Whitewash Merten Death Mental Report

Media Release: Friday December 22^nd 2017

The Review by the Chief Psychiatrist following the death of patient Miriam Merten at Lismore Hospital, made very serious criticisms of the NSW Mental Health System, but didn’t make a single recommendation that would prevent its reoccurrence. The 19 Recommendations missed the point entirely, just offering more money without changing any of the dynamics. That is unsurprising as the problems are deep-seated cultural ones, and the so called independent review is by insiders who are part of the system” said Justice Action Coordinator Brett Collins.

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DEINSTITUTIONALISATION:

Why community living has been accepted as the appropriate model

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Mental Health Crises: Proposal for Intervention

A paper presented at CJC & ICJA’s ‘BEDLAM: A hypothetical journey through the Justice and Mental Health Systems’ Held on 29 September 2012

This leaflet highlights problem areas of the current Criminal Justice and Mental Health systems and raises possible solutions for the same.

In a situation when a person feels disturbed or others feel disturbed by a person’s behaviour, it is most often handled by social processes in the person’s immediate community. At times, help is requested from outside organizations. The starkest failures have occurred after referral to police.

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Media Release Thursday September 29, 2011

Mental Health breakthrough – hospital visit approved
"In a breakthrough over two years in the making, Justice Action workers will visit patient Saeed Dezfouli in the Forensic Hospital Long Bay, at 9:30 this morning. This is the first time his friends have been permitted to see and touch him, yet he is a non-violent man forcibly injected every two weeks, denied education, social support and his identity. The team will conduct media interviews upon their exit at 10:45am" said Justice Action coordinator Brett Collins.

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Medication Forced Again

Kerry O’Malley Report: Mental Health Review Tribunal Hearing 1/4/20

See full report here

Denial of Representation                                                                                                                        2

Access to Documentation                                                                                                                        3

Personal Control Obstructed                                                                                                                 4

Independent Tribunal?                                                                                                                            5

Appendix A: Selective Examination of the MHRT Annual Report 2018-9                          6

Appendix B: Negotiations with Mental Health Review Tribunal                                           6

Kerry O’Malley, defending against an application by the Health Department for a Community Treatment Order (‘CTO’), lost her case at the Mental Health Review Tribunal (‘MHRT’) hearing on the 1st of April, 2020. The CTO is now in force, permitting the Health Department to forcibly inject her every month.

The Tribunal, held at Gladesville, consisted of three members: a lawyer, a psychiatrist and a former nurse acting as a community member. It was held as a video-conference linking to the Nepean Hospital treating team - psychiatrist and a nurse/case manager, with Kerry O'Malley in the JA office. Kerry again requested Justice Action’s (JA) support for the hearing. JA has stood beside her since 2015 after her doctor requested its assistance.

This hearing followed an adjourned hearing on 11th of March, 2020, when the Tribunal had agreed that Brett Collins,  her primary carer, would be recognised as her representative and thus have access to the Health Department file for the purpose of the case. However, in the intervening period, two Deputy Presidents of the Tribunal overruled the hearing decision and said that no person was allowed representation if they were not a patient locked in hospital.

Not only was Kerry denied representation at the hearing, but also as a consequence, independent access to her file. The Penrith Mental Health Service then gave Kerry herself 30 minutes to look at 6 pages rather than the whole file as required by law.

The primary point of discussion in both hearings was intended to be the replacement of the forced CTO with the Personal Management Plan (PMP) prepared by Kerry with her support people.  The Plan was created as a workable alternative to the CTO, incorporating both medical and social intervention strategies. Ultimately, the Plan aimed to enhance Kerry’s autonomy over her own life and mental health rather than her feeling sick from the side effects of the forced medication.

Contrary to this Plan, the Tribunal gave the Order to the Health Department and rescheduled the next hearing for 30 September 2020, in 6 months’ time; bringing her to a 9 month CTO period in total (after discharge from Concord Hospital). This was despite the Concord psychiatrist’s statement that medication was probably unnecessary.

The case raises a number of considerable procedural issues, including but not limited to the denial of representation, access to files, and Tribunal independence. Ultimately, these issues turn on a denial of rights to Kerry O’Malley, with the creation of a CTO without any justifying ‘risk of serious harm’ despite her two years of stable independence. The O’Malley case certainly has wide and significant implications. If this lovely woman, a mother of five, cannot be defended against coercive treatment, with access to information and representation, nobody is safe.

See full report here

Kerry's Index page

For the last two years, Kerry O’Malley was in control of her life and living independently. Recently, she travelled alone to Ireland for a six-month holiday, visiting friends and relatives without any difficulty and occasion of trouble. Upon returning home, she was disturbed by an incident involving a person she knew.

Kerry soon after became more disturbed and sought assistance from the hospital. They injected her with medication and then applied for a community treatment order (CTO) for six months, which would involve forced injections of Ablify (aripiprazole). The forced injections caused her great ‘anxiety, distress, and restlessness’. Kerry entered the hospital as a voluntary patient but was converted against her will to an involuntary patient. The CTO deprived her of her dignity and control over her life.

Over the last decade, Kerry has been subjected to various CTO’s however there have been significant and prolonged periods where she was able to live her life without medication. She wishes to control her own life. This is why Justice Action (JA) became involved at Kerry’s request.

Our team assisted Kerry earlier in 2015 and 2017 where we won agreement from the Mental Health Review Tribunal (MHRT) to reject the imposition of CTO’s due to the lack of legal justification and lack of evidence of how Kerry poses a risk of ‘serious harm’ to herself or others. It was recognised that the ‘Personal Management Plan’ that JA and Kerry proposed addressed the concerns of NSW Health and satisfied the criteria of ‘safe and effective care’ and was of a ‘less restrictive kind’ as per the statutory requirements of the Mental Health Act 2002 (NSW).

On 17 December 2019, Kerry asked for JA’s assistance to represent her in a hearing held by the MHRT at the Concord Centre for Mental Health on the day she was to be discharged from hospital. Despite her stated needs and the ‘Personal Management Plan’ that JA proposed as an alternative to forced medication, we were not successful in blocking the CTO. However, a concession was made by the MHRT as the CTO period was reduced from six to three months.

The hearing represented a struggle for consumer empowerment and the prevention of patient coercion. It was the matter of ensuring Kerry’s dignity and rights were not ignored. The forced injections also placed her at risk of iatrogenesis (medically-induced illness), which can entail compounding negative medical side effects. Kerry sought to avoid unnecessary medical intervention. Clearly the CTO and forced medication will discourage her from seeking any medical help she may require in the future.

There was no evidence presented at the hearing that justified continued forced treatment – only a medical ‘preference’ rather than necessity. Kerry told the tribunal that she did not oppose undergoing medical support with the exception of the forced anti-psychotic medication, which generated restlessness, full feelings of anxiety, and an inability to concentrate. Her medical history of ‘Neuroleptic Malignant Syndrome’, which makes certain medications incompatible with her genome causing her distressing side effects, was ignored. Despite Kerry’s vocal distress and objection against forced injection, her needs were disregarded and her autonomy was overridden.

During the hearing, Kerry’s input was ignored by the MHRT and resisted by the hospital. Her proposed ‘Personal Management Plan’ was not read or discussed – her choice to work closely with her nominated social supports and consult with her private psychiatrist was rejected on the basis that they did not support forced medication.

JA is concerned about the breach of formal obligations under Kerry’s recent NSW Health ‘Treatment Plan’ in relation to the hospital’s responsibilities to collaborate and work with her chosen services and clinics. As a provider of specialist mental health services, the hospital is required to engage in ‘close collaboration with other service providers’ towards ‘agreed upon goals’ with its patients. It is dubious whether they will properly uphold these responsibilities and act in accordance with Kerry’s wishes.

Kerry rang the team recently to say that she was home and extended her gratitude for JA being there to assist and represent her during the hearing even though we were not successful in blocking the CTO.

Kerry and JA intended to lodge an appeal to the Supreme Court to block the wrongful imposition of this CTO based on its lack of legal justification. However, three months was insufficient time to complete the necessary administrative processes to have the appeal heard by the Court, before the next Tribunal hearing Review, if the Health Department decides to pursue renewing the CTO. Had the CTO term been six months, the appeal would have been pursued.

 Kerry's index page

Kerry O’Malley – Chemical Restraint in Practice 22/8/17
Kerry O'Malley is back on the CTO despite never having demonstrated threatening behaviour towards herself or any other member of the public. See the full report of the August 22 Mental Health Review Tribunal Hearing for more information on the arguments adopted by Justice Action and the appalling decision of the Mental health Tribunal. 
 

Triumph at the Tribunal 27/05/15
Kerry O’Malley is a 71-year old woman who has been subjected multiple times to Community Treatment Orders (CTOs). In May 2015, Kerry, working with Justice Action, was successful in having the CTO removed by the Mental Health Review Tribunal. Read the full article here.Download media release here.

LATEST NEWS ON MICHAEL'S CASE

 Appalling Outcome Report: Rehospitalised - 16th November 2016

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