A recent study from the University of NSW and the University of Sydney, in assistance with NSW Health, revealed that patients born overseas are more likely to receive involuntary treatment. Under this study, all inpatient psychiatric admissions in Australia were studied, and it was found that nearly 54% of these patients received involuntary care on at least one day. Additionally, patients who are born overseas, speak a language different from English or are unemployed, are more likely to be hospitalised involuntarily.
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Involuntary Treatment
Involuntary treatment is a restrictive practice and requires legal approval and territory legislation. According to the NSW Mental Health Act, involuntary admission is permitted only if the person has a mental illness and “there is no other available and less restrictive way of preventing serious harm” to themselves or others.
Australia being the highest rated in cases of involuntary treatment, it is very likely that patients hold themselves back from reaching out to healthcare facilities in future! Regarding this, Amy Corderoy, the author of this study, from the Department of Psychiatry and Mental Health at UNSW, says, “In some cases, involuntary treatment can be lifesaving… but in some cases, it can be scary, it can be traumatising, it can be difficult to trust health services once something like that has happened.”
According to the Australian Institute of Health and Welfare (AIHW), 53% of all mental health hospitalisations in NSW are involuntary, and this figure has remained unchanged since 2019. According to the NSW Mental Health Commission, this shows that the system is failing to help people in mental distress at an early stage.
Priscilla Brice, CEO of the mental health advocacy group BEING, stated that involuntary treatment is a major concern for consumers. “They’re subjected to it rather than asked whether that’s something they would like or need,” she explained. Mental health accounts for 15% of the entire illness burden in NSW, although it receives just 5% of total healthcare spending. Ms Brice supports additional funding to grow the peer workforce, which provides more empathetic support based on lived experience.
A Lived Experience Of Receiving Involuntary Care
Jasper, a pseudonym for a 38-year-old woman, was not only admitted to the hospital involuntarily but was held there for more than two months. She has a psychotic condition that causes her to be unable to speak or eat for extended periods and leads to heightened suicidal thoughts. Jasper shared being detained, kept in isolation, subjected to electroconvulsive treatment, forcefully medicated, and having her phone taken. Notably, just two days before this coerced treatment, Jasper had voluntarily presented herself to the same hospital but was turned away and advised to see a psychologist. She was involuntarily admitted again just a month after her discharge. Since then, Jasper has been involuntarily admitted nearly 30 times.
“Time away from your family, time away from work—those important things that give meaning and purpose to your life, you don’t have all of a sudden because you’re detained,” she said. “And instead of having compassionate care where people connect and establish rapport, it’s like they seek to threaten instead.”
Sharing the difficulties she encountered while seeking help, Jasper recalls visiting a mental health crisis centre after not sleeping for five days and experiencing suicidal thoughts, only to find that the centre was not equipped to manage her condition. “They didn’t know how to come down to my level, to gather the story of what was happening,” she said.
Despite all these challenges, for Jasper, involuntary care was a speedier path to clinical recovery than community-based care, since general practitioners frequently lack the skills to deal with severe episodes of mental health. This creates a conflict as she feels there is no other alternative! She advocates for more compassionate care in healthcare.
Key Takeaway
The findings of this study emphasise the critical need for early intervention and a more compassionate, culturally sensitive approach to mental health care. While existing legislation provides a framework, addressing the gap between rules on paper and their implementation in real life is more important. By prioritising early intervention and creating a healthcare environment that respects the diverse needs of individuals like Jasper, we can work towards building a system that not just treats mental illness but also respects the dignity of the concerned persons.
References +
https://www.abc.net.au/news/2024-05-22/nsw-involuntary-treatment-mental-health-study-patients/103794854
