Lacking Insight - Community Law

Part 3 > The Involuntary Patient Experience• Consumers are disadvantaged if interpreters arebooked only for a limited period and the timeexpires before the hearing is completed.Effects on consumers’ lives• Consumers describe their Board experiences asdisempowering and distressing. This experiencecontinues after the hearing, having a negativeimpact upon the way the way they view their life.Legal representation• Legal representation before the Board is highlyvalued by consumers many of whom toldresearchers that without representation they haveno chance of discharge. Having representationensures that all appropriate factual matters areraised, and proper procedures are followed.It also takes the pressure off the consumer topresent the case whilst he or she may be underthe effects of medication.Increased role forcommunity members• The role of the community member is viewed byconsumers as ineffective. Greater clarificationof the role is needed. Consumers want moreinput from the community member during thereview process and see that role as havinggreat potential to improve the hearing process.Consumers view the community member asa potential ally. They see great potential forcommunity members providing the Boardwith knowledge of less restrictive options toinvoluntary treatment. Consumers believe thatthe role would be enhanced by the appointmentof community members who have experiencedmental illness, in particular of people who havethemselves experienced involuntary treatment.Second opinions• Consumers report great difficulty obtainingsecond opinions. Without a second opinion,consumers experience reluctance on the part ofthe Board to accept any view other than that ofthe clinician. They also query whether cliniciansare brave enough to contradict previous clinicalopinions expressed in the file, without the supportof a second opinion.Training of Board members• Board members must be aware of theconsumer’s perspective; they must have currentknowledge of mental health services andcommunity supports to assist them to apply theleast restrictive alternative. It is crucial that theseattributes are demonstrated by all applicantsto Board positions and that applicants alsodemonstrate an ongoing commitment to keepingabreast of the community service developmentsand treatment options.• Ongoing training is essential to ensure that Boardmembers are aware of current treatment options.Continuing Professional Development should be arequirement of any appointment.• Ongoing training includes the conduct ofhearings with an emphasis on active listening andeliciting information in a dignified, respectful way.Evidence from clinicians and consumers must beequally weighted.• Ongoing training is essential to assist the Boardwith the conduct of the hearing to ensure clarityof purpose and procedure.63