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					Media Topics Reports (Comment on our Message Board ) Hospital warning on patient suicides
Reported in The Age 19 / 2 /04. Large numbers of mentally ill patients are committing suicide after receiving inadequate care in Victoria‟s public hospitals according to a damning letter to the State Government by a senior hospital administrator. Director of emergency services at Maroondah Hospital, Peter Archer, wrote that at his hospital alone, 13 patients had committed suicide in 13 months. This included a “High risk “ patient who hanged himself on the day the letter was written. “It is clear to all who wort at Maroondah that we are not able to offer these people the level of support they need.” Dr Archer wrote. The letter - emailed on Monday to state Health Minister Bronwyn Pike, with a copy to Premier Steve Bracks came to light yesterday after being leaked to ABC Radio. Dr Archer said emergency departments at ehe stat‟s public hospitals had become “defacto holding bays”, with 25 to 40 percent of his hospital‟s trolleys occupied by mental health patients every weekend. Dr Archer who has been physically assaulted by “desperate families”, also wrote of a mentally ill patient who went home and killed his partner after he was assessed and discharged from the emergency department, “despite his threats to do this”. “Our staff are also at risk, with frequent assaults and multiple instances of verbal abuse” he wrote. Dr Archer could not be contacted yesterday, but Penny Speed, clinical director of psychiatry for the Outer East Area Mental Health Service, which includes Maroondah Hospital, said these were daily occurrences of patients remaining in the emergency department until an appropriate bed could be found. Ms Pike conceded to the Age that the rate of suicide among discharged mentally ill patients was “indicative of the pressure this system is under”. She attributed part of the problem to the decline in bulk-billing, and more mentally ill patients. Ms Pike said the issue had to be tackled at federal level as well. She said it was “absolutely appropriate” that mentally ill patients were admitted into the general hospital system. But Opposition health spokesman David Davis said the Government had closed 600 hospital beds during the past two years, and a portion of that could have been used for mentally ill patients. “ This indicates mismanagement of the most extraordinary kind,” he said. Acting executive director of mental health charity SANE paul Morgan, said the six months after a patient was discharged from hospital were their most vulnerable. “The resources are not there to support them and they commit suicide at 12 times the rate of the general population” he said “This is going to keep happening unless we put serious money into mental health services.” The Director of mental health service Orygen Youth Health Patrick McGorry, said Australia spent only 7 per cent of its health budget on mental health, compared with up to 15 per cent in other developed countries. Author Carol Nader The Age Melbourne. ........................ ABC RADIO John Faine Program. Earlier in the day prior of 18 / 2 / 04 Paul Mckillop Convenor President of NNAAMI joined the debate on ABC Radio in support of Dr Archer letter as reported by ABC. Maroondah Hospital had only offered a spokes person and it was reported by Mr John Faine ABC Radio morning program that Dr Archer may not be given the chance to speak. Paul Mckillop stated that some people who attempt suicide may be then admitted to hospital only to be discharged the next day. This is deplorable he said. Mr Mckillop stated that Dr Archer should be allowed to speak. Mr Mckillop stated that there was a snowball effect back onto families who already share the enormous burden of coping with a person with mental illness., That where there are children in families, where there is a person with mental illness, this all rebounds and impacts back on children and comes back on them as increased stress and burden of care. That these situations really affects hundreds of thousands of people in this state (due to the numbers of people with mental illness and their families and carers). Mr Mckillop called on The Human Services Department and the Victorian Government to let Dr Archer speak and to speak with Dr Archer and listen to these concerns, That Dr Archer was only articulating what most Doctors already see around the state in casualty / emergency departments of public hospitals, Mr Mckillop said. ..................

Bed crisis blamed for deaths
A Shortage of beds for people suffering mental illnesses is costing lives, a senior emergency department doctor warns in a leaked letter to the State Government. Maroondah Hospital emergency services director Dr Peter Archer‟s Letter says emergency departments have become “defacto holding bays” for mental health patients because of a lack of beds in psychiatric clinics hospitals. “Consequently we are asked to care for and restrain these patients in facilities never designed for that purpose,” he says in the letter. Dr Archer detailed how 13 people from Maroondah Psychiatric Service had taken their lives in the past 13 months. One patient took his life this week after he was held in the emergency department for 14 hours and then escaped, he says. Dr Archer says up to 40 percent of emergency trolleys were taken up by people suffering mental problems over weekends. “Other patients including the children and the elderly, at the times they are least likely to cope , have to face the constant presence of many aggressive and behaviourally disturbed mental health patients, “the letter says. In the letter, addressed to Health Minister Bronwyn Pike and to be forwarded to Premier Steve Bracks, Dr Archer says staff are also being threatened assaulted and verbally abused. Opposition health spokesman David Davis said the Bracks Government‟s mismanagement of the health system was severely affecting emergency departments, and called on Ms Pike to intervene immediately. A spokesman for Ms Pike Ben Hart said yesterday a new emergency department, which included a designated area for psychiatric patients, was to be opened at Maroondah Hospital next week. A new designated psychiatric area would also be opened at the Angliss Hospital this year. A further 25 beds for psychiatric patient‟s would be provided at the new Casey Hospital and eight more at Box Hill Hospital he said. Mr Hart said hospitals all around Australia had been put under pressure from the increasing needs of people suffering mental illnesses, and the Government was working to address the problem. Reported in Herald Sun by Tanya Giles 22 / 2 / 04. ......................

FAX
MEMO URGENT From Mr Paul Mckillop Convenor NNAAMI Fax 98893095 Mobile 0407 857465 Copy Ms Bronwyn Pike Minister for Health Victoria. Children are affected by these issues Please provide me with a copy of your statements on 774 ABC Radio for 19/2/04 18 February, 2004

To Dr Peter Archer Director Emergency Dept Maroondah Hospital Dear Dr Archer, I have made public statements in support of you this am on 774 ABC Radio. I feel it is important that your concerns as articulated on radio by John Faine this am are appropriately addressed by government. I heard Minister Bronwyn Pike‟s reply on radio and I remain concerned that the governments statements translate to an actual increas in psychiatric beds across the state to begin to alleviate the burden on people who experience mental health conditions, their families and emergency departments of public hospitals. Emergency Departments of Public Hospitals I believe is often and inappropriate place to treat people with mental health conditions unless they present for emergency medical treatment relating to physical health issues. I‟m sure you are aware it can take some time to appropriately assess, monitor and medicate / treatpeople with serious

metnal illness even while admited in psychiatric inpatient units. The mental health system seems to be under greater pressure than ever before right across the system in Victoria. I have left a message for you to contact me on .......... Congratulations on Speaking up and drawing these serious issues to the attention of the Minister for Health. I await with interest to hear the outcome of the governments decissions. I would be pleased if you would keep me informed. Paul Mckillop ………………………….. NNAAMI would like to know the actual numbers of people with mental illness waiting on emergency departments trolleys in each hospital in the state. Ms Bronwyn Pike Minister for Health Victoria.,. as yet has not provided NNAAMI with a copy of her statement on ABC Radio. NNAAMI looks forward to the governments appropriate increase of beds at Psychiatric Inpatient Units across Victoria proportionate to need, so there are no unnecessary waiting times to access beds in psychiatric inpatient units.

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.......................................... Reported in the Age Letters & Opinion The Age.23 / 2 / 04Letters to the Editor The Age Why my daughter killed herself Referring to mental illness and suicides my daughter is one of those who did commit suicide. Her experiences of casualty departments were awful. She was treated very disrespectfully , and was even told at one stage that she was selfish because all the other people in casualty had “real” illnesses - the absurd assumption being that mental illness is not “real”. The effect of this on her - an intelligent medical student was that she found progressively more extreme ways to try and kill herself, precisely so she could avoid the punishment and derision she now assumed she would receive from staff in casualty and intensive care if she were found and revived again. This meant that she eventually found a place to die where she would not be discovered and employed a method she absolutely knew would not let her down. Yes Patrick McGorry (22/2), we do need to spend much more money on mental health - but the value and attitudes of health professionals towards mental illness also need to change, and this might not be achieved solely by the infusion of more resources. This is no way to treat my patients I am a junior psychiatric doctor in a Melbourne Metro community mental health clinic. What I do with my patients is tantamount to abuse. To them, for 20 minutes a month, I resemble a vending machine. They punch in answers to my five quick questions and receive their next packet of medicine (costing the PRS up to $400.per month). They are distressed. They need to talk . But there‟s only one of me and many of them. I wonder which they would prefer to get 15 more hours of my time a month($26 an hour ) and take $20 per month drug with more side effects,

or have the newest dearest drug based on a rapid military-style assessment. Who knows if they actually felt listened to, they might not leave the clinic and commit suicide, or keep bouncing back into the emergency department or the psychiatric ward. The nurses haven‟t been pushing for humane / nurse patient ratios because they want to have more cups of tea in their day. They just want to give patients more time than it takes to turn a screw on the assembly line. The mental health system is geared to deal with more people more quickly than ever before. Is it a cause or a consequence that it has more mentally ill people to deal with than ever before ? We have better, more expensive psychiatric drugs than ever before. Is it a cause or a consequence that there are more people on them than ever before ? Dr Kaveh Monshat. Why are there no beds in the inn for mental patients ? I would like to comment on the subject of mentally ill patients not having access to adequate care in Victorian public hospitals (the Age 19/2 - 20/2/04). Our family had the misfortune to be caught up in this horrible mess recently. Our daughter took three overdoses and threatened and (actually succeeded) in harming herself on three separate occasions. We presented her a the emergency department at Maroondah Hospital each time After a lengthy wait, she was examined physically and told she could go home. She begged to be admitted, as she knew there was something very wrong with her. On one occasion she climbed on to a high embankment outside the hospital and threatened to jump. She actually slipped and grazed and cut herself and had to be admitted back to emergency for treatment, still to be told to go home. Our daughter was told she would be held in emergency while they tried to get her a bed in the psychiatric ward.On the third attempt the next day, she was finally admitted and told she would be held in emergency department while they tried to get her a bed in the psychiatric ward. After two hours we were told that there wasn‟t a bed available in any public hospital. She subsequently spent four days in the emergency department and then spent a further four days in the psychiatric ward at Maroondah. I also feel sorry for the doctors and nurses who have to work in these conditions. It is very obvious that resources are not available in this area, and I agree that serious money needs to be put into mental health services. Mother. .......................................... Media Topics, I found the following article in the Melbourne Age. I feel its really worth adding to Media Topics . If adults find this stuff hard, what hope have kids got coping through parents mental illness and then left trying to negotiate treatment systems, Treatment that just spews people out prematurely, offering quick fixes and sending them home again to the kids with parents still in suicidal condition ? Mentally ill parents come home unprepared too. Their kids, the real carers, need a better system of treatment too for suicidal and psychotic parents. Mentally ill parents need to get into proper hospital psychiatric treatment wards, not disrupting casualty departments, and they need to be able to stay in hospital longer as a priority, so they don’t continually reek havoc on the next generation ! Psychiatrically ill Parents should not be discharged, till the kids agree they feel the parents condition has sufficiently improved to a stable state and they don’t feel, the parent or themselves, are at risk. If you are lucky to get your parent to hospital,….Casualty / Emergency department is not the place for my mum when she is sick, I don’t need the embarrassment of her behavior displayed in front of all the poor stressed doctors and accident victims. Cynthia. Reported in The Age Wed march 17 2004 Critical Condition Jason Bond suffered from a depressive illness. He was 20 years old when he dilled himself after being discharged from a Melbourne Hospital. Here, recalls the events leading up to his son‟s death, a death which he blames partly on the poor state of mental health care in Victoria.

Until the night of March 29, 1993. I had no knowledge or experience of mental illness and not the slightest inkling that my 20 year old son, Jason was suffering from a depressive illness. There had been

some behaviour on occasions that had caused concern, but it was easily dismissed as within the boundaries of sometimes difficult, teenage behaviour. I recall Vividly the late – night dash I made to the unit in which Jason had been living with his girlfriend before their break up. Earlier, I had spent the evening with one of his brothers searching unsuccessfully for him after a friend had phoned and expressed great concern about his behaviour over the preceding few days. My frantic dash was triggered by a call from my ex-wife who had just spoken to Jason on the phone and was gravely alarmed by the content of the call and his demeanour. I was so numb with grief and shock I had to be driven to the scene. I arrived just as the undertaker was removing my son‟s body. He had again taken an overdose of prescribed medication. I arrived just in time to see Jason collapse and begin convulsing as a result of a massive overdose of prescribed medication. I struggled desperately to keep Jason alive survived that night CPR until the MICA paramedics arrived. It was a close call, but Jason survived that night and , two days later, he was transferred to the psychiatry department of a major public hospital. The next eight days were enormously disorienting exhausting. Within 24 hours of his arrival at the hospital, Jason was discharged without either of his parents being advised that this was going to happen, and a visitor pressured into taking responsibility for him. The same visitor had reported to a psychiatric registrar that Jason had told him that he was going to “con the shrink, get out and do it again. “ Despite this, the discharge went ahead. Within a few hours of leaving the hospital Jason had become distressed after visiting his ex-girlfriend and had attempted to ram an oncoming vehicle on a major road. Fortunately, his visitor had stayed with him and prevented a tragedy. He contacted me immediately and together we were able, after several hours, to persuade Jasonto accompany us back to the hospital. These events were described in detail to hospital staff when Jason was re-admitted and I felt sure they were sufficiently serious to ensure Jason remained in hospital until his crisis was resolved. This was not the case. A few days later, Jason simply walked out of the hospital one evening and went and had a few drinks. He was reported missing and police were notified. Jason was actually making his way back to the hospital when he was bashed to the point of being knocked unconscious and robbed by unknown assailants. When police arrived, he was agitated and they took him back to the hospital. He was settled when he returned to the psychiatry department, but became agitated and again and when staff would not take his account of being assaulted seriously. Staff responded by grappling with him and attempting to inject him with tranquiliser haloperidol. Jason broke free and staff simply watched while he left the ward at about 3.15am in an agitated state. Their response was to go to a computer terminal and discharge him. Shortly after this, I received a reverse charges call from a public phone box near the hospital. Jason was sobbing, he was very distressed Accompanied by his brother, we raced to the hospital and found him. He was reluctant to return to the hospital after his treatment there and it took several hours, with the assistance of police who had earlier apprehended him, before he could be persuaded to return to the hospital. The hospital re-admission procedure took several hours and , in an assessment carried out by a nurse and a psychiatric registrar, Jason stated that that he “still wished to die” and that he “felt safe in the hospital, but did not trust himself outside not to act on his impulses. “ This was recorded in his medical history although later, at Jason‟s inquest, denied by the psychiatric registrar. Two days later, the same psychiatric registrar allowed Jason to be discharged at his request. Next of kin, who would be expected to look after him , were not contacted at the time or subsequently. No advice as to his diagnosis his diagnosis, how to care for him , danger signs to look for , or any such

information was ever provided. Had it not been for the fact that his 16 year old brother, a female school friend and his 20 year old female cousin, were visiting Jason at the time, he would have left unaccompanied. For the next 24 hours, all concerned felt an enormous tension in Jason‟s presence. We were dismayed that he was clearly not well, but had been discharged. How could we have him re-admitted to hospital without some quite specific grounds for concern ? We felt powerless and tried as best we could not to upset him. Had we been better informed, we might have recognized some of the subtle indications of impending suicide, such as Jason giving away his prized possessions, Jason left his mother‟s home in the evening saying he was going to visit a friend. Within minutes, his youngest brother, just 14 at the time, discovered his suicide note. Police were contacted immediately and they began an intensive search, which included the use of a police helicopter. Jason‟s mother phoned me and I got her to read the note to me very carefully in case of any clue as to where he might have gone. The clue was there but we didn‟t understand it at the time and he went to a place just outside the search area. I phoned Jason‟s friend and asked to be contacted if Jason arrived and for him to restrain Jason if necessary. Jason had also discovered where his mother had hidden his medication and he had taken it. But how much was there ? Was it a lethal dose ? My mind raced as I tried to gather the information and do the calculations Inevitably , the dreaded call came. A young man , believed to be Jason, had been attended by ambulance and police and was dead. I was so numb with grief and shock I had to be driven to the scene. I arrived just as the undertaker was removing my son‟s body. He had again taken an overdose of prescribed medication. With what I had witnessed just 11 days earlier, I could picture his death. To this day, that scene returns to haunt me. In a recent letter to the Victorian Government. Dr Peter Archer, director of emergency services at the Maroondah Hospital, re-ignited debate about the parlous state of mental health services in Victoria when he described how 13 patients admitted to that hospital had committed suicide in 13 months. He pointed to the inability of the faci8lity to provide appropriate care for such patients due to a lack of psychiatric beds. But while the specifics he pointed to were new, none of the underlying issues were. existed when my son killed himself existed today. In a letter to the Age of Feburary 21 Patrick McGorry, professor of psychiatry at the University of Melbourne, said while mental illness constitutes 20 per cent of the illness burden, it attracts only 7 per cent of the health budget. He also noted that suicide now kills the same number of people as road accidents. In October 2002, the Victorian auditor- general released the report Mental Health Services for People in Crisis. The statistics in the report are stark, ) percent of discharge plans met all the required standards; only 4percent of patient files met audit standards; in only 6percent of cases was there evidence of carer collaboration in “case closures” ; (carer psycho-education (educating Carers about the condition of patients) was absent in 98 percent of files reviewed. In short, the report disclosed a massive problem concerning quality. In our mental health system, deficiencies are the norm; This is no doubt, caused by the under-funding disclosed by Professor McGorry. By my reckoning, mental health receives barely one third of the funding it should, based on the relative illness burden. This situation will not be resolved by opening a handful of new beds, as the Victorian Health Minister Bronwyn Pike seems to think. Also in the case of these acute psychiatric patients, talk of community care is about as appropriate as suggesting your local GP undertake major cardiac surgery in his rooms. In 1993, the year my son Jason Killed himself, he had been repeatedly discharged from a psychiatric department of a major public hospital. It was also the year the Burdekin Report (Human Rights & Mental Illness ) was released. Its two volumes and 1008 pages are an indictment of the systematic neglect of mental health services in all Australian states. The response to the litany of horrors documented so comprehensively in the Burdekin Report was, predictably, denied by health departments everywhere.

The election of the Bracks Government brought a feeling of hope that, at least, the tide would turn and services would be restored to a reasonable level. But the tide has shown little sign of turning. There has been no significant improvement in the public mental health system Indeed, some of the worst of the Kennett “initiatives”, which were rightly criticized by the then Opposition spokesman on health John Thwaites, remain in place. One of the more bizarre amendments to the Mental Health Act implemented in 1995 was the removal of the whole of Section 7, which dealt with involuntary patients, Indeed as far as the Mental Health Act is concerned there is not no such thing as an involuntary patient They have ceased to exist. Although with the removal of involuntary patients went the right to appeal to the chief psychiatrist against being refused admittance to a public mental health facility. Interestingly, in relation to this experiences at Maroondah. Dr Archer said in his letter; “ It is only the fact that these patients have limited ability to access legal and complaints mechanisms that we are able to get away with the sub-humane care that they currently receive.” All admissions to the public mental health system are now as a result of assessment by a crisis and treatment team (CAT) attending a patient. ACAT team where I live is one person at the end of a phone outside of the hours of 9am and 7pm Outside these hours, a patient experiencing a crisis will be taken to the accident emergency department of a public hospital by either relatives, ambulance, or police where a CAT team will assess them the following morning, if the patient stays. The presence of a psychiatric patient in a busy A&E department geared to dealing with physical illness and injuries is inappropriate there are no trained psychiatric staff to care for them and they can become a sourse of disruption and potential danger to other patients. In some cases, they end up strapped to a trolley and attended by a security guard. When I last checked, the mental health region I live in had 25 acute beds for a population of 450,000. Confronted with similar circumstances, the New South Wales Government held a parliamentary inquiry into the death of psychiatric patients in care or soon after discharge. The ensuing report, Tracking Tragedy; a systematic look at suicides and homicides amongst mental health inpatients was released in December 2003 and can be found on the internet. Such an inquiry, broadened to include patients denied admission and the adequacy of psychiatric inpatient services, is long overdue in Victoria. The needless dealth of many patients denied appropriate treatment is nothing less than euthanasia by neglect. By Greme Bond can be contacted at; vigilance@optusnet.com.au .......................................... Article found in ‘The Age’ ‘ Letters and Opinion Section 23 Feb 2004’.

Please post this on your nnaami Media Topics Page. Peter.
This is no way to treat my patients I am a junior psychiatry doctor in a Melbourne metro community mental health clinic. What I do with my patients is tantamount to abuse. To them, for 20 minutes a month, I resemble a vending machine. They punch in answers to my five quick questions and receive their next packet of medicine (costing the PBRS up to $400 per month).

They are distressed. They need to talk. But there‟s only one of me and many of them. I wonder which they would prefer: to get 15 more hours of my time a month ($26. an hour) and take $20. per month drug with more side effects, or have the newest dearest drug based on a rapid, military – style assessment. Who knows if they actually felt listened to, they might not leave the clinic and commit suicide, or keep bouncing back into the emergency department or the psychiatric ward. The nurses haven‟t been pushing for humane nurse/patient ratios because they want have more cups of tea in their day. They just want to give patients more time than it takes to turn a screw on the assembly line. The mental health system is geared to deal with more people more quickly than ever before. Is it a cause or a consequence that it has more mentally ill people to deal with than ever before ? We have better, more expensive psychiatric drugs than ever before. Is it a cause or a consequence that there are more people on them than ever before ? Dr Kaveh XXXXXXXX, ( xxxxxx Melbourne Australia )

..........................................

System failed my son: mother
By Jamie Berry The Age September 1, 2004 The mental health system "totally failed" a man who committed suicide, his mother told an inquest yesterday. Mark Patten, 27, was an electrician with a young daughter who committed suicide on March 7, 2003. On the night before his death, Mr Patten's mother, Janet Fenech, was trying to have him admitted to hospital, while a psychiatrist had also written to St Vincent's Hospital seeking Mr Patten's admission.

"I spoke to a psychiatric triage nurse and said that I wanted to send him in by ambulance," Ms Fenech said in her statement. "The nurse told me he was not on the critical list and she could not help me."

Ms Fenech said the triage nurse advised her to give Mr Patten his medication and that she would report it to the crisis and treatment team, which would contact her the next day.

On March 7, Ms Fenech had an appointment with psychiatrist Lyn-May Lim from the crisis and treatment team, who informed her that her son had committed suicide earlier that day.

Ms Fenech said her son was "reasonably well" during his 20s but by mid-2002, his mental illness had reached the point where he was severely depressed and had expressed suicidal ideas.

Ms Fenech said her son's condition had deteriorated further in early 2003 but he was happy after seeing psychiatrist Paul Wendiggensen in February 2003. "He was finally going to get help and (be) admitted to hospital," Ms Fenech said.

But Dr Wendiggensen told the inquest yesterday that he ceased being Mr Patten's psychiatrist in late February after failing in his bid to get Mr Patten into St Vincent's Hospital. "My hands were tied," Dr Wendiggensen said. "I could do nothing."

Accusing the crisis and treatment teams of "blocking" beds in public hospitals, he said it was unfortunate but necessary for him to stop treating Mr Patten.

"I considered Mark to be in need of in-patient care and that I considered him as a high suicide risk," he said in his statement.

Mr Patten had been visited by crisis and treatment teams three times between December 2002 and February 2003.

Ms Fenech sought an inquest on her son to "highlight the difficulty of getting hospital admission for someone with a great need for intensive treatment and hospitalisation".

"Although Mark had a long history of depression, he had never been able to obtain hospital admission despite serious psychological problems," Ms Fenech said. "Why had he never been admitted to hospital for proper assessment and treatment? The mental health system totally failed to treat Mark and to help him get better in the way he so desperately wanted."

The inquest, before Coroner Heather Spooner, continues today. ..........................................

This one even got to hospital, but really too late.
Psychosis certainly twists the reasoning, its a license to kill ? and the Children are the ones who really suffer ! Every day, Children Face Psychotic parents, Alone, without help, without a hope. When will governments give priority to treatment of parents of young children, and to prevention and support services and fund nnaami. These parents always plead mental illness, to get out of facing the consequences, Parents with mental illness, they never think they are at fault ! Why was this mentally ill parent in the care of her child, and not in hospital ? I found this report in the, Herald Sun. At least they did not try and tell us mental illness is no worse than the common cold. I wonder how long will it be, before she is out of hospital and ready to kill again ? Jayne.

Sick mum killed son
Reported in The Herald Sun By Katie Lapthorne August 2004.
A MOTHER killer her toddler son because she hallucinated that he was Jack the Ripper, a court heard today. Adele Denise XXXXX, 38 fed and anti psychotic drug to two year old Shaun Clancy and then suffocated him on march 20 2002, the Supreme Court was told. Ms XXXXX has pleaded not guilty to murder because of mental impairment to a charge of murder. Prosecutor Mark gamble told the jury Shaun‟s naked body was found on the door step of the Ascot Vale flat he shared with his mother.

The court heard when police were called and approached Ms Stuart she was clearly psychologically unwell and denied Shaun was her child. Mr Gamble said Ms XXXXX was a schizophrenic and after Shaun‟s death was made an involuntary patient at the Alfred Hospital before being transferred to the secure Thomas Embling psychiatric hospital, The court heard a toxicology report showed Shaun had a 106mg/L of the anti psychotic drug prescribed to his mother in his blood, 100 times more thank the therapeutic limit for adults. Mr Gamble said Shaun also had bruises around and in his mouth consistent with a hand being forcibly placed over it to smother him. He told the jury Mrs Stuart was experiencing frightening hallucinations on the day of Shaun‟s death. “She said her head had started telling her that Shaun was Jack the Ripper and she had to kill him before he killed her “ he said. The trial continues.

The election issue neither side wants to tackle
The Age October 4, 2004 Health promises have come with much fanfare, but not when it comes to mental health, writes Greg Barns.

Iris Gray lives in a modest brick home in the working-class Hobart suburb of Glenorchy. She is 74, and frail. Her main preoccupation is her 50-year-old son, Rodney. Rodney Gray suffers from schizophrenia and has been institutionalised for much of his adult life at a mental institution called Royal Derwent in New Norfolk, about 40 kilometres from Hobart.

Since the closure of Royal Derwent a decade ago, Rodney has lived alone in a small flat in North Hobart. He has suffered malnutrition, been admitted to hospital for drinking cleaning fluid, and regularly forgets to take his medication.

Despite a letter-writing campaign to state and federal politicians, a personal visit from the former Labor premier Jim Bacon in 1998, and an article in The Mercury last year highlighting her plight, Mrs Gray has been unsuccessful in her efforts to ensure her son.

A month ago, I went to see Iris Gray and as she walked me to the front gate of her home, she shook her head, cried and said, "what will happen to Rodney when I die?"

This story is heart wrenching. As is the plight of "George", a middle-aged man whom my mother and I found crying alone in Middle Park in Melbourne earlier this year. While George sat alone in tears, at least 50 people sat literally a few metres from him sipping coffee and reading the weekend papers. My mother, who has spent more than two decades working in the welfare sector, told me George only had access to supported accommodation from Monday to Friday.

Unlike the Tasmanian forests, Iris Gray hasn't had politicians beating a path to her home to see what they can do to help her and Rodney.

And George doesn't get Mark Latham's attention when he comes to Melbourne.

When Latham launched his mental health policy last Tuesday he chose to do so in the clinical safety of a maternity ward to emphasise his fight against postnatal depression. What a pity Latham didn't head to the streets and meet some of the thousands of homeless mentally ill people who have nowhere to live safely.

It must also be said that Latham's promise of $100 million to tackle mental health is underwhelming. For a start, it seems a pitifully small amount compared with the $1.6 billion for child care Latham announced a day earlier or his $350 million for hospital emergency departments.

The ALP package does not tackle the 20-year-old running sore of the disaster that is deinstitutionalisation. There is no plan to work with the states and territories to address the damning conclusions reached by psychiatrists Carol Harvey and John Fielding in the Medical Journal of Australia last year. Harvey and Fielding wrote that the increased number of homeless people in Australia with mental illness is likely to be a consequence of inadequate implementation of the deinstitutionalisation policy and inadequate provision of alternative community mental health services.

Having made no mention of mental health in his $6 billion re-election pitch last Sunday, Prime Minister John Howard launched his mental health policy only 24 hours after Latham. Like Latham's package, it throws resources at the national depression initiative Beyond Blue and GPs, but fails to address the deinstitutionalisation crisis and is only worth $10 million more than Latham's proposals.

In short, both leaders have missed an opportunity to think laterally and recognise mental health as a national issue.

The Public Health Association of Australia, a group representing thousands of health professionals, has previously made some useful suggestions that would assist individuals such as Iris and Rodney Gray and George. They include the Federal Government actively pushing each state and territory to deliver high-quality community-based treatment, care and disability support, including rehabilitation and recovery programs and pre-vocational programs.

The crass materialism and cynical environmental vote buying of the election campaigns prevents the national scandal of the mental health crisis from seeing the light of day, except in a cursory and piecemeal way.

Meanwhile, Iris Gray battles on helping Rodney, and George has to find somewhere to sleep every weekend.

Greg Barns has been a state and federal Liberal government adviser and member of the Australian Democrats.

At last some one has recognized that pressure of coping with mental illness from childhood causes real health problems. When will governments provide the Vital and necessary support to reduce this stress through NNAAMI and WAYMI ? So funding NNAAMI could also be really cost effective for the public health system. Good on you Julie Robotham… Article found in the Age 9 /10 / 04 Federal Election Day Australia, Christine Vic.

Childhood abuse link to heart disease
By Julie Robotham The Age October 9, 2004 Childhood experiences of abuse and neglect can increase dramatically the risk of developing heart disease in later life, research shows for the first time.

Having been emotionally abused as a child increases by 70 per cent the chance a person will be diagnosed with heart disease by their 50s, while physical violence raises the risk by 50 per cent. Growing up in a family where there is mental illness, substance abuse or criminality also increases the risk, a US Government-funded study of more than 17,000 people found.

The more types of abuse or neglect a person experiences, the higher the risk of developing heart disease.

The study comes amid rising political acknowledgement in Australia and overseas of the importance of early childhood and family support services for healthy social adjustment and educational achievement.

The study suggested that heart specialists would have to look more closely at patients' psychological and social backgrounds.

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