Chief Psychiatrist's annual report 2008-09 - Department of Health

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2 Chief Psychiatrist’s annual report 2008–09 • working with mental health services to improve standards of treatment and care, and the application of the Act to clinical practice • providing policy and clinical advice to the Mental Health, Drugs and Regions Division, government and other mental health stakeholders • providing departmental and ministerial briefings about critical incidents • examining and providing advice on sentinel events or critical incidents under the auspices of the Quality Assurance Committee • reviewing the suitability of ECT licensing in the public and private sectors • performing statutory functions relating to patients detained under the Sentencing Act 1991 and Crimes Mental Impairment (Unfitness to be Tried) Act 1997 • undertaking and promoting quality improvement initiatives and projects relating to mental health treatment and care • developing clinical guidelines • delivering education and training • participating on working parties and interdepartmental committees about the welfare of persons receiving treatment or care for a mental illness.
Chief Psychiatrist’s annual report 2008–09 3 2 Statutory reports for 2008–09 2.1 What services must report The Mental Health Act requires mental health services to report monthly to the Chief Psychiatrist on the use of seclusion, mechanical restraint and ECT. These reports are known as the ‘statutory reports’ and they enable the Chief Psychiatrist to monitor the use of these practices, including trends over time. The Act also requires mental health services to report the annual medical examination of involuntary patients who have been in continuous care for 12 months, as well as the death of any patient that is a ‘reportable death’, within the meaning of the Coroners Act 2008. Electronic reporting was introduced in October 2006 for seclusion and mechanical restraint reporting. Services now record each occurrence of these practices on their local client management information (CMI) system, and submit data electronically via the statewide mental health information system known as the Operational Data Store (ODS). Electronic reporting of ECT also commenced in 2008. Eliminating the potential for errors inherent in a paper-based system should ensure more efficient data handling and improved data integrity. Integration of this information into the CMI also enables services to interrogate their own client information systems to monitor the occurrence of these practices in the context of the broader clinical and demographic information recorded for their client population. To provide some context to the data, the total number of consumers treated by public mental health services was 59,986 in 2008–09 and 59,362 in 2007–08. Consistent with contemporary practice, the majority of these consumers received their treatment in the community. Only 21 per cent of these consumers had a hospital admission during 2008–09 and 24 per cent in 2007–08. 2.2 Seclusion Section 82(1) of the Act defines seclusion as: ‘the sole confinement of a person at any hour of the day or night in a room of which the doors and windows are locked from the outside’. Under the Act a person receiving treatment in a public mental health service can be secluded if it is necessary to protect them or others from an immediate or imminent risk to their health or safety or to prevent them absconding. Seclusion should only be used as an intervention of last resort when a person is unable to be treated less restrictively. Seclusion is not permitted in a private psychiatric hospital. Seclusion For more information on minimum practice standards on seclusion, see: Clinical guideline on seclusion (Department of Health, 2006). A registered nurse must review the secluded person at least every 15 minutes and a medical practitioner must examine the person at least every four hours (unless this is varied by an authorised psychiatrist). Each seclusion episode must be recorded and reported to the Chief Psychiatrist.
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Chief Psychiatrist's annual report 2008-09 - Department of Health

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