Disparities in mental health treatment emerge from report
MEDIA RELEASE
January 16, 2009
The Mental Health Foundation is concerned about significant disparities between district health boards (DHBs) in their treatment of mental health clients.
Figures released this week by the Ministry of Health in the 2007 Annual Report from the Office of the Director of Mental Health show some DHBs are far more likely to issue compulsory treatment orders, place patients in seclusion or administer electro-convulsive therapy (ECT) than others.
"We welcome the release of these figures as it allows us to see where change most needs to occur," says Judi Clements, Chief Executive of the Mental Health Foundation. "All of these practices are of concern to us, and while the report cites reasons for these disparities, we don't believe these reasons sufficiently explain the variances in treatment practice between DHBs, which are quite significant."
The Foundation says it is pleased that the Ministry of Health has restated its commitment to reducing the incidence of seclusion, but notes that nearly one in five patients admitted to mental health units in 2007 were placed in seclusion.
"We are concerned that the report shows Maori are statistically more likely to be secluded than other ethnic groups, and for longer periods," says Judi Clements. "Questions need to be raised about why this is happening - are mental health services reaching Maori early enough? Are services being provided in a culturally appropriate manner? Are assumptions being made about the danger posed by certain patients?"
Also of disappointment is the failure of most DHBs to provide at least 90 percent of their long-term mental health clients with relapse prevention plans, a target set by the Director-General of Health for 2007/08.
"Only four out of twenty-one DHBs consistently met this target. At the other end of the scale, five DHBs provided less than 45% of their long-term clients with relapse prevention plans," says Judi Clements. "We're disappointed as this would seem to be quite a basic aspect of mental health service provision."
On a positive note, the Foundation is pleased to note the continued reduction in the use of ECT, but again raises concern over significant variations in its use across different DHBs.
"ECT is a controversial procedure which can be traumatising for those who undergo it," says Judi Clements. "Those who consent to undergoing ECT need to be truly informed as to what they are consenting to.
"For those who have ECT administered while under a compulsory treatment order, such consent is not possible as the patient is deemed mentally unsuitable for decision-making. In these situations, the Foundation is in favour of ‘advance directives', which allow mental health consumers to make decisions about potential future treatment options while they are in a state of wellness."
Further information about terms used in this media release
What is seclusion?
Seclusion is the placing of a person at any time and for any duration, alone in an area where he/she cannot freely exit. In addition to containment and isolation, seclusion is usually accompanied by a reduction of sensory input. The room is bare, often limited to blank windowless walls, fluorescent lights, a bed and sometimes a toilet. Time spent in seclusion can vary from minutes to hours and even days.
What is a compulsory treatment order?
A court order requiring a person to be treated for a mental disorder. There are two types of compulsory treatment orders, community treatment orders and inpatient orders. An inpatient order requires a person to be detained in a hospital for treatment. A community treatment order entitles the patient to be treated and live in the community. The order must specify the place where the patient is required to attend for treatment.
What is ECT?
Electroconvulsive therapy (ECT) is a controversial therapeutic procedure in which a brief pulse of electricity is delivered to a patient's brain in order to produce a seizure. It is used as a treatment for various types of mental illness, including depression, mania, schizophrenia, catatonia and other neuropsychiatric conditions. Known side-effects include confusion and memory loss.
For further inquiries
Chris Banks
Senior Communications Officer
Mental Health Foundation of New Zealand
09 300 7028 or 021 790 236
