Interventions in the 18 months since a Dhulwa nurse had his finger partially severed and degloved in an occupational violence incident seem to be working, with no serious altercations reported in the past year.
Alarm bells had been raised by staff at the Dhulwa Mental Health Unit in April last year, with more than 100 assaults by patients reported in six months, with a subsequent review painting a scathing picture of the facility’s practices and care.
Canberra Health Services (CHS) has since closed off 29 of the 53 actions from the review, including seven of the 29 recommendations.
CHS CEO Dave Peffer said this had not only improved the culture at Dhulwa, but safety as well.
“A key indicator for us and something that we are very proud of – and I am proud of the team as well – is that the last occupational violence incident reported at Dhulwa was October 2022, over 12 months ago,” he told annual reports hearings.
He later clarified there had been an incident reported from Dhulwa in August, which “did not lead to an injury or any time off work”.
A CHS spokesperson clarified this reported incident involved a patient who had thrown their chocolate milk, which hit a wall near a staff member.
“The Dhulwa staff used their training to de-escalate the situation, no physical contact occurred and no physical injuries were reported,” the spokesperson said.
Asked about using security guards to protect staff during potential incidents, Justice Health, Alcohol and Drug Services executive director (Mental Health) Katie McKenzie said that wouldn’t be appropriate as such circumstances needed a clinical response.
“There is no need for them. The role of security is perimeter,” she said.
“The role of their clinical team is managing those interpersonal dynamics that happen on the ward.”
Mental health and justice representatives were also asked about mental health patients absconding during day leave across Canberra’s facilities.
During the 2022-23 financial year, 28 people receiving mental health care were uncontactable during a period of leave, with two of those people under a Section 309, which is a compulsory treatment or mental health order from the courts.
Ms McKenzie explained that no matter a person’s classification, the absent without leave (or AWOL) policy would be enacted.
”There are a couple of people in that who will have left without being on approved leave,” she said.
”Our response in those spaces is a dual response – to try and contact the consumer, firstly, because it is actually about encouraging them to return, and to work with the police to try and locate the consumer.”
The difference in numbers between those who were AWOL when returning from leave and those who didn’t have leave privileges in the first place was taken on notice.
A CHS spokesperson pointed out day leave was an important “therapeutic” tool for inpatients.
“Granting leave from a CHS mental health unit is a clinical decision made by the treating team and is carefully determined by a range of factors,” they said.
“We have appropriate treatment plans, behavioural management plans and risk mitigations in place for all patients and these plans are regularly updated to ensure they remain relevant to their stage of recovery.”
CHS has been working through the recommendations from the Independent Inquiry into the Legislative, Workplace Governance and Clinical Frameworks at Dhulwa.