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Mentally ill trapped in casualty
By Carol Nader
The Age - February 15, 2005
Psychiatric patients are spending up to five days in emergency departments due to a bed
shortage.
Mentally ill patients who should be in psychiatric care are spending up to five days in
emergency departments.
An investigation of five public hospital emergency departments between April and September
last year found that the longest stay of a mentally ill patient was four days and 23 hours.
Five others spent four days in emergency because there were no acute mental health beds
available and one was restrained with shackles for 39 hours.
The data, obtained by The Age, is part of research commissioned by the Department of Human
Services in response to a rise in mental health presentations to emergency wards.
From 2000 to 2002, there was a 13.9 per cent rise. According to the report's author, emergency physician and
Melbourne University researcher Jonathan Knott, 11 per cent of those patients had conditions requiring admission
to a psychiatric ward but a bed could not be found.
Their average length of stay was 20 hours, but almost a third spent more than a day on an
emergency trolley. Dr Knott said these patients got "stuck" in emergency.
"This is certainly a group that, by definition, doesn't need to come to the emergency
department," he said. "They've arrived when everyone else in the community has tried to find a
direct bed for them which doesn't exist and, by default, there is nowhere else for them to go."
The analysis of more than 3700 mentally ill patients who attended emergency departments at
The Alfred, Dandenong, Geelong, Maroondah and Royal Melbourne hospitals found the
average length of stay was eight hours, but most stayed about 41/2 hours. In the most extreme
cases, they stayed for five days.
More than 20 per cent stayed for more than 12 hours, and 6 per cent for more than one day.
Dr Knott said emergency departments had their limitations.
"You do get these situations where you have someone who's very disturbed threatening to kill
(the person next to them), like a 16-year-old with asthma," he said. "What should be considered
is having an area for people that are very behaviourally disturbed."
He said improving access to beds was a priority, and no patient should spend more than six
hours in emergency.
"Emergency departments have become the place that can't say no," he said. "The emergency
department is obliged to keep its doors open."
The figures follow a damning letter written by Maroondah Hospital emergency director Peter
Archer to Health Minister Bronwyn Pike last year, in which he said 13 patients in 13 months
had committed suicide because they had received inadequate care in hospital.
The Age believes the Government intends to make mental health a priority in the next budget.
Opposition health spokesman David Davis said the figures were "a shameful indictment" on
the Government's management of mental health.
Maroondah Hospital clinical director of psychiatry Penny Speed said: "This research helps to
identify where those very long waits are occurring and hopefully allows us to direct where we
need to put resources to try and minimise those wait periods."
Melbourne University professor of psychiatry, Patrick McGorry, said it was inappropriate for
psychiatric patients to be treated in emergency wards.
"The human rights of these psychiatric patients are really being trampled on by shackling
them," he said.
A spokeswoman for acting Health Minister Gavin Jennings said the research was
commissioned to improve the system.
"The Government recognises that there are challenges facing the mental health system, and this
is why this research has been commissioned and why funding has increased by $198 million, or
30 per cent, since it came to office," she said.



States get mental health blast
By Carol Nader
The Age - February 19, 2005


Services are underfunded and are in a disgraceful state, a Liberal says as a national
inquiry looms.
The Federal Government has attacked the states for the "disgraceful" condition of mental
health services in the lead-up to a national inquiry that aims to tackle a system in crisis.
Parliamentary secretary for health Christopher Pyne yesterday accused state governments of
seriously underfunding mental health for more than a decade.
The states needed to consider whether they had the capacity to provide these services, he said.
"Mental health services are in a disgraceful state around the country," he said. "The
Commonwealth is now spending over a third of the mental health dollar in Australia, and yet
we have no responsibility over mental health, so there are some serious questions to be
answered about the way forward to provide the best mental health services to Australians."
Mr Pyne said the states had been running mental health services poorly, but it was premature
for the Federal Government to consider taking them over.
His comments follow bipartisan support for a Senate inquiry into mental health, which is
expected to start after April.
Mr Pyne denied the inquiry was in response to the Cornelia Rau debacle. It had been planned
from late last year, he said.
The inquiry will consider the success of the national mental health strategy, established
between the Keating government and the states.
It will also investigate resources put into mental health and research, the division of
responsibility between Canberra and states, and the number of mentally ill people in jails and
detention centres.
A statement issued by beyondblue welcomed the inquiry, and quoted chairman and former
Victorian premier Jeff Kennett as saying: "You don't need a Senate inquiry to establish that the
funding for the mental health sector has been inadequate for the last 40 years."
Democrats leader Senator Lyn Allison said it was not helpful for the Federal Government to
attack the states when they should also be involved in the process.
Federal Opposition health spokeswoman Julia Gillard accused Health Minister Tony Abbott of
being "indifferent" to mental health by not dealing with the issue at a senior ministerial level.
"The very fact that it's palmed off to a parliamentary secretary lends itself to a perception that
mental health is on the side," she said.
A spokeswoman for acting Victorian Health Minister Gavin Jennings accused the Coalition of
trying to score political points.
"It's a pity the inquiry has already deteriorated into a situation where the Liberal Government is
taking any opportunity to criticise the states," she said.
Mental health groups welcomed the inquiry. Mental Health Council of Australia chief
executive John Mendoza said it was a positive sign that the inquiry had bipartisan support.
Melbourne University professor of psychiatry Patrick McGorry said an inquiry would probe
deeper than a mere need for extra short-term mental health beds.



Four Corners                                   ABC Television Documentary

Messing With Heads
8:30pm Monday, March 7, 2005
Janine Cohen explores new evidence that smoking marijuana is a major cause of depression
and psychoses among Australian teenagers.

‘ Young People with a family history of mental illness are at great risk ’ this
program reports.

Get the transcripts from the TV Documentary now form the Australian
Broadcasting Commission or view the digital program here at the ABC TV
4 Corners Program site.
www.abc.net.au/4corners/content/2005/s1315274.htm
www.abc.net.au/tv/
Printed info on ABC four Corners Site below

Please note: this program will be repeated at the later date of Wednesday 23rd March 05, 11pm.




Canberra censured for detainees' treatment
The Age May 6, 2005




The Federal Court accuses the Government of culpable neglect of two mentally ill men at
Baxter.
The Federal Court has condemned the Government for failing in its duty of care towards two
severely depressed Iranian detainees held at Baxter.
The psychiatric service given to the men was "clearly inadequate", with the men forced to
endure "long delays" and the neglect contributing to their deterioration, Justice Paul Finn has
found.
The men have been in immigration detention in various parts of Australia for about five years.
Although authorities knew that S, who had a history of self-harm, was mentally ill, he was
treated with "culpable neglect".
From late December last year, the Commonwealth had grounds to believe M had major
depression. "He could not take care of himself. Those who should have, did not".
The criticism comes as the Government is under acute pressure over its detention policy. The
Palmer inquiry into the Rau case was widened last week after it was discovered that the
Government had deported an Australian citizen four years ago and now could not find her. It
also discovered it had wrongly held other Australians in detention.
The ABC's Lateline on Wednesday reported that the woman, who was born in the Philippines,
had been sent back there.
Acting Immigration Minister Peter cGauran said the Government took the court decision "with
the utmost seriousness".
It was seeking advice from the department on the judgement's implications for the provision of
mental health services in immigration detention centres.
Justice Finn said that given the prevalence of mental illness among more than 100 long-term
detainees at Baxter, and the likely needs of S and M, the psychiatric service for them "was, and
remained, clearly inadequate".
Justice Finn said the Commonwealth's conduct contributed to the "progressive deterioration"
of the men.
The judge found the Commonwealth had ignored medical opinions from two outside
psychiatrists and a GP who challenged treatment plans for S and M. It had relied on these plans
"without feeling it necessary to obtain competent, independent, third-party advice that it was
reasonable to continue to do so".
The outside opinions indicated that conditions at Baxter were a contributing cause of the
mental illness of S and M. Baxter was unable to provide the care they needed and it was an
inapproriate environment.
The judge said the Commonwealth outsourced health-care services for Baxter but had failed to
audit these.
The detainees sought a court order for a transfer to Glenside mental health hospital in South
Australia, which the Government resisted. But by the time the case finished, the men were
already there. Justice Finn said if they had not been, he would have granted an injunction
against the Commonwealth.
The Mental Health Council called for the Government to immediately release all mentally ill
people held in immigration detention centres into the care of mental health services.
Keith Wilson, chairman of the council, said 60 to 80 per cent of people being held in
immigration detention by the Government were believed to be suffering mental illnesses.
"That the Australian Goverment's treatment of them has exacerbated their illnesses is
unacceptable," Mr Wilson said. "It is now time for the Government... to provide the proper
mental health care these people are entitled, by law, to receive."

Deported woman mentally ill: claim
The Age May 4, 2005
An Australian woman wrongly deported by immigration officials four years ago was suffering
a mental disorder and had been sent to the Philippines.
Acting Immigration Minister Peter McGauran conceded earlier this week a search was under
way for the woman - whom he would not identify for privacy reasons - after the immigration
department received a concerned letter from a family member.
The government and Australian Federal Police (AFP) have been trying to track the woman but
ABC television said the woman, who was mentally ill, was in the Philippines.
Labor's immigration spokesman Laurie Ferguson predicted the woman would be in dire
circumstances if she was in the Philippines and suffering mental illness.
He said at the very least the government should confirm the country to which the woman was
deported and said she may be eligible for compensation for her wrongful deportation.
"Clearly this is a case the department hasn't been aware of for four years, it's only been revealed
as a result of the Rau inquiry and the public revelations and I think it's pretty appalling that the
department is unaware for four years an Australian has been deported from the country," Mr
Ferguson told ABC television.
"One would think there are big issues of compensation here and I'm just unaware of why this
has not been revealed for four years and why she hasn't attempted to re-enter (Australia)."
Mr McGauran said the missing woman's family contacted the immigration department in the
wake of the closed government inquiry into the detention of Australian woman Cornelia Rau -
a schizophrenic who spent 10 months locked up before being released in February.
The government then extended that inquiry, which is headed by former Australian Federal
Police chief Mick Palmer.
The probe will now examine the details of the new case and others unearthed in a search of the
immigration department's records which found 33 people had been wrongfully detained
between July 2003 and February last year.
But Mr Ferguson said the inquiry was inadequate and called for a royal commission into
Australia's immigration detention system.
"We see a need for a full judicial public inquiry," he said.
"Mr McGauran simultaneously says that this whole thing is just an opportunity for critics to
have a circus.
"The Rau incident was bad enough, dreadful enough, but without talking about large numbers
of people it's far more endemic in the system then one would have originally thought."
Asked if he thought a royal commission was necessary, Mr Ferguson replied: "Absolutely".
He said the Palmer inquiry was inadequate because it lacked power and was being held behind
closed doors.
ABC television reported the number of wrongful detentions had blown out to more than 100, a
figure Mr Ferguson said was "mathematically logical".

Howard regrets woman was deported
The Age May 6, 2005 - 10:54AM
Prime Minister John Howard has apologised if anything "unfair" happened to an Australian
woman mistakenly deported by immigration officials.
The woman was deported to the Philippines four years ago after Australian police failed to
realise she was listed as a missing person.
Mr Howard said it appeared the woman had been treated unfairly.
"I am very sorry if anything unfairly has happened in relation to that and on the face of it that
does appear to be the case," he told Southern Cross Broadcasting.
Mr Howard said the closed government inquiry into the detention of Cornelia Rau, a mentally
ill Australian woman who was locked up as an illegal immigrant for 10 months, had been
extended to examine the case of the missing woman.
The Australian newspaper has revealed the woman, who claimed she was kept as a sex slave in
Queensland, identified herself to Philippines consulate staff as Vivian Alvarez.
She is believed to have been born in the Philippines where she apparently married an
Australian man with a surname believed to be Wilson.

Deported Australian left son behind
By Andra Jackson
The Age May 7, 2005
An Australian woman mistakenly deported to the Philippines left behind a son who is in foster
care in Queensland, it has been revealed.
Queensland Premier Peter Beattie said yesterday that the woman's son, now nine, was placed in
foster care four years ago after his mother, Vivian Alvarez, failed to pick him up from a
Brisbane creche.
Prime Minister John Howard yesterday said he was sorry about the circumstances of the
woman, who was deported in late 2001 after reportedly telling Philippines consular staff in
Brisbane that she had been held as a sex slave in Queensland.
Despite being listed as a missing person in Queensland at the time, the woman was deported by
Australian immigration authorities to the Philippines, where she was born.
The Federal Government is now under extreme pressure over what appears to have been
systemic failures in the Immigration Department.
The Government has started a so far unsuccessful search for the woman in the Philippines in
the past week.
Mr Howard told Southern Cross radio: "I am very sorry if anything unfairly has happened in
relation to that (the woman's case)." "On the face of it that does appear to be the case."
Mr Howard has refused to apologise about the mistaken detention of a mentally ill Australian
resident Cornelia Rau, saying he would instead await the outcome of the inquiry into her
detention, headed by former federal police chief Mick Palmer.
Acting Immigration Minister Peter McGauran has referred the Alvarez case and other recently
discovered cases of wrongful detention to the closed inquiry into the Rau detention.
Mr Beattie yesterday called on the Howard Government to open a judicial inquiry into the
detention scandals.
He said the latest case highlighted the need for a national system of listing missing people.
The Alvarez case came to light after Ms Alvarez's family in Australia - believed to be her
husband - contacted the Immigration Department two weeks ago about her whereabouts.
Mr Beattie said the woman's son was placed in foster care after she failed to pick him up from
the Brisbane City Hall child-care centre on February 16, 2001. The Queensland Department of
Family Services reported Vivian Alvarez as missing to police on July 17, 2001. She was listed
on the Queensland missing persons register under that name and also as Vivian Wilson, her
married name.
It is believed she married the Australian man in the Philippines and was fleeing domestic
violence when she was struck by a car in Lismore in northern NSW.
This was some months after July 2001, said Mr Beattie.
He said she was taken to a NSW hospital where she used a different name. Hospital staff could
not confirm her identity and called immigration officials who could not find any records of her
arrival in Australia.
"Three days later the Department of Immigration brought her to Coolangatta and arranged for
Queensland police to escort her under deportation to the Philippines. She was going under a
name of which Queensland police had no record," Mr Beattie said.
Yesterday, the Philippines embassy refused to confirm a report that just before she was
deported its staff had interviewed the still-injured woman in a Coolangatta motel and that she
claimed to have been held as a sex slave.
Queensland police yesterday declined to say if it had investigated the woman's claims, saying
the matter was being investigated by the Rau inquiry.
Phil Glendenning, from the social justice Edmund Rice Centre in Sydney, said it seemed that
wrongful deportation was more likely to occur if one was non-white, had poor English, or was
mentally ill.- with AAP
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A prisoner all her life, this girl bears the
scars
By Lee Glendinning and Joseph Kerr
The Sydney Morning Herald May 7, 2005




"Her life is so unfair" ... Virginia Leong on her daughter, Naomi.
Photo: Tamara Dean

Three-year-old Naomi Leong was born into detention and has known no other life but still asks
her mother when they are going home. She started off warm and engaging but became
increasingly disconnected as she grew. Now she is listless, will not play with other children and
wants only constant nursing by her mother.
"Every time she sees me upset and feeling sad she bangs her head against the wall," her
31-year-old Malaysian mother, Virginia Leong, told the Herald from Villawood Detention
Centre yesterday. "But there's nowhere I can hide. I am unstable and screaming all the time. I
cannot help it."
Of the 74 child detainees in Australia, Naomi has been in detention longer than any of them.
Ms Leong says she lives only for her daughter, and has told a psychiatrist she is "exhausting"
herself trying to look happy even though she "feels dead".
"She seems very weird," she said yesterday of her daughter. "She is never playing around
children her own age and she will never talk much, but she always says to me, 'When can we go
home?' and I say we can't and she says, 'No, let's go go home?' What can I say to that?"
Psychiatrists have said detention is indelibly damaging Naomi. According to one psychiatrist's
report obtained by the Herald, Ms Leong was said to be apparently suffering severe major
depression and psychotic features.
"She and Naomi are both potentially at risk of their safety if this condition is allowed to
continue without adequate treatment, as it has been so far," said Michael Dudley. He also
recommended removing Ms Leong and Naomi to a psychiatric unit.
It is understood Ms Leong entered Australia on a valid visa, but overstayed.
She was two months pregnant with Naomi when she was detained for trying to travel to Hong
Kong on a false passport.
Naomi's case is just the latest to raise concerns about how immigration authorities are
managing detainees' mental health. A Federal Court judge this week said the Government had
failed in its duty of care to two long-term Iranian detainees who are now in a psychiatric
hospital. The inquiry into Cornelia Rau's detention has also been widened to include 33 other
people wrongly detained.
AN Immigration Department spokesman said Naomi was not an Australian citizen and that Ms
Leong was free to leave Australia.
So disturbing has been Naomi's behaviour - she has stopped eating and drinks only juice - that
a psychiatrist asked the department in March to let her visit a children's play group centre for
two hours a week.
Ms Leong said: "My brain has already been destroyed but I am trying to stop hers from being
destroyed. Her life is so unfair."
   The Prime Minister has apologised for the wrongful deportation of Australian Vivian
Alvarez to the Philippines. Ms Alvarez, who went missing in 2001, has a nine-year-old son in
foster care in Brisbane.

Don’t Let them Die in Vain
Herald Sun, WED 04 MAY 2005, Page 020
By: John Ferguson
SO who was Mark Bailey, and will his life mean more in death?
It is a name that in normal circumstances would remain in the public
mind for weeks, if not months or years.
Despite having shot Sen-Constable Tony Clarke less than a fortnight
ago, it is becoming clear that 26-year-old Bailey has been all but forgotten
by those unaffected by the trauma of April 24.
Unlike police killers of past generations and circumstances, there
seems to be some comfort being taken in the fact that Bailey killed himself;
that he was disturbed, rather than a career criminal seeking revenge.
With apologies to his family, Bailey's suicide has taken some of the
sting out of the anger that followed the execution of Sen-Constable Clarke.
Rather than lingering in a cell, rough justice was self-administered
in the Yarra Ranges.
Yet it would be a profound mistake if Bailey were simply confined to
the scrap-heap of society's collective short-term memory. Indeed, for the
sake of his victim and his wife and child, Bailey's violent end should not
be ignored.
INSTEAD, it should be examined in fine detail to determine what --
if anything -- could have been done to prevent the two deaths.
The coroner will have his say, but police, the State Government and
the health industry should be asking whether a more detailed investigation
-- such as a royal commission -- should be held into not only Bailey but the
wider issue of dealing with mentally ill Victorians.
Any investigation should go beyond the simple argument of whether
Sen-Constable Clarke should have been operating alone. That answer is
simple: in an ideal world, no.
Yet for the deaths to have real long-term impact, authorities would
be well advised to open up mental health services statewide to a meaningful
inquiry.
Mental health is, of course, a subject with which governments and
society are slowly coming to grips.
The stigma of suffering from depression and related ailments will
surely last to some degree for many years, but there is finally a growing
consensus that heads in the sand don't equate to either good policy or
compassion.
The Bracks Government deserves credit for its package of mental
health reforms, announced last week.
But the hype that surrounded the social package needs to be seen in
context. The $180 million injection into mental health services is over four
years, and $55 million relates to capital works.
So the money to be spent on services and wages is limited to $124.8
million, or a shade over $31 million each year.
Which is, in reality, a piddling amount in the bigger picture,
dwarfed by land tax relief and other such initiatives.
It means that, in effect, the health system will continue to be
burdened by insufficient mental health resources, though there appears to be
an acceptance by the Government that major aspects of critical care are
failing.
Bailey's parents complained at the weekend that they had stood in
the emergency department of a suburban hospital in 2002 crying out for help.
They were, it seems, well and truly in the wrong place.
Yet for all his hurdles, Bailey had a lot more support than many
others who find themselves in the same position. He was loved by a family
who may not have understood their son but certainly threw their arms around
him.
None of this is to diminish or excuse his actions as a killer. But
for the wider good, Bailey -- and people like him -- deserve to have their
plight and the resources available to them open to meaningful scrutiny.
Few would suggest that the Cain and Kirner governments'
de-institutionalisation policy, which involved the shift from psychiatric
hospital to community-based care, should be wound back.
But there is plenty of evidence on the streets to suggest that there
remain insufficient resources for the mentally ill, who once might have been
institutionalised and under constant care.
The biggest single impediment to serious reform on mental health is
that those who need the help aren't always the most efficient advocates for
change.
Where a pensioner waiting for a new hip is likely to open her mouth
and complain, it's not quite the same for a pensioner in the midst of a
crippling depression.
SOCIETY, no matter what many would like to think, still can't
properly get its head around mental health problems.
Mark Bailey couldn't come to terms with his life and the
consequences were powerfully tragic for the Clarke family as well as the
Baileys.
Bailey, like Sen-Constable Clarke, is gone.
Neither should be forgotten, even though one died in shame, the
other a servant of the people.

Doyle's mental health vow
By Mathew Murphy
The Age May 2, 2005




Mr Doyle to match Premier's pledge.
Photo: James Davies

State Opposition Leader Robert Doyle has pledged to match Premier Steve Bracks' funding of
mental health if the Liberal Party wins the next election.
Mr Doyle said there was "no question" a Liberal government would match the $180 million
extra to mental health over four years, which was outlined in the Government's social policy
statement last Thursday.
While he welcomed "every single extra dollar into mental health", he said the Government had
not gone far enough.
Former Liberal premier Jeff Kennett, who praised Mr Bracks on Thursday for focusing on
mental health, said the move was a "small step for mankind".
"It is never enough, but it is a start," he said.
Mr Kennett, chairman of the national depression initiative beyondblue, described the funding
as "the largest contribution to mental illness by any state government ever" and said if he was
still premier mental health would be in his top two or three priorities.
"Knowing what I know today it would be among my top priorities. You can't live in the past,
but if I knew what I know now about mental health it would have been different," he said.
Mr Bracks said he was pleased to hear Mr Kennett's approval of the funding. "He has certainly
made a mark on mental illness and on ensuring there is a clear focus around Australia on that
issue."
Mr Bracks challenged Mr Doyle to take another look at the statement on mental health.
"In opposition it's easy to be against everything, it's harder sometimes and it takes a bit of
courage to say that was a good initiative," Mr Bracks said.
Mr Doyle said he believed the measures were lacking in detail. "I am happy to give a tick if it is
deserved. I am not a negative person. But tell me how you are going to do things. I want
transparency and specifics - what is new and what is just trotted out as a re-announcement?"
But Mr Doyle congratulated the Premier for allocating $6.5 million to early intervention
measures focused on 16 to 25-year-olds showing signs of mental health problems.
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