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THE

REPORT

The OUR PICK Report accuses the Australian health industry of corruption and proposes the empowerment of mental health patients and prisoners to achieve effective delivery of services.

Proposal

l thatafixedpercentageof0.1%ofthementalhealthbudgetbesetaside asmandatoryfundingofindependentconsumergroups;

l thatthoseconsumergroupsbedemocraticallyresponsivetoconsumers’concerns,addressingissuesofgeneralimportance,fundingconsumer-directedresearchand interactingwithgovernmentpolicies;

l thatintheinterim,allserviceprovidersinthementalhealthindustry fundindependentconsumerfunctionswithapercentageoftheirbudgets.

LaunchedattheInternationalConferenceonPenalAbolitionICOPA13inBelfast onJune252010andintheForensicHospital,LongBay,SydneyonJuly1,2010.

July 2010ISBN:9780980672251(pbk.)NationalLibraryofAustraliaCataloguing-in-PublicationOffenderswithmentaldisabilities--Abuseof--Australia. Peoplewithmentaldisabilities--Abuseof--Australia. Healthfacilities--Complaintsagainst--Australia. Prisoners--Abuseof--Australia.DeweyNumber:362.20994

About our sponsorJUSTICEACTIONisfundedbythesocialenterpriseBREAKOUTDESIGNPRINTWEB,whichhasprovidedtopqualityprinting,designand webservicestounions,communitygroupsandcorporationssince1984.OfferworktoBREAKOUTatthesamepriceyouarenowpaying,and youwilladdstrengthtoJUSTICEACTION.Ordonatetohelpthework.www.breakout.net.auTelephone(02)92830123

TheOUR PICK

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REPORT CONFRONTING THE ABUSE OF “CARE” IN MENTAL HEALTH AND PRISONS

PublishedbyJUSTICEACTION Suite204,TradesHall 4GoulburnSt,SydneyNSW2000,AustraliaP.O.Box386Broadway,Sydney NSW2007,Australiawww.justiceaction.org.au ja@justiceaction.org.auTelephone: 61292830123

Fax: 61292830112

Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Proposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

SECTION 1: THE REALITIES OF MENTAL HEALTH CONSUMERS

LongBayLockdown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

BanonSmokinginHospitals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

CaseStudy:SaeedDezfouli . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

InvoluntaryInjection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

MentalHealthConsumersintheMedia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

TheJudicialSystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

SECTION 2: MECHANISMS FOR OPERATION IN PRACTICE

MentalHealthAct2007(NSW) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ConsumerandCarerOrganisations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

SECTION 3: KEY CHARTERS AND LEGISLATION

UNHighCommissionerforHumanRights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

UnitedNationsUniversalDeclarationofHumanRights(1948) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

UnitedNationsConventionontheRightsofPersonswithDisabilities(2007) . . . . . . . . . . . . 13

DisabilityDiscriminationAct1992(Cth) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

MentalHealthAct2007(NSW) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

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REPORT CONFRONTING THE ABUSE OF “CARE” IN MENTAL HEALTH AND PRISONS

IntroductionJusticeActiondecidedtofocusonthementalhealthareaafterithadbecomeapparentthatanewstrategywasrequiredtodefendcommunityinterestsandprisoners’rightsagainstthelawandtheaddedeffectsoftension,boredom,powerlessnessandisolationoccurringinimprisonment.Manyprisonersbecomeforensicpatientsorremaininprisonundermedication:theratesofmajormentalillnessinprisonshavebeenfoundtobethreetimeshigherthanthatofthegeneralpopulation.1

Inmentalhealththefocusisonmakingpatientswell,withouttheelementsofguiltandpunishmentwhileretainingstatecontrolofcitizens.Patients(consumers)2hadbeenaskingforourassistance,andwesawthechanceofaforwarddefenceformentalhealthpatients’rights.Ifwecouldnotdefendpatients’humanrightswhatchancehadwewithprisoners?Uponexaminationwediscoveredthatforensic(incarcerated)mentalhealthconsumersreceiveevenlessrespectfortheirdignityandhumanity.Inpracticeitisdefinitelybettertobebadthanmad.Lawyerswhohaveenticedclientswithapsychiatricdefencearecursedfromthedungeons.Inbothprisonsandmentalhealthwardsalmosteveryonesmokes,butitistheforensicconsumerswhohavelosttheirtobacco.Prisonersareregardedasnormalpeoplewhohavemademistakes,havetopayapenaltyandthenreturntotheirformerstatus.Forensicconsumershowever,aretreatedlikechildren,unabletotakeresponsibilityfordecision-makingsometimesfortherestoftheirlives,dependingontheirpsychiatricdiagnosis.Totalarbitrarycontrolcontrarytoconsumers’wishesiscloakedaseuphemismsofexpressionsofcare.Theindustry’sculturecreatesprofessionalslackingempathyforpatients;stumblingglassy-eyedhumansareseenaseffectiveworkpractice.3InthenewLongBayForensicHospital,allpatientsaremedicated.Patientresistanceisconstruedassickness.Theconsumerfocusinmentalhealthhasbeenhijacked.Statedrightshavebecomevaluelessinthefaceofthisculture.Externalserviceprovidersdependentongovernmentmoneyarepartoftheproblem.Patientsaredehumanisedandexploitedtoyieldbudgetsofover$205,000perforensicpatientperyear.Privacyandsecuritymeanhidingfromexamination.Visitorsarediscouragedandrefused.Socialsupportforpatientsisseenascausingdisturbancerather

1 AustralianInstituteofHealthandWelfare(2009)The Health of Australian Prisoners Report.2 Theterm‘consumers’wasthepreferredtermbyparticipantsoftheNationalStatementofMentalHealth

RightsandResponsibilities(1991)3 TheWorldHealthOrganisation(WHO)identifiedtreatmentofmentalhealthconsumersasoneofthree

priorityproblemsinits‘HealthinPrisons’Project:AlexGatherer(2005)‘TheWorldHealthOrganizationEuropeanHealthinPrisonsProjectAfter10Years:PersistentBarriersandAchievements’American Journal of Public Health.

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thanacommunityright,anecessarymeasureandanalternativetomedication.A“clinicaldecisionthatthepatient’smentalhealthmightbeaffected”isenoughforarefusal.Therearenostatedrules.Alonglineofreports,includingthe1992‘Burdekin’Reportandthe2005MentalHealthCouncilofAustralia(MHCA)(inassociationwiththeHumanRightsandEqualOpportunityCommission)‘NotforService’Report,allexpressthefailureinmentalhealthandtheneedforchange.However,nothinghaschangedonthegrounddespitebillionsoftaxpayers’dollarsbeingspent.Theproblemliesinthepowerlessnessofthoseforwhomtheservicesareprovided:identifiedbytheWorldHealthOrganisation(WHO)asoneofthekeybarrierstoconsumerparticipation.4 Authoritieshaveusedthestigmaofmentalillnessandabusedthetrustofthepublicpurse.Theyhavetakencontrol,redefinedtheservicesprovidedforthesickandboughtthesilenceofthosewhoshouldprotest.Allparticipantsinthepublicmentalhealtharea,excepttheconsumersandcarers,arepaidbyHealthDepartmentmoneyandareallcontrolledbythesamepeople.Obviouslytheseservicesarenotpatient-focused:theconsumershavenomoney.Patients’opinionsandcontributionstotheirownwellbeinghavebeende-legitimizedbythosewhomsocietyhastrustedtohelpthem,despiteinvolvementbeingessentialtogoodhealth.Further,enforcedmedicationisoftenusedcontrarytointernationalstandardstofillthegap.Contrastthisrealitywiththestatedpurposeofthehealthsystem,andtheessentialtenetsofdemocracythateveryhumanbeingisentitledtofairtreatmentandequalityregardlessoftheirmentalstatusordisabilityandregardlessofwhetherornottheyareincarcerated.5ThoseprinciplesintheUniversalDeclarationofHumanRightsandotherconventionsformthebasisofourlaws,butthereisnopowerofenforcement.Thispaperisbrokenupintothreeparts:1 Thefirstdescribesthealarmingrealitiesformentalhealthconsumersdespitetheexisting

legislationthatisintendedtoprotectthem.2 Thesecondpartfocusesonfundedandnon-fundednon-governmentorganisationsand

theirrolesasmechanismsforassertionofconsumers’rights.3 Thethirdpartofthispaperisanexplanationofkeychartersandlegislationsignedbythe

Australiangovernmentthatarerelevanttomentalhealthconsumers’rights.

ProposalWepropose:l thatafixedpercentageof0.1%ofthementalhealthbudgetbesetasideasmandatory

fundingofindependentconsumergroups;l thatthoseconsumergroupsbedemocraticallyresponsivetoconsumers’concerns,

addressingissuesofgeneralimportance,fundingconsumer-directedresearchandinteractingwithgovernmentpolicies;

l thatintheinterim,allserviceprovidersinthementalhealthindustryfundindependentconsumerfunctionswithapercentageoftheirbudgets.

4 WHO(1992) British Columbia Participation Project Report.5 WHO(2007)Health in Prisons Report,xvii.

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Section 1: The Realities of Mental Health Consumers

To be a mental patient is to be stigmatised, ostracised, “ socialised, patronised, psychiatrised. — Rae Unzicker Thelossofcontrolmentalhealthconsumershaveovertheirhealthisdisturbingonallaccounts.Thelegislationandorganisationsdiscussedintheothersectionsofthispaperdon’teffectivelyprotectconsumers’rights,butrestrictthemandjustifytheirabuse.Theauthoritiesandorganisationscorruptlytaketheveryresourcesandfundingmeanttoserviceconsumers’needsanduseitdehumanisethem.Consumersmusthavepowerovertheirownlivesandreceivesupporttoconsiderallmethodsoftreatment(exceptinthecaseofapresentseriousrisktothemselvesorothers).Thisshouldincludenotreatmentatall,withoutarbitrarydeterminationbythegovernment,psychiatrists,anddrugcompanies.JusticeActionhasbeenworkinginmentalhealthfordecades.Ouranalysesareonourwebsite.ButourfocusintensifiedafteranapproachbyforensicpatientsintheLongBayprisonhospitalinMarch2008,discussedbelow.Followingthis,consumersenteringhospitalsbegantocomplainthatsmokingbanswerebeingintroducedinthementalhealthunitsandunlikeotherpatients,theywerenotpermittedtogooutsidetosmoke.Wethencreatedananalysisthatunderminedanyhealthjustificationfortheban,showingitwascounterproductiveandanabuseofpower.In2008weformedtheRighttoChoosecampaign.WealsoexaminedthecaseofSaeedDezfouliduringourinvolvementinthementalhealtharena.Saaedisjustatypicalinvoluntarymentalhealthpatient.ButinexaminingwhathashappenedtohimitbecameobviousthattheHealthDepartmentitselfissick,thatpolicehandlementalillnessverypoorlyandthatitisdifficulttosupportconsumers’rightsagainsttheHealthDepartment.Consumersareoftenatthecentreofabuseandneglect.WenowareSaeed’sPrimaryCarerandstandbesidehimasasymbolforallinvoluntaryconsumers.

Long Bay LockdownForensicpatientsatLongBayprisonhospitalpetitionedJusticeActioninMarch2008followinganorderedremovalof28officersfromtheprisonhospitalareabytheprisonauthorities.Thiswasapartoftheirironicallynamed“WayForward”plan.Patientswerelockedintosolitaryconfinementcellsat3.30pminsteadof9pmaspartofacost-cuttingmeasure.Neitherorganisationsnorindividualsonthegroundseemedtocare.WethenapproachedthosedirectlyinvolvedintheissueandbeganaprocessofconsultationandcampaigningtoforcethetransferofcontroloftheLongBayprisonhospitalfromtheprisonstotheHealthDepartment.Thehealthprofession,includingAustralia’sleadingforensicpsychiatrists,nursesandtheMentalHealthCouncilofAustralia,unanimouslyagreedthatlockingpatientsinsolitaryconfinementforthatperiodwouldbelikelytoexacerbatementalillness.Thenurses,prisonofficersandpatientsthemselvesagreedthatitwasdetrimentaltotheirrecoveryandwouldcauseahugeincreaseinself-harmandsuicide.Thenursessaidthattheycouldnotgivehospitalcareunderthoseconditions,andthatthoseveryvulnerablepatientswithseverementalillnessesandmedical/surgicalpatientswouldneedtobetransferredtogeneralhospitals.6

6 ToaccessthecorrespondencebetweenJusticeActionandtheNSWNursesAssociationandotherdetailsseehttp://tiny.cc/0f5e0

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Thepatientstoldthemanagerthattheywouldberefusingmedication.Bytheendofthecampaign,thefollowingactionhadtakenplace:

l TwoNoticesofMotionhadbeenplacedbeforeStateParliament,decryingthepractice(oneeachfromtheLiberalsandtheGreens)

l SupremeCourtproceedingsseekingordersthatthepracticebestoppedimmediatelywereimminent

l LegalproceedingsbasedonbreachesofAustralia’shumanrightsobligationsunderinternationaltreatieswerealsoimminent

l AcomplainthadbeenmadetoICACallegingDCSemployeeshadindulgedincorruptbehaviourbymisrepresentingthewishesofthepatientsandthedangeroushealtheffectsoftheearlylockdownpractice

l Significantadversemediacoveragehadbeengeneratedinnewspapers,onradioandaninvestigativepiecehadappearedonABCTV

l AnumberofadversewrittenstatementsandletterstotheAttorneyGeneralhadbeenmadebyAustralia’sleadingforensicpsychiatristsandtheirrepresentativebodies,aswellastheNSWNursesAssociation,HREOC,SANEAustralia,NCOSS,theAboriginalJusticeAdvisoryCouncilandothersignificantcommunityorganisations.

Finallythegovernmentacknowledgedtherightofforensicconsumerstotreatmentthatrespectedtheirspecialneeds.Tocausevulnerablecitizenstosufferforadministrativepurposesisessentiallytortureanddiminishesusasacommunity.ThegovernmentdecidedtotransfercontroloftheLongBayprisonhospitaltotheHealthDepartment.EventhenthegovernmentstalledandanUrgencyDebatewasplacedbeforeParliamenton12November2008.JusticeActionandtheNSWNursesAssociationprovidedwrittenandoralpresentationstothecrossbenchers.AllthepartiesintheUpperHousejoinedtogethertoensurethemotionwasdebated.7 Duringthecourseofthedebate,MinisterHatzistergosgaveanassurancethatby28November2008allforensicpatientswouldbetransferredtothenewforensichospital.Hiswordswereunequivocal:‘EveryoneknowsthatthecurrentsituationatLongBayprisonhospitalistemporary.Isaytemporarybecauseitisenvisagedthaton28NovemberthisyearthenewForensicHospitalwillcommencetooperate.WhenthatoccurssomeofthosepersonsdetainedintheLongBayprisonhospitalwhoareforensicpatientswillmoveintothenewforensichospitalunderaregimethatwillbemanagedentirelybyJusticeHealth.However,thoseinmateswhoremainintheprisonhospitalwillnotbeforensicinmates…’8 Butmanyarestillthere.Wearewatching.

Ban on Smoking in Hospitals TheRighttoChooseCampaign(http://www.righttochoosealliance.com.au/)inregardstothesmokingbanforpatientsisofspecialinteresttoJusticeAction.Thereisnobanonsmokinginregardstothelargerpopulation,andyetthegovernmentistryingtolegallywithholdthosesamerightsfrompsychiatricinpatientconsumers.Insomestatesprisonersarealsounderthreat.Smoking,albeitharmfultoone’shealth,isacommonrecreationalpastimeenjoyedbyanestimated17%ofthelargerpopulationofAustraliathatisnotsubjectedtoconfinement.Theattackontherighttochoosewithsmokingisjustasymptomofthesicknessinthehealthsector,wherethoseforwhomtheserviceisintendedreceivewhatothersdecideisgoodforthem.Wechallengethepolicyofdictatinglifestylestoconsumersinclosedinstitutions,

7 Seehttp://tiny.cc/0f5e0formoreonthispoint.8 Ibid.

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includingforcedmedicationtochangebehaviour.Wefocusontheforcedwithdrawaloftobaccoassymbolicofdishonestconcernforconsumers’welfarethatyieldscounterproductiveresults.Smokingisextremelyimportanttopatientsandprisoners.Fromourowninvestigationswehaveobservedthatmanyprisonersearnlessthan$20aweek,andspend$18ontobacco.Inprisonsandmentalhealthunitsover80%ofthepopulationsmokes.Itistheirhome.ItisapersonalpleasureacceptedsincetheformationofthePenalColony.JusticeActionstronglybelievesthattoimposesuchabanonaparticularlyvulnerablesectionofsocietywhenthesamebanisnotimposedonthelargercommunityisnotonlyundemocraticbutalsoimposesadisproportionatelevelofsufferingonthosewhoarealreadydisadvantaged.Evenpubsandcasinoshavespecialareasforsmokersdespitepatrons’abilitytogooutside.Thebanningoftobacco–consumers’legaldrugofchoice–fordependentpopulations,whilstforciblyimposingmedicationtolessentheresultingtrauma,isoutrageous.Itisinbreachofethics,lawsandcovenants,anddoesnotachieveitsstatedintention.9 Whilethegovernmentsaysitisconcernedaboutpatients’health,thebansdonotstopsmokinginthelongterm.Whereconsumersareforcedtogiveupsmokinginmentalhealthunits,mostresumesmokingimmediatelyupondischarge.Oneoftheworld’sleadingresearchersinthearea,SteveKiselyfromGriffithUniversityMedicalSchool,isadamantthatbansdonotwork,statingthatthemotivationtochangetheoryemphasisesthatmeaningfulchangewillonlyoccurwhenthepatienthasmovedthroughthepre-contemplative,contemplativeandplanningstagesthroughtotheactionstage.10 Itisclearthatthegovernmentpositioniswrongfromeveryperspective.Itisdishonest,ineffectiveandtriestoovercomethelittlecontrolthatprisonersandpatientshaveovertheirlives.Furthermore,ithasattemptedtosilencedissenters.InOctober2007,JusticeActionwasexcludedfromrepresentingconsumersatJusticeHealth’sConsumerandCommunityGroupfollowingpublicityonapossiblesmokingban.Astheonlyrepresentativewithprisonexperience,otherparticipantssaidJA’sinvolvementwasessential,buttheexclusioncontinues.Thelessonofthesmokingcasestudyisthatonlythroughworkingtogetherwithpatientsandprisonerscanchangesoccur.Thisattemptatabanprovidesanexcellentchancetoexaminegovernmentrehabilitationpoliciesgenerallyincludingwithprisoners,andwhytheyhavefailedsocomprehensively.Theeasytop-downdictatorialstyleofpeoplemanagementalwaysfails,absorbsscarceresourcesandcausesunnecessarytensions.Workingwithpeoplerequirespatienceandsensitivitybutismoreeffectiveinthelongrun.

Case study of Saeed Dezfouli TheclosedsystemoftheNSWHealthDepartment’smentalhospitalsisgettingexposurethroughthewindowofpatientSaeedDezfouli.Itshowssystemicabuseofdependentpeoplecloakedascare.Saeedpresentsnothreattothecommunity.HeneedssupportasanIranianrefugeeaffectedbystressandwithaheartcondition.In2002helitafireinhisworkplacetodrawattentiontohisconcerns.Thiswasfollowingmorethanfivemonthsofdistressedfaxestopoliceandpoliticiansinwhichhehadstatedhisintentions.Onthatdaythefireescapewaslockedandawomandiedofsmokeinhalation.Saeedregrettedhisactionimmediately,huggingthoseoutsidethebuilding.Thiswouldneverhavehappenedwithproperhealthandpoliceintervention.Saeedisinauniqueposition.Hehaswatchedthesystemfrominsideforeightyears,andpointsoutitshypocrisy,whilstJusticeHealth(anarmoftheHealthDepartment)triestocrushhimintosubmissionwiththerestofthepatients.Heisagentlepersonneverwantingtohurt

9 Seehttp://tiny.cc/gjdfqformoreonthispoint.10 TranscriptofemailreceivedbyJusticeActionMarch2008.

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anyone–theyagreeheisnon-violent,buteverytwoweekseightstaffholdhimdownandinjecthimwithapowerfulsedativewhileheisheldinthehighestsecurityarea:theForensicHospital.Heisrefusedachoiceofpsychiatrist,educationandexercise,isnotpermittednewvisitorsandtherulesaren’tevenstated.WebecamehisPrimaryCarerwhentherewasnooneelse.Saeedissufferingbecausehewon’tshutup.JusticeHealthhasabsolutepower.Patientshavenofinitesentencesandaretotallydependentonthetreatingpsychiatrist.Theprinciplesofpatients’rightsunders68oftheMentalHealthAct2007(NSW) donotapplyinpractice.Inthis‘care’system,no-onecares.Taxpayersarecharged$200,000ayearforSaeed,and$130mforthenewprivatelyfinancedBayhospitals.SaeedappealedtotheSupremeCourtagainsttheMentalHealthReviewTribunal’srefusaltoorderchangestohistreatment.TheTribunalandtheAttorney-Generaltriedtoblockthisfirstrealappealagainstitsnewpowerstomakeorders,refusingtosupplyitsdecision,untilanaudiorecordprovedSaeed’sentitlement.ItseesitsroleassupportingJusticeHealthandnotmakingaseparatejudgment.PreviouslytheTribunalhadcalledforanewreviewofSaeedbutwasoverruledbyJusticeHealth.ThelackofcomplaintfromthosearoundSaeedshowswidespreadabuseandthecompromiseofthoseparticipatinginthehealthsystem.TheTribunaltriedtoforceSaeedtousethediscreditedMentalHealthAdvocacyService. WehaveajobandahomeforSaeed,andwillcontinuetheJusticeActionMentoringrelationshipwhichisfundedbyBreakoutDesignPrintWebwhenheisreleased.

Involuntary Injection MichaelHeston,aninvoluntarymentalhealthpatient,wrotethesewordstoMindFreedomaskingforhelp: “Lifeisnofunwhenbeingtorturedandterrorized.Pleasehelpme.Theyhavenorightto

shootme.Iwantmyspiritback.That’sallIwantismyspiritback.Thedrugsmakemenervousandparanoid.I’mfidgetyandantsyfromthemedicine.Godmademeacertainwayandthat’showIwanttostay.I’mbeingshotdownlikeadog.”11

Thesecommentsraisetheissueofeffectiveness,whichiscentraltoinvoluntarytreatmentregimes.AccordingtoDrPennyWeller,involuntarytreatmentscan“mask,ratherthanrelievethesymptomsofmentalillness.”12Shearguesthatsuchtreatmentsoftenhavesedativeeffects,whichareusedaschemicalrestraints.Atothertimes,theyhavedisablingsideeffectsthatmimicsymptomsofmentalillnesses,whichleadtointerpretationsbymedicalofficersthatpatients’behavioursreflectescalationsofmentalillness.Thesefindingshavefurthermorebeencomplementedbystudiesdoneinthisfield.Alarmingly,intheCochranereviewentitled“CompulsoryCommunityandInvoluntaryOutpatientTreatmentforPeoplewithSevereMentalDisorders”,itwasrevealedthatthereislittleevidencethatcommunitytreatmentordersareeffectiveforcompetenthealthcare.Thatstudyconcludedthatstatisticallyittakes85communitytreatmentorderstopreventonere-admission,27topreventonecaseofhomelessnessand238topreventonearrest.Thisastonishingevidenceisjustanotherindicationofwhyinvoluntarytreatmentisinappropriateformentalhealthpatients.Furthermore,itindicatesaclearwasteofpublicexpenditureinmentalhealthtreatment.Instead,suchfundingcouldbeusedtopromoteeffectivementalhealthcareinaccordancewithfundamentalhumanfreedoms,suchastreatmentwithfreeandinformedconsent.AccordingtoProfessorAmitaDhanda,ifmentalhealthpatientsrefusetreatments

11 MindFreedom.‘USAFederalPrisonerCommitsSuicideAfterForcedPsychiatricDrugs’[online]<http://www.mindfreedom.org/kb/prison-mental-health/forced- psychiatric-drugs/?searchterm=michael%20heston>(3May2010).

12 PennyWeller(2010)‘DevelopingLawandEthics:TheConventionontheRightsofPersonswithDisabilities,35Alternative Law Journal1,2.

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recommendedtothem,theyaredeemedtolackthecapacityorinsightintowhatareintheirbestinterestsfortreatment.Thismaybeeseenasthe‘catch-22’ofthementalhealthsystem.Itisclearthatthislogicdoesnotrealisethecapacityof“allpersons,whetherornottheyhaveadisability,aremoreorlessabletoreason”.13 Infact,patientsthemselvesarearguablythemostcapableofmakingdecisionsastowhetheratreatmentisintheirownbestinterests.However,inthecaseofthosetrulylackingthecapacitytomakefreeandinformeddecisions,substituteddecision-makingisstillnotappropriate.Instead,supporteddecision-makingismoredesirable.Thismeansthatmentalhealthpatientsshouldbeencouragedtoworkinconjunctionwithsupportpersonnelinordertocometoanadequatesolutionregardinghealthcare.Whileitistruethattheamountofsupportrequiredwouldvaryfrompatienttopatient,ifwearetorespectthehumanrightsofsociety’smostvulnerablefriends,suchanapproachisnecessary.Thepublicfundingcurrentlybeingwastedonunjustinvoluntarytreatmentregimescanbeutilisedinthiswaytoprovidemorerespectablegoals.InNSWmentalhealthconsumerscanbeinvoluntarilysedatedwhentheyareseenasaseriousrisktothemselvesorothersinapsychiatricemergency.14Thisisgovernedbystrictregulationsunderthe‘SeclusionPracticesinPsychiatricFacilities’DepartmentofHealthpolicy. 15Thispolicydirectivestates,“anyrestraintmustbeproportionaltotheactionsofthepatient.Anyactionoutofproportiontothedangertheyareplacingthemselvesorothersin,maybeconsideredanassault.”16Thus,criminalassaultisrelevantwheredisproportionateforceisusedinthesecircumstances.However,ifinvoluntarymedicationisdefinedas‘treatment’ratherthansedation,suchinterventionintendedonlyforpsychiatricemergenciesbecomesacommonplaceroutine.Thisisunacceptable-theseactionsshouldberegardedasassaults,andasdiscussedabove,areineffectiveabinitioandshouldhavenoplaceinthementalhealthsystem.Thus,onlythroughacceptingthelimitationsofinvoluntaryinjectingpowerscanmedicalpractitionersperformtheirrolesandrespecttherightsofmentalhealthconsumers.UnderArticle17oftheConventionontheRightsofPersonswithDisabilities(CRPD)“everypersonwithdisabilitieshasarighttorespectforhisorherphysicalandmentalintegrityonanequalbasiswithothers.”17Involuntaryinjectionisaninfringementofthisfundamentalhumanright.Thepointsjustoutlinedaimtoprovideajustalternativetooutdatedinvoluntarytreatmentregimesthatviolatementalhealthconsumers’rights.Forciblyholdingdownahumanbeingandinjectingthemwithdrugsagainsttheirwillbreachesallhumanrights.

Mental Health Consumers in the MediaThemediahasanenormousimpactonsocietyandhowpeopleperceivetheworldaroundthem;itcontributes,shapes,andformstheiropiniononimportantissues.Mentalhealthconsumersareportrayednegativelyinthemediadespitealldeclarations,conventions,andlegislationsthatexiststoprotectthem.Themedia’snegativityblatantlydefiestheCRPD,despitetheUN’sspecificpurposes“tolimitmechanismsthatreplicateandreinforcethesocialexclusionandmarginalizationofpeoplewithdisabilities.”18 Twentypercentofnewsarticlesthatcovermentalhealthconsumersusethewords“psycho”,

13 Ibid,3.14 MentalHealthAct2007(NSW)s14.15 NewSouthWalesHealth(2007)Seclusion Practices in Psychiatric Facilities[online]<http://www.health.

nsw.gov.au/policies/pd/2007/PD2007_054.html>(22June2010).16 Ibid.17 UnitedNations,Convention on the Rights of Persons with Disabilities(2008)art17.18 PenelopeWeller(2009)‘HumanRightsandSocialJusticeTheConventionontheRightsofPersonswith

DisabilitiesandtheQuietRevolutioninInternationalLaw’,4Public Space: The Journal of Law and Social Justice, 5.

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“schizo”and“nutter”.19Televisionnewsprograms,newspapers,andradioareconsideredtrustednewssourcestosociety,andsometimestheonlysourceofeducationtoitsviewers.Whenthesenewsoutletshighlightandexaggeratementalhealthconsumersandcrime,theyareonlyreinforcingthestigmasthatsocietyaccepts.Howeverstudieshaveshownthatevenwhenmentalhealthconsumersareportrayedcorrectly,itisonlythesortofarticlesthatdramatizethecircumstancesthatattractthemostattention.20AmericanconsumerandactivistRaeUnzickerwrote,“TobeamentalpatientistowatchTVandseehowviolentanddangerousanddumbandincompetentandcrazyyouare.”21

Seventypercentofthepopulationbelievesthatmentalhealthconsumersareviolentwhichreflectspublicconcernandgovernmentspendingonsecurity.ItwasfoundintheUnitedStatesthatmostmentalhealthpatientsinprisonwereuninsured,poor,homelessminoritygroupswhohadcommittedmisdemeanorcrimes.22Theyareunjustlycommittedascriminalsintotheprisonsystemtokeepthemawayfromasocietythattakesnoinitiativetounderstandthem.In1992BrianBurdekinreleasedthereport‘NationalInquiryIntoTheHumanRightsOfPeopleWithMentalIllness’.Hisreasonforconductingthisinquirycamefromevidencepresentedtothehomelesschildren’sinquiry,whichsuggestedthatinmanyareasthehumanrightsofindividualsaffectedbymentalillnesswerebeingignoredorseriouslyviolated.FurtherresearchbyBurdekinalsoindicatedwidespread:

l ignoranceaboutthenatureandprevalenceofmentalillnessinthecommunity; l discrimination; l misconceptionsaboutthenumberofpeoplewithamentalillnesswhoare

dangerous,and; l beliefsthatfewpeopleaffectedbymentalillnesseverrecover.

TheMHCA/HREOCreport:“NotForService:ExperiencesofInjusticeandDespairinMentalHealthCareinAustralia”showedthatafter12yearsofmentalhealthreforminAustralia,anypersonseekingmentalhealthcarerunstheseriousriskthathisorherbasicneedswillbeignored,trivialisedorneglected.Theadversehealth,socialandeconomiceffectsofAustralia‘smentalhealthcaresystemfallslargelyonthosewithrecurrentorchronicdisordersandtheirfamiliesandcarers.Thesearesomeofthemostvulnerablepeopleinourcommunity.

The Judicial SystemAtlaw,personssufferingarecognisedmentalillnessatthetimeofanoffencearenotcriminallyliablefortheiractions.23Despitethis,forensicconsumerscontinuetobeincarceratedforlongerthaniftheyhadbeenfoundguiltyofacriminaloffence,particularlywheretheywishtoalterorceasetreatment.Involuntarypatientsalsosufferfromlackofchoiceintreatmentasaresultofassumedincapacity,asdiscussedbelow.

Forensic patientsIndeterminingwhetherapersoncanbefoundnotguiltyofanoffencebyreasonofmentalillness,thecourtmustfindthatthestateofthepersonsmindatthetimeoftheoffencewas

19 DanielleAndrewartha(2010)“WorldWillNeverHurt?MediastigmatisationofpeoplewithmentalillnessesintheCriminalJusticeContext”,35Alternative Law Journal 1,4.

20 Ibid.21 RaeUnzicker(1984)“To Be A Mental Patient”,NationalAssociationforRightsProtectionandAdvocacy,

<http://www.narpa.org/to_be_a_Mental_Patient.htm/>(11May2010).22 Weller,aboven18,5.23 Rather,theywillbenotguiltybyreasonofmentalillnessunderMentalHealth(ForensicProvisions)Act

1990(NSW)s38.

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diseased,disorderedordisturbedtosuchadegreethatitpreventedthemfromunderstandingthephysicalnatureoftheunlawfulactorrecognisingthattheoffendingactitselfwaswrong.24 Ifthisisfound,thecourtwillorderthatthepersonberecognisedasnotguiltybyreasonofmentalillnessornotfittobetriedanddetained.TheMentalHealthTribunalmaymakeanorderforreleasefromcustody“whensatisfiedonthebalanceofprobabilitiesthatthesafetyofthepersonoranymemberofthepublicwillnotbeseriouslyendangered”25and“whereothercareofalessrestrictivekind,thatisconsistentwithsafeandeffectivecare,isappropriateandreasonablyavailabletothepatientorthatthepatientdoesnotrequirecare”.26 Despitetheseavenuesfordischarge,manyforensicpatientswillremaininmentalhealthfacilitieslongaftertheircriminalcounterpartsdespitethefacttheyarenotguiltybylawofanoffence.Theyareseentolackthecapacitytomakedecisionsfortheirownmedicaltreatment.Thereisnochoiceinthissystem.

Involuntary patientsApersonmayalsobeadmittedtoamentalhealthfacilityaftertheissueofamentalhealthcertificatebyanaccreditedpersonincircumstanceswherethepersonisfoundtobeamentallyillordisordered,andwhereinvoluntaryadmissionanddetentionisdeemednecessary.27

Unders14oftheMentalHealthAct2007(NSW)apersonismentallyillifthepersonissufferingfrommentalillnessandowingtothatillness,therearereasonablegroundsforbelievingthatcare,treatmentorcontrolofthepersonisnecessaryfortheprotectionofthepersonorothersfromseriousharm.ResearcherAmitaDhandahasidentifiedthattestsof‘capacity’havebeenentrenchedintowesternlegalsystemsinordertopromoteefficientcompliancewithpsychiatrictreatmentwithoutreferencetoindividual’srightsandchoiceoftreatment.28Forexample,the‘status’teststatesthatwhereapersonsuffersfromaseverementalillness,theywillautomaticallylackthecapacitytoinvolvethemselvesintheirtreatment.The‘outcome’testinamedicalcontextdictatesthatwhereconsumersrefusetreatment,thiswillbeseenasanindicationoftheirlackofcapacity.29

Therefore,ifapersonacceptspsychiatrictreatment,heorsheisdeemedtohavecapacityandwillbeadmittedtoavoluntarytreatmentprogram,ofwhichtheymaydischargethemselvesatanytime.However,iftheydonotfeeltreatmentisnecessary,theywillbesubjectedtoincarcerationandinvoluntarytreatment.Thesemethodsservetocrushmentalhealthsufferersintosubmissionforthepurposeofachievingaquickandefficientprocesswithoutsubstantialconsiderationsofpatientsrighttoinvolvementorchoiceintheirtreatment.

24 R v Porter(1933)55CLR182.25 MentalHealth(ForensicProvisions)Act1990(NSW)s39.26 MentalHealth(ForensicProvisions)Act1990(NSW)s43.27 MentalHealthAct2007(NSW)s19.28 AmitaDhanda(2005)‘TheRighttoTreatmentofPersonswithPsychosocialDisabilitiesandtheRoleofthe

Courts’28International Journal of Law and Psychiatry155,157.29 Weller,aboven12,2.

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Section 2: Mechanisms for Operation in Practice Thefollowingsectionfocusesontherolesofnon-governmentorganisationsasmechanismsforassertingtherightssupposedlyaffordedtoconsumers.Italsoexaminestheeffectivenessofcurrentgovernmentfundingprograms.ThefollowingistakenfromtheNSWMentalHealthCharter30forcarethathasderivedfromnegotiationswithconsumergroups.Accordingtothischarter,whichisontheNSWHealthwebsite,allNSWconsumersareentitledtoservicesthatabidebytheseguidelines.1. Respecthumanrights.2. Arecompassionateandsensitivetotheneedsoftheindividualstheyserve.3. Fosterpositiveattitudestomentalhealthinthelargercommunity.4. Promotepositivementalhealth.5. Encouragetrueconsumerinvolvementatalllevelsofservicedeliveryandpolicy

development.6. Provideeffectivetreatmentandcareacrossthelifespan.7. Arewidelyaccessibletopeoplewithmentalhealthneeds.8. Providecareintheleastrestrictiveenvironment,consistentwithtreatmentrequirements.9. Provideeffectiveandcomprehensivepreventionprogramsacrossthelifespan.10. Promote‘livingwell’withmentalillness.11. Addressqualityoflifeissuessuchasaccommodation,education,workandincome,

leisureandsport,homeandfamilyandotherrelationships.12. Uselanguagethatreducesstigma,discrimination,ornegativityforthoseaffectedand

theirfamilies.13. Respectandareresponsivetothediversityinlifestyle,sexualityandsexualpreference.14. Areculturallysensitiveandappropriatetotheneedsoftheindividualstheyserve.Despitetheflowerylanguageinlegislationandmotives,theNSWJusticeHealthispartofthe“system”andthesystemhasitsownagendasthataremaskedbywordsconsumersarefightingtohearinabrokensystemthatlimitsthem.Infact,theprovisionsoftheMentalHealthActservetohindertheachievementoftheaimsstatedabove.

Mental Health Act 2007 (NSW)IntheMentalHealthActthereexiststhepotentialforabuseofpower.ItstatesinitsobjectivesthattheActprovidesthecare,treatment,andcontrolofpersonswhoarementallyillormentallydisordered.31ThefactthatNSWJusticeHealthdeliberatelyincludedtherighttocontrolmentalhealthconsumersintheobjectivesoftheActreinforcesandprovidesjustificationtosociety’sstereotypeofmetalhealthconsumersaspeopletobecontainedandisolatedfromthemainstreamcommunity.IfthegoalsofNSWJusticeHealthistoprovidementalhealthservicesthatamongotherthings,respecthumanrights,arecompassionateandsensitivetotheneedsoftheindividualstheyserve,andfosterpositiveattitudestomentalhealthinthelargercommunity,thenslipping

30 NSWDepartmentofHealth(2000)Charter for Mental Health Care in NSW[online]http://www.health.nsw.gov.au/pubs/2000/mhcharter.html(3May2010).

31 ContainedintheMentalHealthAct2007(NSW).

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thewordcontrolintotheverycatalystoftrustbetweenauthoritiesandconsumerscontradictsthesupposedintentions.Theuseofthewordcontrolisadeliberatemanipulationofpowerandaviolationofmentalhealthconsumer’sinherenthumanrights.

Consumer and Carer OrganisationsConsumerandcarers’organisationsareusedasthemechanismfortheassertionofrightsofconsumersinthissystem.Essentially,therearetwotypesofconsumerorganisationsdiscussedinthispaper:non-governmentandgrassrootsconsumergroups.Thereisoneunderliningdifferencebetweenthetwo:funding.Withoutthefundingfromthementalhealthdepartmentandaccesstothehospitals,itisdifficultfororganizationstobeeffective.Unfortunately,whenorganisationsacceptfinancialassistance,theiractionsarelimitedinthementalhealthmovementandmustturnablindeyetotheinjustices,orlosetheirfunding.Itisthisissuewhichmustbechangedinordertotrulypursueeffectiveprotectionofconsumerrightsinthisfield:mandatoryfundingmustbeallocatedtoindependent consumergroupsinordertoadequatelyachievethisgoal.

Funded Organisations:TheMentalHealthCoordinatingCouncilisthecoordinatingorganizationfornon-governmentorganizationsinmentalhealthservicesinNSW.Theirpurposeistoseektoimprove,promoteanddevelopqualitymentalhealthservicestothecommunity.Theirgoalisalsotoextensivelyparticipateandinfluencepolicymakerstoimprovementalhealthcare.

Non-funded Organisations:Criticalorganisationsthatdonotreceivefundingfromthegovernmentarethemosteffectiveatthepresenttime.Asaresulttheyhavetheabilitytopursuementalhealthgoalswithoutanyoutsideinfluences.Theconsumerorganisation’smovementisledby(mostimportantly)mentalhealthconsumersaswellascarers,familymembers,doctorsandothersfromthebottomwhobelievethereisanalternativewaytoworkingwithmentalhealthpatientsinsteadoftheHealthDepartmenttakingresponsibilityfromthetop.JusticeActionhasbecomeinvolvedduetoourconcernaboutgovernmentabuseofpower.ThehalfwayhouseGlebeHousewhichwasfoundedbytheprisonermovementlostitsfundingduetothecriticaladvocacyworkofitsDirectors.AmericanactivistRaeUnzickerandEnglishactivistR.D.Lainghavemadesignificantcontributionstothemovementofconfrontingmentalhealthauthorities.ToLaing,consumer’sbehaviorswerearesponsetotheirinabilitytoconformtosociety’sdemandsinthechangingworld.Hisideasoftreatmentstemmedfromthebeliefthatconsumersareresponsiblefortheirownprogress,andthroughtheirprogresstheywouldbeabletoreturntoamorestableandgroundedlife.RaeUnzicker,anAmericanadvocateformentalhealthconsumers,sawmentalhealthinasimilarway.Moreimportantly,shebelieveditwasinexcusabletodenymentalhealthconsumerstheirrights,particularlythefreedomtochoosehowandwhereconsumerswillreceivetreatment,ifany.ConsumerorganizationstodaycontinueLaingandUnzicker’sworkandtheirvoicesarefarfromsilent.GroupssuchasTheConsumerActivityNetwork(www.canmentalhealth.org),TheIcarusProject(www.icarusproject.net),Mindfreedom(www.mindfreedom.org),andMadPride(www.mindfreedom.org/campaign/madpride)havealladdressedtheirissuesandconcernspubliclyinregardstomentalhealth.Mindfreedomspecificallyadvocatestherighttochooseasoneoftheirmainprioritiesinthementalhealthcaresystem.Thisorganisationaimstoestablishtheconsumer’scontrolover

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theirlifeandtohavetheiropinionsconsidered.TheConsumerActivityNetwork(CAN)focusesontherightofconsumerstobeinvolvedinthedecision-makingprocessoftreatmentaspartoftheindividual’srecoveryjourney.Thisisseenasimportantsoastoallowtheconsumeraqualitylifestyleofchoice.TheIcarusProjectadvocatesaslightlydifferentmessage.Notonlydotheysupporttherighttochoosethemethodoftreatment,theyalsoadvocatetherighttonotbecategorizedasillinthefirstplace.Thebeliefofthisparticularorganizationisthatpersonswhoarelabeledmentallyillarereallypeoplewhoareabletoseetheworldinawaythatdoesnotconformtosociety’sviewof“normal”and“sane”.

Section 3: Key Charters and LegislationThefollowinginternationalcovenantsanddomesticlegislationareprovidedbelowsoastohighlightthedifferencesbetweentheobligationsoftheAustraliangovernmentunderinternationallawandtheobligationsofJusticeHealthunderdomesticlawincomparisontocurrentpracticesexperiencedbyconsumers.UN High Commissioner for Human Rights32

“Australia,beingadualistnation,needstoincorporaterightsencompassedbythosetreatiesintodomesticlawtomakethemdirectlyjusticiable.Currently,noneoftheaforementionedtreatieshasbeenentirelylegislativelyincorporatedintoAustralianlaw.TheSpecialRapporteurregretsthatthereisnosuchformalrecognitionoftherighttohealthinAustralia.“United Nations Universal Declaration of Human Rights (1948)ThefollowingarticlesfromthisDeclarationmaybeappliedspecificallytothecaseofpatientswithamentalillness.However,allthearticlesundertheUniversalDeclarationofHumanRightsareunderstoodtobetherightsofmentalillnesspatients.

l Allhumanbeingsarebornfreeandequalindignityandrights(Article1). l Everyoneisentitledtorightsandfreedomwithoutdiscriminationandeveryonehasthe

righttolife,libertyandsecurity(Article2). l Nooneshallbesubjectedtotortureortocruel,inhumanordegradingtreatmentor

punishment(Article5). l Allareequalbeforethelawandareentitledwithoutanydiscriminationtoequalprotection

ofthelaw(Article7). l Nooneshallbesubjectedtoarbitraryinterferencewithhisprivacy,family,homeor

correspondenceortoattacksuponhishonourandreputation.(Article12). l Everyonehastherighttoastandardoflivingadequateforthehealthandwell-beingof

himselfincludingfood,clothing,housingandmedicalcareandnecessarysocialservices,andtherighttosecurity…(Article25).

l Everyonehastherighttoaneducation.(Article26).

32 UnitedNationsOfficeoftheHighCommissionerforHumanRights(2009)Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health(AnandGrover)

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United Nations Convention on the Rights of Persons with Disabilities (2007)ThisConvention(CRPD)doesnotintroduceanynewrights,butholdsnationsresponsibletoprotectthosewhoseopportunitiestopursueafulfillinglifehasbeenlessenedduetodiscrimination.33Onceacountryratifiestheconvention,itisrequiredofthatnationtostartimplementingappropriatelegislation.Australiaratifiedtheconventionon17July,2008.Personswithdisabilitiesincludethosewhohavelong-termphysical,mental,intellectual,orsensoryimpairmentswhichininteractionwithvariousbarriersmayhindertheirfullandeffectiveparticipationinsocietyonanequalbasiswithothers(Article1).Itisclearthatmentalhealthpatientsareincludedinpersonswithdisabilitiesandshouldbetreatedassuch.

l HealthandTreatment(Article9) l StatesPartiesrecognizethatpersonswithdisabilitieshavetherighttotheenjoymentof

thehighestattainablestandardofhealthwithoutdiscriminationonthebasisofdisability. l Equalrecognitionbeforethelaw(Article12)StatesPartiesshalltakeappropriate

measurestoprovideaccessbypersonswithdisabilitiestothesupporttheymayrequireinexercisingtheirlegalcapacity

l FreedomfromExploitation,ViolenceandAbuse(Article16)StatePartiesshalltakeallappropriatelegislative,administrative,social,educational,andothermeasurestoprotectpersonwithdisabilities,bothwithinandoutsidethehome,fromallformsofexploitation,violenceandabuse,includingtheirgender-basedaspects.Inordertopreventtheoccurrenceofallformsofexploitation,violenceandabuse. States Parties shall ensure that all facilities and programs designed to serve persons with disabilities are effectively monitored by independent authorities.

l Protectingtheintegrityoftheperson(Article17)Everypersonwithdisabilitieshasarighttorespectforhisorherphysicalandmentalintegrityonanequalbasiswithothers.

l RehabilitationandCare(Article26)Eachandeveryindividualhastherighttomentalhealthservicesthatarecompassionateandsensitivetothepatients’needsandcare.InrelationtotheDeclarationofHumanRights,forensicmentalhealthpatientsshouldnotbesubjectedtocruel,punishmentordegradingtreatment.

l Education(Article24)StatesPartiesrecognizetherightofpersonswithdisabilitiestoeducation.

l RighttoHealth(Article25)StatesPartiesrecognizethatpersonswithdisabilitieshavetherighttotheenjoymentofthehighestattainablestandardofhealthwithoutdiscriminationonthebasisofdisability.StatesPartiesshalltakeallappropriatemeasurestoensureaccessforpersonswithdisabilitiestohealthservicesthataregender-sensitive,includinghealth-relatedrehabilitation.

Disability Discrimination Act 1992 (Cth)WhiletheaimofthisActistoidentifytherightsofmentalhealthpatients,itprohibitstheconsumer’sownassertionofrightsandleavesallpowersofthematterinthehandsoftheDepartmentofHealth.

33 UnitedNations,Why a Convention? (2006)[online]at<http://www.un.org/disabilities/convention/questions.shtml>(3May2010).

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Mental Health Act 2007 (NSW)34

ThisActlaysoutpowersandobligationstothegovernmenttofacilitatecare,treatmentandcontrolofmentalhealthpatientswhileprotectingtheirhumanrights.Again,thisActfailstoempowerconsumerswiththerighttoaddresstheirownhealth.Instead,throughthisActitistheresponsibilityofauthoritarianfiguresatthetoptodeterminewhattheybelieveisbestfortheconsumers.

s 1: Objects of the Act: (a) provideforthecare,treatmentandcontrolofpersonswhoarementallyillormentally

disordered(d) whileprotectingthecivilrightsofthosepersons,togiveanopportunityforthosepersons

tohaveaccesstoappropriatecare,and(e) tofacilitatetheinvolvementofthosepersons,andpersonscaringforthem,indecisions

involvingappropriatecare,treatmentandcontrol.

s 68: Principles for care and rehabilitation (a) peoplewithamentalillnessormentaldisordershouldreceivethebestpossiblecare

andtreatmentintheleastrestrictiveenvironmentenablingthecareandtreatmenttobeeffectivelygiven,

(d) theprescriptionofmedicinetoapersonwithamentalillnessormentaldisordershouldmeetthehealthneedsofthepersonandshouldbegivenonlyfortherapeuticordiagnosticneedsandnotasapunishmentorfortheconvenienceofothers

(e) peoplewithamentalillnessormentaldisordershouldbeprovidedwithappropriateinformationabouttreatment,treatmentalternativesandtheeffectsoftreatment,

ConclusionThelanguageauthoritieshaveusedintheirlegislationisdeceivingtoconstituents.Thepoliticalgametheyplaywhenusingsuchflowerylanguageonlybenefitstheirpersonalinterests.Inrealityauthoritiesgivementalhealthpatientslittlerespectfortheirrightsandinmanycasesletthemwasteawaywithlittlecommunicationorstimulation.Taxpayerscontribute$205,000perpatientperyear.Theirmoneyisbeingwastedandusedforabuse.Thelossofcontrolmentalhealthconsumershaveregardingtheirhealthisdisturbingonallaccounts.Consumershavetherighttotakeallmethodsoftreatmentintoconsideration,includingnotreatmentatall,withouttheoverbearinginfluenceofthegovernment,psychiatrists,anddrugcompanies.Nomatterhowtheirconditionsarediagnosed,thewesternmethodoftreatmentshouldnotbetheonlymethodtakenintoconsideration.Itistherightofthepatientstohaveallmethodsconsideredandtobethefinalauthorityoverthemselvesinthedecisionofwhichmethodtopursue.Alsoofequalimportance,mentalhealthpatientspossessthesamehumanrightsaseveryindividualintheworld.Theyshouldbetreatedasequalsandtheirdifferencesshouldnotbeexploitedorusedfordiscrimination.

34 s76BofMentalHealthForensicProvisionsAct1990(NSW) referstos68oftheMentalHealthActandstatesthattheprinciplesofcareandrehabilitationappliestoforensicpatientsaswellasvoluntarypatients.

● Iranian refugee● Mental health patient costing $200,000 a year● Not guilty due to mental illness● Lit a fire in his workplace to draw attention – woman died● Gentle person – Intended no harm – warned police who ignored him

Saeed Dezfouli

● Health Department breaches its obligation of care – they don’t like him● Locked in cell for eight years● Highest security area● Forcibly injected every fortnight, yet non violent – breaches UN Conventions● Refused education● Refused psychiatrist change● Refused access support

Action!Sign petitionDonate to campaignAppeal launched to Supreme Courtwww.justiceaction.org.au02 9283 0123

The Right to Choose