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

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.