Claims of forcible patient injection

Human rights campaigners have accused the NSW Ministry of Health of forcibly medicating mental health patients in an effort to decrease the amount of time they are allowed out of their cells.

Brett Collins, coordinator of community organisation Justice Action, has launched legal action against the NSW Mental Health Review Tribunal for failing to intervene in the Ministry of Health’s efforts to restrict the amount of time patients are allowed out of their cells.

“They [the NSW Mental Health Review Tribunal] have a responsibility in every case to properly uphold the principles of Section 68 of the Mental Health Act – which is that they [patients] should be held in the least restrictive environment,” said Mr Collins.

“Six years ago I received a complaint about the way people in the Long Bay Prison hospital were to have the time they were allowed out of their cells reduced because the hospital had intended to cut its costs,” he said.

“Instead of having something like 13 hours a day out in the open where they could speak with each other, it was going to be reduced to something like six or 10 hours.”

This month the Supreme Court extended an injunction against the NSW Ministry of Health, preventing it from forcibly injecting mental health patient Saaed Dezfouli with the drug Zuclopenthixol until a full hearing in December.

Zuclopenthixol is an antipsychotic drug used in the treatment of schizophrenia with evidence suggesting it may be helpful in the management of aggressive behaviour. A 200 mg injection peaks after 48-72 hours and provides 2-3 days of sedation.

However, experts fear that drugs like Zuclopenthixol can produce side effects that cause behaviours seen in those with mental disorders – such as violence, psychosis and suicidal tendencies.

There is increasing concern that doctors are misdiagnosing patients with mental illnesses instead of identifying those suffering from a substance or medication-induced state.

“There is a whole generation of psychiatrists that doesn’t know the difference between a mental illness and a substance or medication-induced state,” said forensic psychiatrist Dr Yolande Lucrie.

“The drug companies have instilled into a generation of psychiatrists that people who have once had a nervous breakdown of any sort – depressive or psychotic – should be on medication forever,” she said.

“They end up on medication that has a list of side effects like suicide attempts, akathisia and homicidal idealisation – so this is your crisis in mental health.”

Justice Action claims that Mr Dezfouli would benefit more from social support in his rehabilitation.

“Using social support and dealing directly with people who have mental illness is more effective than medical intervention and medication and taking control away from them,” said Mr Collins.

A spokesperson for the NSW Ministry of Health said mental health patients were involved in their own care as much as possible.

“The Justice Health & Forensic Mental Health Network clinicians provide tailored, individual treatment plans for mental health patients that engage multidisciplinary teams and are centred on the ‘Recovery Model’ of healthcare.

“This model promotes involvement of patients in their own care as much as possible and assistance in establishing appropriate support to manage their mental health and wellbeing as they transition back into the community.”

Dr Lucrie believes a culture of misdiagnosis is leading to an increase in mental health patients that could see an epidemic of medication-induced suicide and violence.

“Mental health costs have quadrupled and suicides and homicides under mental health care are very very high,” she said.

“Instead of being 40 beds [in Sydney] – which is what you would need for a population of six million – I think there are at least 150 forensic patients because the doctors in that hospital don’t want to know that these drugs have side effects.

“The outcome is an epidemic of medication-induced suicide and violence and an increasing demand for what is causing it – as a person cannot recover on a drug that makes him sicker and more dangerous than he was.”