Lacking Insight - Community Law

Part 4 > The Views of the Stakeholderscare less to see their files. That seems to bereflected by what I hear when I talk to peopleabout it. But the fact that that’s true doesn’tmake the rule right or wrong. I think the rule hasto apply.I think in the area of all health and certainly inthe area of mental health it’s fraught with somedifficulties because the files you know, containlots of information which is in a sense third handand historical and, you know, revisited historicalfiles are tricky and they’re problematic and so Idon’t know if there’s a right or wrong answer.I mean there’s certainly some incongruitybetween the strict rules of procedural fairnessthat involve having access to the sameinformation as the decision maker has andwhat are the normal bounds of doctor / patientor provider / patient sort of processes. I don’tthink they are often a big issue and the Act doesallow for them anyway. I know that they’re notsomething we deal with regularly to be honestwhich probably reflects that it’s only occasionallya real problem.But I think certainly in terms of the attitude ofservice providers that’s slowly changing but it’sbeen a long hard road. They see it, they seefiles very differently to . . . a rights lawyer andprobably most patients see them. The truth isthat I think historically patients haven’t really hadmuch opportunity [to view their files] . . . I wouldsuggest so it is most probably more of problemfor the lawyer.Board PresidentConsumers require more assistancebefore reading their fileA Senior Psychiatrist told the researchers that theway the report is presently conveyed to the consumermay be distressing – it was suggested that before thefile is read, clinicians need to discuss the contentswith the consumer. This is a matter of providingbetter access to information by contextualizing thecontents prior to their being read, thus causing lessdistress to the person whose file it is.The hearing itself can be therapeutic to somepatients but unfortunately for a lot of othersit is not and some find it a very traumatizingexperience, some find it a very unpleasantexperience . . . Part of the documentation ofappearing before the Board is the documentationprepared by the medical staff regarding thereason for detention or applying the involuntarystatus. That document is supposed to be givento the patients two hours before the Boardhearing, the problem is that that documentcontains all the materials [about why cliniciansview involuntary treatment as necessary].Obviously the problem is time and how busypeople are and all these sorts of things and inreality you end up having that document presentedto the person just an hour before they arrive. Ithink that the information in this document needsto clearly be discussed with the patient . . . Themedical board can be part of the treatmentplan rather than against it. So that all patientsget the benefit of that rather than it becoming atraumatising experience to the patients.Senior Psychiatrist67