warnings are the same. Professor Ian Hickie, chairman of the Melbourne-based national depression initiative beyondblue, says there has been great progress in the control of physical illnesses in children and adolescents. "Now the big problem is mental health, which has been a neglected area for so long," Hickie says.

While rates of depression in old people have fallen because of improving physical health, anxiety and depression, suicide rates and alcohol and drug use have increased unchecked in children and adolescents, he says. "We need to focus on the more complex issues around social networks ... disconnected communities and more pressures on parenting. For children, the focus on educational success gets out of proportion with other issues."

Both Stanley and Hickie push the concept of early intervention - not just for children with mental illnesses, but for those on the edge of the criminal justice system."Kids in trouble ... are the worst served by our current mental health system," Hickie says.

For Michael Sawyer, professor of child and adolescent psychiatry at the University of Adelaide, the high prevalence of mental illness among young people must be tackled in the same way infectious diseases were 100 years ago.

"It involves interventions on a number of levels - with infectious diseases that meant looking at housing, sanitation, education ... and when you improved those things, you got infectious diseases under control."Mental health problems require a similar range of interventions," he says.

Sawyer warns that children with significant health problems, such as diabetes or asthma, are also at increased risk of developing mental illnesses. "Whatever the case, it is a prevalent condition that causes a substantial amount of distress, which is why it is so important to improve our prevention programs," he says.

Last year Stanley took on the role of chief executive officer at the newly-formed Australian Research Alliance for Children and Youth. There are high hopes for the alliance, which will focus on all health problems, from brain development, early childhood issues and education, to crime prevention and early intervention at a child's first contact with criminal justice system. "If you want a future, if you want to compete as a knowledge-based nation ... you cannot have one in five kids going off the rails, because that is one in five future parents going off the rails."

There is a confidence among her colleagues that the alliance, with Stanley at the helm, will succeed. Science and medicine are in her blood. Her husband, Professor Geoffrey Shellam, holds the microbiology chair her father Neville created at the University of Western Australia. Her brother is a top scientist in the US, her sister is an associate professor in veterinary sciences, also in the US.

Born in Sydney in 1946, Stanley moved to Perth with her family in 1956 and later studied medicine at the University of Western Australia. But it was the field of epidemiology that grabbed her - lifting her from the depression that set in after seeing little improvement in basic health standards in the two years she worked in Aboriginal health.

Along with a colleague, Stanley first showed that a maternal diet rich in folic acid can prevent spina bifida in babies. She also found that cerebral palsy is due not so much to birth trauma, as previously thought, as to other factors such as infections or blood incompatibilities. "[Epidemiology] taught me how to use research to improve social justice - that is a pretty powerful thing," she says.

It was one of the institute's first studies on childhood mental health in 1992 that next caught her attention. Eighteen per cent of males and 15 per cent of females reported experiencing mental illness. But only 3 per cent of those teenagers were getting access to assistance. "Are we going to keep on blaming schools for the problems in our children, or are we as a society ... going to take responsibility for preventing these illnesses?" Stanley says."We want to say this is a priority for the nation, that it is more important than anything else."

Twelve months as Australian of the Year should give her the best chance she's had so far to shine the light on one of health's most neglected areas.

A project that goes beyond the personal

Secondary schools are obvious sites for health promotion, holding a captive audience of adolescents who can experience traumas arising from activities such as substance abuse and risky sexual behaviour as they pass through the grades.

One Melbourne-based program has tried to move health promotion in schools beyond the personal to create more supportive environments and strengthen community action and advocacy.

The Gatehouse Project, run in 26 Victorian schools, has achieved remarkable results, says Professor George Patton, from the Centre for Adolescent Health at the Royal Children's Hospital in Melbourne.

"The reductions in tobacco use, binge drinking, socially disruptive behaviour and early initiation of sexual intercourse were of the order of 20 per cent to 30 per cent," Patton says. "It was a new approach - it wasn't health, it wasn't education, it was a combination. The new problems that are facing children and youth are complex in their origin; they will demand communities of all kinds pulling together - schools, families and local neighbourhoods."

The aim of the project was to work out how schools could better respond to and prevent mental illnesses, Patton says. Students were surveyed about their beliefs around security, communication and participation, looking at issues such as bullying, social support and attitudes to school. They were also asked about tobacco, alcohol and other drugs, theft, violence and sex, depression and self-harm.

It was then up to the schools to review the survey reports and introduce strategies to meet their needs.

An adolescent health team was established in each school, made up of school staff and representatives from external health agencies.

Among the strategies implemented were guidelines for the prevention of bullying, mentoring and peer-support programs, Patton says. "It represents a promising new direction for school health promotion work," he says.

Lucky Door Prize

Close your eyes.
What can you see?
Nothing?
So without you there is no beauty.
Then Repeat After Me!
You're nearly as good-looking as I am!
Go on tell your friends..You're nearly as good looking as I am.
Because I am special to me and everyone else is equal to me.

LUCKY!

By The Children January 29 2003

THE EGG: Thanks

Related:

Parents call for feedback on social skills
Parents are calling for the same level of feedback on their children's social development as on their academic progress, according to a national survey.

Call to update suicide prevention strategy: study
A four-year study of suicides by people under the age of 18 in New South Wales, has found little difference between rates of suicide in rural and regional areas and cities.

NSW prisons - primary industry bailed up!
In many quiet regional centres around NSW there is a new primary industry shaping up. It has something to do with Bail but not with bales. The minister for Agriculture Richard Amery who also has the prisons portfolio is now committed to farming prisoners.

NSW police cracked up on antisocial behaviour
Hundreds of extra police will be on the streets of Sydney from this afternoon as part of a major blitz on crime and activities as "antisocial behaviour" says the ABC online last Fri 24 May 2002.

Alcohol is just the beginning
People who start using alcohol by their mid teens are more than twice as likely as others to experiment with different drugs and to become dependent on drugs a major Australian study has found.

RESTORING TRUE JUSTICE:
Australian prisons are fast becoming the new asylums of the third millennium. The prison industry is booming, while Australia spends far less on mental health services than similar countries.

The punishment: Is the 'crime'
The punishment is the crime according to retired chief Justice of the Family Court of Australia Justice Alistair Nicholson. "Smacking a child ought to be seen as assault".

This is not how you eat 'antisocial behaviour'
Process corruption, perjury, planting of evidence, verbals, fabricated confessions, denial of suspects rights, a solicitor to induce confessions, tampering with electronic recording equipment, framing. Generally green lighting crime, and I say Murder, including the kids who overdosed on heroin. No doubt.

The Seed
Respect, you only get out what you have put in. What about Life Skills, Communication and Conflict Resolution. Evolution, perhaps some children and adults miss the whole or part of the course. I did, and so how surprised do you think I was when I realised my parents missed the course as well. Things like Compromise, Win Win, Empathy, and Love. Invisible energy and other skills like public speaking, how to Relate, Assuming, Blaming, Forgiveness, Freedom and Discrimination. This is how I learned respect. If you don't know what it is then how do you relate?

Youth Suicide
I would like to suggest firstly that starting at the root in a holistic pattern so that everyone in our community is included and a seed is planted to prevent our youth dying.

The Tree of Dreams
Come make a wish. I know it will come true, it did for me...