Quis custodiet ipsos custodes? An audit of records of involuntary detention

Author:

O’Connor Nick1,Belford Andrew2,Corish John3,Olmstead Colleen4

Affiliation:

1. Clinical Director, North Shore Ryde Mental Health Service, Northern Sydney Local Health District, Sydney, NSW, and; Clinical senior lecturer, Department of Psychiatry, University of Sydney, Australia

2. Psychiatry registrar, Northern Sydney Local Health District, Sydney, NSW, Australia

3. Consultant psychiatrist, South Coast Private Hospital, Wollongong, NSW, Australia

4. Clinical nurse consultant, Northern Sydney Local Health District, Sydney, NSW, Australia

Abstract

Objectives: To determine the appropriateness and utility of the certificates issued under the New South Wales Mental Health Act (MHA) and compliance with the requirements of the MHA. The analysis also compares MHA documentation by different groups of health professionals and police. Methods: The MHA certificates associated with 100 consecutive involuntary Emergency Department presentations were audited. Results: Considerable variability exists between professional groups in the level of detail, appropriateness, clinical utility and compliance of MHA certificates. Over 10% of Schedule 1s failed to meet the requirements of the MHA, potentially invalidating the involuntary detention of these patients. Information provided by police was typically superior in informing initial risk assessment and emergency management. Conclusions: A number of patients are presently being detained under incomplete MHA certificates. Educational initiatives that aim to improve awareness of the MHA’s requirements, and the potential uses of the information contained in MHA certificates, could encourage professionals to complete these certificates in a more appropriate and clinically useful manner.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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