S053: The Law & Legislative Reform
Tracks
Track 5
| Thursday, August 27, 2015 |
| 1:30 PM - 3:00 PM |
| Sutherland Theatrette |
Speaker
Robyn Humphries
Manager, Systems Transformation Mental Health Branch
Department of Health and Human Services Victoria
Legislative reform in Victoria: Mental Health Act 2014
Abstract
Victoria's Mental Health Act 1986 was 28 years old and no longer reflected contemporary attitudes and practice. The 1986 Act was introduced in the policy context of the closure of large, stand-alone psychiatric institutions and it introduced regular external review of involuntary patients through establishment of the Mental Health Review Board (MHRB). In his public address on the 20th anniversary of the MHRB Mr Neil Rees, the first Chairman of the MHRB, said “The Mental Health Review Board entered a relatively closed world in which the superintendents of large hospitals, who exercised significant powers, had seldom been challenged or overruled”.(1) The legislation established a legal base for the rights of people with mental illness, and their right to representation.
That was last century and we have all come a long way since then! Now in Victoria most people receive most of their treatment in community settings, clinical practice and models of service delivery have evolved, and perhaps most importantly, consumers and their families and carers now have a voice and are providing strong leadership and influence in the way mental health services are developed and delivered.
Mental health legislation is largely a reflection of community values and attitudes about how treatment for those with mental illness should be provided. The 1986 Act reflected an air of beneficence and a concern to protect the community from harm. It also reflected a desire to have some checks and balances around the deprivation of personal liberty.
Although there were many amendments to the 1896 Act over ensuing years to accommodate changes in community values and expectations,after 28 years the fundamental underpinning values and attitudes were no longer acceptable or appropriate.As is generally the case, reform was needed so that legislation could catch up with the 'real world'.
Clinical practice and community expectations have evolved to the point where we all recognise that best practice involves collaboration between consumers, family and carers and clinicians, and that personal recovery is as important, perhaps even more important, than clinical recovery. It is in this context that the Victorian Mental Heath Act 2014 has been drafted and implemented.
The new act has clear links to human rights and is underpinned by the Victorian Charter of Human Rights and responsibilities (2006 Act) and the United Nations Convention on the Rights of Persons with Disabilities (2006). The legislation has four key objectives:
To establish a recovery oriented framework and embed supported decision making
To minimise the use and duration of compulsory treatment
To increase safeguards to protect the rights and dignity of people with mental illness
To enhance oversight and encourage service improvement.
At the heart of the Mental Health Act 2014 is the presumption of capacity and supported decision making. It is this that will transform practice. Under Victoria's previous legislation persons receiving involuntary treatment were presumed to lack capacity to consent to treatment and therefore substitute decision making occurred. Now compulsory patients are presumed to have capacity and must therefore be involved in all decision making about their treatment and care.
The Mental Health Act 2014 introduces several mechanisms to support patients to participate in decision making, and strengthened safeguards to protect the rights of compulsory patients.
This symposium will outline the processes of legislative review, and planning and preparation for implementation of the new legislation. Key features of the Mental Health Act 2014 will be described and resources developed to promote awareness and practice change will be shared. The symposium will also include a detailed descriptions of the roles of the Mental Health Tribunal and the Mental Health Complaints Commissioner and consideration of the issues and themes that have emerged in the first 12 months of their work.
Reflections on the impact of the legislative reform will be shared, along with insights gained from the process of such large scale reform, and plans for evaluation and next steps.
The symposium will include a range presenters, including consumer and carer leaders and other key stakeholders.
1.LEARNING FROM THE PAST, LOOKING TO THE FUTURE: IS VICTORIAN MENTAL HEALTH LAW RIPE FOR REFORM?
Neil Rees
Mental Health Review Board of Victoria’s 20th Anniversary Conference
6 December 2007, Melbourne .
That was last century and we have all come a long way since then! Now in Victoria most people receive most of their treatment in community settings, clinical practice and models of service delivery have evolved, and perhaps most importantly, consumers and their families and carers now have a voice and are providing strong leadership and influence in the way mental health services are developed and delivered.
Mental health legislation is largely a reflection of community values and attitudes about how treatment for those with mental illness should be provided. The 1986 Act reflected an air of beneficence and a concern to protect the community from harm. It also reflected a desire to have some checks and balances around the deprivation of personal liberty.
Although there were many amendments to the 1896 Act over ensuing years to accommodate changes in community values and expectations,after 28 years the fundamental underpinning values and attitudes were no longer acceptable or appropriate.As is generally the case, reform was needed so that legislation could catch up with the 'real world'.
Clinical practice and community expectations have evolved to the point where we all recognise that best practice involves collaboration between consumers, family and carers and clinicians, and that personal recovery is as important, perhaps even more important, than clinical recovery. It is in this context that the Victorian Mental Heath Act 2014 has been drafted and implemented.
The new act has clear links to human rights and is underpinned by the Victorian Charter of Human Rights and responsibilities (2006 Act) and the United Nations Convention on the Rights of Persons with Disabilities (2006). The legislation has four key objectives:
To establish a recovery oriented framework and embed supported decision making
To minimise the use and duration of compulsory treatment
To increase safeguards to protect the rights and dignity of people with mental illness
To enhance oversight and encourage service improvement.
At the heart of the Mental Health Act 2014 is the presumption of capacity and supported decision making. It is this that will transform practice. Under Victoria's previous legislation persons receiving involuntary treatment were presumed to lack capacity to consent to treatment and therefore substitute decision making occurred. Now compulsory patients are presumed to have capacity and must therefore be involved in all decision making about their treatment and care.
The Mental Health Act 2014 introduces several mechanisms to support patients to participate in decision making, and strengthened safeguards to protect the rights of compulsory patients.
This symposium will outline the processes of legislative review, and planning and preparation for implementation of the new legislation. Key features of the Mental Health Act 2014 will be described and resources developed to promote awareness and practice change will be shared. The symposium will also include a detailed descriptions of the roles of the Mental Health Tribunal and the Mental Health Complaints Commissioner and consideration of the issues and themes that have emerged in the first 12 months of their work.
Reflections on the impact of the legislative reform will be shared, along with insights gained from the process of such large scale reform, and plans for evaluation and next steps.
The symposium will include a range presenters, including consumer and carer leaders and other key stakeholders.
1.LEARNING FROM THE PAST, LOOKING TO THE FUTURE: IS VICTORIAN MENTAL HEALTH LAW RIPE FOR REFORM?
Neil Rees
Mental Health Review Board of Victoria’s 20th Anniversary Conference
6 December 2007, Melbourne .
Biography
Robyn Humphries has worked in public sector clinical mental health services in Victoria for more than 30 years. Her career commenced as a social worker and case manager, then as a community programs program manager and for 12 years as the Manager of the Northern Area Mental Health Service, a large adult service in northern metropolitan Melbourne. In June 2014 Robyn commenced in her current position in the Department of Health & Human Services Victoria. As Manager System Transformation, Robyn has been involved with the implementation of significant mental health legislative and community sector reform. She feels privileged and excited by the opportunity to combine her extensive experience in mental health service delivery with policy development and strategic planning at the statewide level.
