Victoria to conduct review into coercive practices in mental health system

·3-min read
<span>Photograph: Joel Carrett/AAP</span>
Photograph: Joel Carrett/AAP

The Victorian government will require patient advocacy services be notified of any compulsory treatment under changes to Victoria’s mental health system, with a former federal court judge to lead a review into the criteria used for coercive practices.

But the state’s peak mental health body said the proposed Mental Health and Wellbeing Act – unveiled by the government on Thursday in response to a scathing royal commission – would not create “fundamental change” for patients.

The Victorian Mental Illness Awareness Council (VMIAC) called on the government to immediately end the compulsory treatment practices of seclusion and restraint on mental health wards.

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“People in mental health services, including children will continue to be detained, restrained, secluded and treated against their will,” said VMIAC’s chief executive, Craig Wallace.

Under the proposed legislation, mental health services are required to notify advocacy services when a person is forced to undergo treatment to ensure patients are aware of their rights and have more agency.

This reflects a recommendation from a royal commission into the state’s mental health system, which found that the intervention of advocacy services may drive down the use of coercive practices.

While the bill makes minor legal changes to the rights of people who experience compulsory mental health treatment, a review – that will commence in October – will make recommendations to the government next year for future legislative changes.

Tabling the new legislation, the mental health minister, James Merlino, announced the government had appointed Judge Shane Marshall to lead the review into the criteria for compulsory treatment, alongside psychiatrist Prof Richard Newton and mental health advocates.

Merlino said the legislation would centre the views and values of Victorians living with mental illness, their families and carers by enshrining in law the vision of the royal commission.

“We will create the service system envisioned by the royal commission, providing world-leading mental health and wellbeing services for all Victorians,” he said.

“This is an unapologetically aspirational bill but it would be naive to expect that the reform of the royal commission can be implemented overnight.”

Marshall – a former federal court judge and acting judge of Tasmania’s supreme court – has previously spoken publicly about his struggles with depression and mental health issues in the legal profession.

The royal commission, which published its final report last year, found human rights were being breached by having patients locked away or handcuffed. It recommended practices like seclusion and restraint be phased out within a decade.

It comes after a damning report by VMIAC, published last week, revealed Victoria’s public mental health facilities were still secluding and restraining people more frequently and for longer than national averages, despite the commission’s recommendation. The report also revealed that physical restraint of children had increased by 32% in 2020-2021 compared with the previous year.

Related: Restraint of Victorian children in mental health facilities increases by 32%

Child and adolescent psychiatrist Prof Patrick McGorry said he supported expediting the phasing out of the practices but stressed they were symptomatic of “neglect” in the mental system.

“The system has been allowed to just collapse on itself,” he said.

The new bill will also establish a new mental health watchdog – to absorb the existing regulator – to hold the government to account on implementing the reform. The independent statutory body will include commissioners who have lived experience of mental illness. For the first time, carers and family members of people who receive mental illness treatment will also be able to make complaints on their behalf.

It will also establish a new youth organisation to oversee reform for young people, which will include those with lived experiences of mental health issues on its advisory board.

Opposition mental health spokesperson, Emma Kealy, said the Coalition would seek feedback from the sector to make sure it could “get the bill right”.