DoH Digital Library: Mental Health Act annual report

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Northern Territory Department of Health Library Services Historical Collection

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362.2 NOR 1983/84

MENTAL HEALTH ACT ANNUAL REPORT 1983/84

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HISTORICAL COLLECTION

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ANNUAL REPORT AS REQUIRED BY

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SECTION 41 OF THE MENTAL HEALTH ACT

1. Psychiatric care in the Northern Territory is provided by the Department of Health.

Because persons who are psychiatrically i l l are sometimes unable to give informed consent to their own treatment, the care of these patients is given a legal basis in the provisions of the Mental Health Act. The medical profession is given authority by a magistrate to take a person into care under section 7 of the Act and to keep him in care by means of an order under section 13 of the Act. In an emergency, a person can be taken into immediate care by a policeman or a medical practitioner in a hospital but a magistrate's concurrence must be sought as soon as practicable (section 9 refers). The Mental Health Act details the necessary steps which must be taken by personnel involved to ensure that the civil liberties of the patient are protected.

Psychiatric patients who are legally capable of giving informed consent to treatment are not subject to the Mental Health Act. These patients are described as voluntary patients. Statistics are kept on these patients as well as on involuntary patients because the one person may be in both categories during the course of his treatment.

NORTHERN TERRITORY PSYCHIATRIC ADMISSIONS 1983/84

2. In 1983/84, there were 667 psychiatric admissions t o Northern Territory hospitals. Eighty-two of these (12.3%) were admitted in accordance with the provisions of the Mental Health Act. The Royal Darwin Hospital admitted 61 compulsory patients, and 21 were admitted to the Alice Springs Hospital. A comparison of voluntary and involuntary patients is shown in Table 1.

2.1 Section 7

During the year, 48 patients were admitted to hospit al in accordance with a warrant issued under section 7 of t he Mental Health Act. This is 49.0% of all involunt ary psychiatric admissions.

2.2 Section 9

Eighteen patients were admitted without a formal warrant in accordance with the provisions of section 9 of the Act which enables a policeman or medical practitioner to take a person into custody without a warrant in an emergency. This number is 18.4% of all involuntary psychiatric admissions. Details of these admissions are shown in Table 2.

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2.3 Comparisons

An examination of all psychiatric admissions for 1983-1984 shows that 385 (57.7%) were males and 282 were females.

There were 576 non-Aboriginal patients and 91 Aboriginal patients. Details are shown in Tables 3 and 4.

Patients aged 30-39 years represented 33.4% of the total of all those admitted, followed closely by those in the age group 20-29 which represented 32.8%. Additional details are at Figure 1.

Of the psychiatric patients who were admitted in accordance with the provision of this Act, the majority were diagnosed as suffering from schizophrenia. This form of mental illness also accounted for the bulk of voluntary patients admitted.

2.4 Facilities

The Royal Darwin and Alice Springs Hospitals admit involuntary patients. Details concerning the staffing of the units are contained in Table 7.

3. LONG TERM PATIENTS

There are 13 patients in South Australian mental institutions who were sent to South Australia by an order issued under Northern Territory Legislation. These patients are reviewed by a Northern Territory magistrate each six months.

These patients have all been institutionalised for many years. Twelve of these involuntary patients are intellectually handicapped while one is diagnosed as mentally ill. These 13, as well as an additional 12 patients for whom no formal order is current under the Northern Territory Mental Health Act, are the financial responsibility of the Northern Territory government.

Legally, all these Northern Territory patients who are held in South Australia are subject to the Mental Health legislation of South Australia.

3.1 Other long term patients for whom six month orders are renewed regularly are two intellectually handicapped

patients at Chan Park Nursing Horne, and two patients in

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maximum security facility at the Royal Darwin Hospital.

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TABLE 1

ADMISSION STATUS BY HOSPITAL: 1983/84

ROYAL ALICE

LEGAL STATUS DARWIN SPRINGS TOTAL

HOSPITAL HOSPITAL

Voluntary 423 162 585

~ ₀ Total (87.4%) (88.5%) (87.7%)

Involuntary 61 21 82

% Total (12.6%) (11.5%) (12.3%)

TOTAL 484 183 667

~ ₀ Total (100%) (100%) (100%)

TABLE 2:

SECTIONS OF ACT USED BY ADMITTING HOSPITAL: 1983/84

SECTION ROYAL

DARWIN HOSPITAL

ALICE SPRINGS HOSPITAL

TOTAL

7

8 9

13 14

TOTAL

NOTES 1.

2.

30 11 15

8

64

18

3 8 5

34

7 - Warrant to take person into custody 8 - Telephone application for warrant 9 - Taken into custody without a warrant 13 - Order to hold person in custody

48 (49.0%) 11 (11.2%) 18 (18.4%) 16 (16.3%) 5 ⁽ 5.1%)

98 (100%)

14 - Order to authorise treatment of a person while in custody

98 warrants/orders were used to admit 82 patients (i.e. some patients received more than one warrant/order)

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TABLE 3:

ADMISSION STATUS BY SEX AND ADMITTING HOSPITAL 1983/84

Voluntary Involuntary Total Admissions Admissions

MALES

Royal Darwin Hospital 238 39 277

Alice Springs Hospital 95 13 108

FEMALES

TOTAL

Of all patients admitted, 385 (57.7%) were males and 282 (42.3%) females.

Males comprised 52 (63.4%) of all involuntary admissions compared with 30 (36.6%) for women.

(i.e. Males had a higher rate of involuntary admissions than of general admissions.)

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TABLE 4

ADMISSION STATUS BY ETHNIC GROUP AND ADMITTING HOSPITAL: -1983/84

Voluntary Involuntary Admissions Admissions

NON-ABORIGINES

Royal Darwin Hospital 391 53 Alice Springs Hospital 118 14 ABORIGINES

Royal Darwin Hospital 32 8 Alice Springs Hospital 44 7

TOTAL

Royal Darwin Hospital 423 61 Alice Springs Hospital 162 21

Total

444 132

40 51

484 183

Of all patients admitted, 576 (86.3%) were non-Aboriginal and 91 (13.7%) Aboriginal.

Non-Aboriginals comprised 67 (81.7%) of all involuntary admissions compared with 15 (18.3%) for Aborigines. (i.e.

Aborigines had a higher rate of involuntary admissions than of general admissions.)

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TABLE 5

VOLUNTARY ADMISSIONS BY DIAGNOSIS AND ETHNIC GROUP:

1983/84

Diagnosis Non-Aboriginal

Schizophrenic psychoses Personality disorders Neurotic disorders Affective psychoses

Other non-organic psychoses Other than those listed above

TOTAL

TABLE 6

93 77 70 55 48 166

509

Aboriginal

33

8 4 0 5

26

76

Total

126 (21.5%) 85 (14.5%) 74 (12.7%) 55 ( 9.4%) 53 ( 9.1%) 192 (32.8%)

585 (100%)

INVOLUNTARY ADMISSIONS BY DIAGNOSIS AND ETHNIC GROUPS 1983/84

Diagnosis Non-Aboriginal

Schizophrenic psychoses 20 Affective psychoses 14 Personality disorders 11 Other nonorganic psychoses 7 Specific nonpsychotic mental 2

disorders following organic brain damage

Other than those listed above 13

TOTAL 67

NOTES FOR TABLES 5 & 6

Aboriginal

3 0 1 2 2

7

15

Total

23 (28.0%) 14 (17.1%) 12 (14.6%) 9 (11.0%) 4 ( 4.9%)

20 (24.8%)

82 (100%)

1. The five diagnostic groups with the highest rates of admissions for voluntary and involuntary patients are listed in order of frequency.

2. "Other than those listed above" refers to all other mental illness diagnoses (including alcoholic and drug psychoses, paranoid states, neurotic distorders, transient organic psychotic conditions, disturbance of conduct not elsewhere classified. )

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TABLE 7 - Facilities and Staffing(l) of Units Accepting Involuntary Patients, June 1984

Occupa-

Resident Occupa- tional Wardsmen

Total Nursing Psychi- Medical Social Welfare Psychol- tional Therapy Bed No. Staff atrist Officer Worker Officer ogist Therapist Aide

Royal Darwin Hospital 20 12.2 1 2 1 0.5 0.2 1

Ward 5

High Security Unit

5 6 P/T P/T P/T(3) ₆

Alice Springs Hospital 10 10.5 1 1 0.1( 2 )

Ward 1

TOTAL N.T. UNITS 35 28.7 2 3 1 0.1 N/A N/A 1 ₆

Notes

1.¹ Staff are listed in full-time equivalents where possible.

2. Estimate based on Welfare Officer's statistics.

3. P/T = Part Time.

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FIGURE 1

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ADMISSION STATUS BY AGE GROUP AND HOSPITAL : 1983/84

AGE (years)

UNKNOWN

20 60 +

38 50 - 59

40 - 49 37

30 - 39

20 - 29

10 - 19

0 - 9

20 0 0 20

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--, --, --, --, --, --,

49

61

40 60

ROYAL DARWIN HOSPITAL

ADMISSIONS

ALICE SPRINGS HOSPITAL

LEGEND

D

Voluntary admission Compulsory detention

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