15 April 2013

Secure mental health. More medium security beds. High security goes overboard

| johnboy
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The Chief Minister has announced she now has paperwork confirming the desperate need for a secure mental health facility in Canberra:

Chief Minister and Minister for Health, Katy Gallagher today confirmed changes to plans for the ACT’s secure Mental Health Facility with reviews of planning for a secure mental health facility in the ACT confirming the need for a facility providing medium and low secure beds.

The two changes to the project include the construction of a medium secure facility rather than a high secure facility and the increase of beds from 15 to 25 for the facility.

“I believe these changes will ensure the best outcome for patients and staff, ensuring sustainability and viability of the service for the future,” the Chief Minister said.

“A secure mental health facility is the missing piece in the current ACT mental health system. We have built an Adult Mental Health Unit, a Mental Health Assessment Unit and a step-up/step-down supported accommodation service, but now we need this service to meet the need that exists and to cater for future capacity.

“After extensive site investigations to determine the most appropriate location for a secure mental health facility in the ACT, the former Quamby Youth Detention Centre site in Symonston was identified as the most appropriate location in 2010.

A pity we’re losing the high security. More beds is probably a good idea though.

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Look, i’m not highly paid consultant getting mega bucks to tell you these things, but let’s face it, you (the Govt) haven’t had a good track record in sizing of new facilities (New TCH Women and Children’s, new TCH high dependency mental health building, AMC to name a few). I suggest you get your consultant-determined sizing for this facility and double it.
There is no charge…. 🙂

Pork Hunt said :

For an Irishman who is a councillor in a small Aussie bush shire, you sure have an opinion on mental health and corrective services issues. Are you in the wrong trade or did you escape the system, so to speak?

If I wanted to use my real name, I would. You start…

IP

IrishPete said :

jimbocool said :

Roundhead89 said :

TCH had a secure mental health unit in the 1990s. It was called PSA. When it was judged that patients had recovered sufficiently they were moved to the low security PSB facility.

Please don’t tell me they spent all that money on a shiny new mental health unit without including a secure area?

I think you’re perhaps confusing “secure” with “dependency”. A “secure” unit in this sense is for forensic patients – that is people who have committed (generally violent) crime but found to be unfit to plead or not guilty by virtue of mental illness. It can also be used for mainstream prisoners who develop mental illness whilst in jail. So the security levels match the security levels used in the corrections system. ACT forensic patients have generally always been held in NSW facilities: Kenmore (near Goulburn, when it was still open); Kestrel Unit at Morriset Hospital near Newcastle. The really dangerous, high security forensic patients are sent to the Malabar Hospital which is part of the the Long Bay Jail complex.

The ACT developing its own forensic facilities is a good thing – better access for patients to family and support networks.

The PSA and PSB were units for high dependency patients – that is patients who were very ill and posed a risk to themselves or others, but who had not yet become involved with the criminal justice system. They still needed to be held in a ‘secure’ environment. The current psych facilites at TCH have a High Dependency Unit and various step downs, with associated levels of security.

Some truth to this, but some a bit off (sorry).

Malabar is next to Long Bay but is not part of the prison system. It’s a hospital. No ACT prisoners have ever been sent there. I don’t think anyone else from the ACT has been either, because it’s always full of pesky NSW patients.

It’s also quite likely some people will be admitted to the forensic unit without having committed an offence yet, or instead of being charged with one. I think this is why they don’t call it a Forensic Unit, they call it a Secure Mental Health Unit.

It remains to be seen how the security levels of the ACT forensic unit will match up to the levels used in Corrective Services. Pretty much everyone comes into prison as Maximum Security until they are properly assessed, so if the two places’ security classificatons are a direct match, no new prisoner will ever be able to be transferred to hospital. And in prison, serious mental illness may be enough to keep you Maximum Security, so I foresee potential for a Catch 22 – “you’re too unwell to be transferred to the hospital”.

Hopefully ACT Health and ACTCS will work this out.

Otherwise this is reasonably good news, at least that there are going to be more beds. Not so good news for the unwell people who are maximum security because of the nature of their offence. It will also be interesting to see how the judiciary treat the news that they can’t send someone to the Unit for admission, only for assessment, because a psychiatrist will still have final say on admission (as it works now).

IP

For an Irishman who is a councillor in a small Aussie bush shire, you sure have an opinion on mental health and corrective services issues. Are you in the wrong trade or did you escape the system, so to speak?

This has been needed for at least a decade. It’s an indictment we are still hanging off govco promises.

jimbocool said :

Roundhead89 said :

TCH had a secure mental health unit in the 1990s. It was called PSA. When it was judged that patients had recovered sufficiently they were moved to the low security PSB facility.

Please don’t tell me they spent all that money on a shiny new mental health unit without including a secure area?

I think you’re perhaps confusing “secure” with “dependency”. A “secure” unit in this sense is for forensic patients – that is people who have committed (generally violent) crime but found to be unfit to plead or not guilty by virtue of mental illness. It can also be used for mainstream prisoners who develop mental illness whilst in jail. So the security levels match the security levels used in the corrections system. ACT forensic patients have generally always been held in NSW facilities: Kenmore (near Goulburn, when it was still open); Kestrel Unit at Morriset Hospital near Newcastle. The really dangerous, high security forensic patients are sent to the Malabar Hospital which is part of the the Long Bay Jail complex.

The ACT developing its own forensic facilities is a good thing – better access for patients to family and support networks.

The PSA and PSB were units for high dependency patients – that is patients who were very ill and posed a risk to themselves or others, but who had not yet become involved with the criminal justice system. They still needed to be held in a ‘secure’ environment. The current psych facilites at TCH have a High Dependency Unit and various step downs, with associated levels of security.

Some truth to this, but some a bit off (sorry).

Malabar is next to Long Bay but is not part of the prison system. It’s a hospital. No ACT prisoners have ever been sent there. I don’t think anyone else from the ACT has been either, because it’s always full of pesky NSW patients.

It’s also quite likely some people will be admitted to the forensic unit without having committed an offence yet, or instead of being charged with one. I think this is why they don’t call it a Forensic Unit, they call it a Secure Mental Health Unit.

It remains to be seen how the security levels of the ACT forensic unit will match up to the levels used in Corrective Services. Pretty much everyone comes into prison as Maximum Security until they are properly assessed, so if the two places’ security classificatons are a direct match, no new prisoner will ever be able to be transferred to hospital. And in prison, serious mental illness may be enough to keep you Maximum Security, so I foresee potential for a Catch 22 – “you’re too unwell to be transferred to the hospital”.

Hopefully ACT Health and ACTCS will work this out.

Otherwise this is reasonably good news, at least that there are going to be more beds. Not so good news for the unwell people who are maximum security because of the nature of their offence. It will also be interesting to see how the judiciary treat the news that they can’t send someone to the Unit for admission, only for assessment, because a psychiatrist will still have final say on admission (as it works now).

IP

Roundhead89 said :

TCH had a secure mental health unit in the 1990s. It was called PSA. When it was judged that patients had recovered sufficiently they were moved to the low security PSB facility.

Please don’t tell me they spent all that money on a shiny new mental health unit without including a secure area?

I think you’re perhaps confusing “secure” with “dependency”. A “secure” unit in this sense is for forensic patients – that is people who have committed (generally violent) crime but found to be unfit to plead or not guilty by virtue of mental illness. It can also be used for mainstream prisoners who develop mental illness whilst in jail. So the security levels match the security levels used in the corrections system. ACT forensic patients have generally always been held in NSW facilities: Kenmore (near Goulburn, when it was still open); Kestrel Unit at Morriset Hospital near Newcastle. The really dangerous, high security forensic patients are sent to the Malabar Hospital which is part of the the Long Bay Jail complex.

The ACT developing its own forensic facilities is a good thing – better access for patients to family and support networks.

The PSA and PSB were units for high dependency patients – that is patients who were very ill and posed a risk to themselves or others, but who had not yet become involved with the criminal justice system. They still needed to be held in a ‘secure’ environment. The current psych facilites at TCH have a High Dependency Unit and various step downs, with associated levels of security.

TCH had a secure mental health unit in the 1990s. It was called PSA. When it was judged that patients had recovered sufficiently they were moved to the low security PSB facility.

Please don’t tell me they spent all that money on a shiny new mental health unit without including a secure area?

So only two people have required high secure care in the last five years? I wonder where Monfries would’ve been slotted,if anywhere.

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