Miriam Merten Lismore Hospital Death

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Miriam Merten Overview

Justice Action submitted a report to the NSW Health Department Inquiry after the death of Miriam Merten, mother of two and a mental health patient from Lismore Base Hospital. Miriam died on 3rd June 2014 from injuries sustained during her time in seclusion. The horrific nature of Miriam’s treatment was evidenced with shocking CCTV footage of her final hours, exposing the lack of care from the NSW Health Staff at Lismore Base Hospital along with their abject failure to intervene in her untimely death.

Ms Merten died in 2014 from a brain injury after she fell more than 20 times whilst in the care of the Mental Health Unit of Lismore Base Hospital. The coronial inquest into Ms Merten’s death found that Ms Merton died from a "traumatic brain injury caused by numerous falls and the self-beating of her head on various surfaces, the latter not done with the intention of taking her life". Disturbing CCTV footage of the neglected, blood and faeces splattered, Ms Merten wondering the corridors of the Lismore facility on the night of her death have emerged, and be viewed in this article.


parliament stairs group photo

 parliamentary inquiry 2

Kerry O'Malley media release 171017


Health Department Rejected

Media Release October 17, 2017

Mental health consumers have won another battle against the use of forced medication. After years of being subject to Community Treatment Orders (CTO), 71 year old Kerry O’Malley today won agreement from the Mental Health Review Tribunal to reject the CTO against her. A forced injection is the antithesis of health care disgracing all who say nothing.

This afternoon Kerry said “There were a number of prayer requests that went up from my friends but I still needed all of you to get Victory. I am very grateful”. Meet her here.

Kerry is one of fifteen thousand people in NSW currently having medication enforced under a CTO, being brutalised and degraded by the Health system, using medication that is uncertain and statistically worse than social support. By stigmatising, monitoring and distressing people under such orders, their use deters the mentally ill from receiving voluntary help and bypasses their engagement.

Kerry told the Tribunal that she’d told the hospital that their medication made her feel sick, depressed, anxious, tired, mentally foggy and unable to concentrate, but the hospital disagreed and said that she could get out of bed, was leaving her house, and it was good for her. Kerry said that the order degraded her and she preferred to choose her own doctor. She had family, friends and health support she trusted and wanted the Health Department to leave her alone as it made her fearful. The Tribunal agreed.

Kerry told the Tribunal that she wanted to speak openly about her experiences, and said ‘I’m not afraid to use my own name. I have had to deal with this for a long time’. She applied and got permission under s.162 for permission to use her own name. She is part of the Justice Action Team presenting to the Inquiry on Health on October 31 at 11.15am”.

Kerry O'Malley - Forced Medication and Community Treatment Orders

The degrading treatment imposed on this gracious 71 year old woman Kerry O’Malley highlights all that is wrong with the mental health system. Over the last 47 years she has been arrested, abandoned to draconian control in a locked hospital and her rights to individual autonomy dismissed. She has been subjected many times to Community Treatment Orders (CTOs) and forcibly medicated with severe physical and social side effects. Only her sister Margaret and her church have stood beside her. Psychiatrist Dr Yola Lucire defended her against the forced medication despite the weight of the industry norms. Legal aid by the Mental Health Advocacy Service is thoroughly discredited as part of the system.

Kerry is only one of fifteen thousand people in NSW currently having medication enforced under a CTO, being brutalised and degraded by the health system.  Many of those people may well have issues and trauma to resolve but are victims further victimised by the system - not dangerous to themselves or others. For themforced injection is the health system's standard expression of "care". Meet Kerry here. She will present to the NSW Inquiry on Health on October 31 11.15am.

Victory at the Mental Health Review Tribunal 17/10/17
Kerry O’Malley will not be placed on another CTO. This is an important win not just for Kerry, but also for other mental health patients who feel they are silenced under the control of the mental health system. Kerry will move forward with continual support of her friends, her family and the Justice Action team. Media release. Media release download

Tribunal denies CTO reversal 22/10/17

Kerry O'Malley is back on the CTO despite never having demonstrated threatening behaviour towards herself or any other member of the public. see the full report of the August 22 Mental Health Review Tribunal Hearing for more information on the arguments adopted by Justice Action and the appalling decision of the Mental health Tribunal. 

Triumph at the Tribunal 27/05/15

Kerry O’Malley is a 71-year old woman who has been subjected multiple times to Community Treatment Orders (CTOs). In May 2015, Kerry, working with Justice Action, was successful in having the CTO removed by the Mental Health Review Tribunal. See the full report of the triumph at the Tribunal. See full report hereDownload media release here

Michael Riley







 Appalling Outcome Report: Rehospitalised - 16th November 2016




Michael Riley is a warm, bright, gentle giant in his late 30’s. He is currently employed at a union and is the loving father of a four-and-a-half year old daughter who starts school this year. While Michael lives, works and is socially engaged in the community, he is subject to a Community Treatment Order (CTO) which has been consistently renewed for 14 years. Michael does not agree with nor does he consent to this order. His diagnosis is one of Schizoaffective Disorder - a diagnosis he rejects.



Michael does not have a criminal record and has no history of violent behaviour. His only contact with the police has been sparked by his CTO on the isolated occasions on which he is essentially arrested on the grounds that he is a danger to his own reputation. At times, these arrests have been carried out with such force that Michael has required hospital treatment. Despite his gentle nature, Michael’s experience at the hands of the police and mental health authorities has resulted in him feeling as though he is being treated like a criminal. This is a common experience for people with mental illness and an ongoing concern for Justice Action.  


Read more about Michael's case here. Watch his interview with Justice Action.




Community Treatment Orders

Forced Medication

Right to Identification



About Saeed

“Free Saeed Dezfouli” Campaign



“I am a patient with patients’ rights, an inmate with inmates’ rights and a human being with human rights.

These rights have been fundamentally and severely violated by unprofessional and sadistic state government employees in the positions of psychiatrists, psychiatric nurses and prison officers. They are required to go by the law, regulations, policy and procedures, codes of conduct practice and ethics, but they don’t”

Saeed Dezfouli



The closed system of the NSW Health Department’s mental hospitals is getting exposure through the window of patient Saeed Dezfouli. It shows systemic abuse of dependant individuals clocked as care and highlights the problem with government bureaucracies dealing with challenging people at the individual level, lacking compassion, concern or rational behaviour.



Saeed Dezfouli was born in Iran in 1958 and came to Australia in 1983. Upon arriving in Australia as a refugee, he earned a degree in Bachelor of Arts and majored in political sciences. In 1986 he became a citizen of Australia and was working as a court interpreter for the Ethnic Affairs Commission NSW. Throughout 2001, he became fearful of his life and safety and stated that he had been receiving death threats. He felt that he was constantly under surveillance. He said that he warned the authorities by sending them letters about his concerns for 5 months prior to the offence.

He was accused of setting fire to the foyer of the Community Relations Commission (formerly the Ethnic Affairs Commission) at Ashfield by using a container of petrol. Three female employees were trapped by the flames and were taken to hospital in an unconscious state. One of them, a 53-year-old woman from Bonnyrigg, subsequently died from her injuries. Most importantly there were other mitigating factors. Unfortunately on the day of the fire, the emergency fire exit door was locked and the rubbish in the foyer hadn’t been collected, leaving it to obstruct the path of the employees escaping the smoke and flames. He was taken to Burwood police station where he was insulted, assaulted and unlawfully interrogated by the NSW Police. He was subsequently charged with several offences.


In contrast to his treatment, Saeed presents no threat to the community. He needs support as an Iranian refugee affected by a heart condition and stress. Saeed is evidently remorseful for his actions and has regrets for what he has done.


However, the main issue that needs to be raised is the irresponsibility demonstrated by the authorities by ignoring his claims that subsequently triggered Saeed’s unlawful actions. Saeed did everything within his power to communicate his concerns to authorities, yet these threats were not taken seriously and Saeed followed through by setting fire to a government office. Although he clearly outlined his intentions, the threats were not deemed serious enough to warrant an investigation, highlight the failure of response mechanisms by government officials.


This tragedy would never have happened in the first place if proper health and police intervention frameworks were enacted.


Detention in Long Bay Forensic Hospital

Mr. Dezfouli has been in detention since 19 January 2002. On 13 February 2002 Saeed was transferred to Long Bay Prison Hospital and in 2004 he was found not guilty due to mental illness. Mr. Dezfouli is not a violent or aggressive man, as has been stated many times by his treating doctors and nurses. He is highly intelligent, articulate and politically aware. He presents no threat to the community and had not intended the harm that was caused more than 15 years ago.


If Saeed was tried through the criminal justice system he would have already served his time and been released. However, because he was tried through the mental health system, he has served a period of over 15 years to date and is now being held indefinitely, despite ongoing reviews with the Mental Health Review Tribunal.


Mr. Dezfouli, up until the middle of July 2011, was held in the highest security area at Long Bay Forensic Hospital, which he shared with 7 other patients who are classified in the  “lowest functioning group.” He was, and is continued to be denied access to ground leave and has restricted access to a small courtyard. Saeed, along with fellow patients, are denied any access to education facilities, despite education as one of the aims of the Rehabilitation wing in which he is currently held.


Since his imprisonment, Saeed has been held indefinitely and subjected to continuous abuse, including:

-   Numerous periods kept naked in a solitary confinement cell for days to “break him down”.

-   Broken ribs and severe bruising and pain from forced medication.

-   Periods of incarceration in cells without basic hygiene, such as four days without toilet paper.

-   In January 2005, he was brutally assaulted by DCS officers resulting in a permanent back injury.

-   Hospitalization due to injuries inflicted by DCS officers.

Mr. Dezfouli now suffers from a heart condition, ulcers and diabetes as a result of the side effects of anti-psychotic medications combined with daily exposure to an oppressive and suppressive regimen.


Defending his rights


Saeed is in a unique position. He has watched the system from inside for 15 years and continues to point out its hypocrisy, whilst Justice Health (an arm of the Health Department) tries to prevent his outcry and force him into submission with the rest of the patients. He is a gentle person – staff agree he is not violent, yet every two weeks he is restrained and forcibly injected with a powerful sedative, which leaves him feeling severely agitated and facing negative side effects. He is refused a choice of psychiatrist, education and exercise and is not permitted new visitors. Justice Action became his Primary Carer when there was no one else.


His mistreatment is a result of Saeed protesting and fighting for his rights and the rights of his fellow inmates. Over the years he has made a number of complaints of assaults by staff, and sustained a hunger strike for his rights for 52 days. He was involved in a campaign to allow patients more time out of their cells, in which at the time they were spending a good part of the day locked inside their cells.  He was also involved in the signing of a petition that stated:

26 of the 30 patients at Long Bay Prison Hospital in the ward have complained to the Health Care Complaints Commission and the NSW Ombudsman about notes on their psychiatric conditions that are fabricated and saying the nurses and doctors rarely bother to talk to them. Several prisoners had gone on hunger strikes. Many patients have been overdosed and medicated against their will.”


Although Saeed forwarded the petition to the NSW Ombudsman, it was decided that the complaint would not be pursued and as such, the issues were not addressed. Attached to the petition was Saeed’s complaint about the issues regarding the medical treatment of patients inside Long Bay Forensic Hospital, some of the issues included:

- That the nurses do not provide adequate nursing care to patients;

- That the nurses fabricated notes and call them nurses’ notes;

- That the psychiatrists show up for a couple of days a week for a couple of hours a day, read the nurses’ notes and then write prescriptions without seeing patients;

- That some patients do not speak to a doctor for months;

- That many nurses do not speak to many patients for months.


We advise no further action occurred nor were any charges laid.


Justice Action believes that Mr. Dezfouli is suffering because his numerous efforts to alleviate his living conditions have to date been futile. Justice Health has absolute power as patients have no finite sentences and are totally dependant on their treating psychiatrist. The principles of patients’ rights under section 68 of the Mental Health Act 2007 (NSW) ('MHA')[1] do not apply in practice. In this system of “care”, no one cares.


Saeed appealed to the Supreme Court against the Mental Health Review Tribunal’s refusal to order changes to his treatment. The Tribunal and the Attorney General tried to block this first real appeal against its new powers to make orders, refusing to supply its decision, until an audio record proved Saeed’s entitlement. It appears that the Tribunal sees its role as supporting Justice Health and not making a separate judgment. The lack of complaint from those around Saeed demonstrates widespread abuse and how compromised individuals participating in the health system are.


Challenge to Tribunal’s Ban on Saeed’s Name

An interpretation of the MHA by Justice Health is currently preventing Saeed Dezfouli from using his own name in his fight to gain freedom. Section 162 of the MHA[2] states that:


(1) A person must not, except with the consent of the Tribunal, publish or broadcast the

name of any person:

(a)  to whom a matter before the Tribunal relates, or


Since this case involves significant matters affecting other patients, powers of Justice Health and that of the Mental Health Review Tribunal (MHRT), Saeed wants to ensure it is conducted openly in the public, which allows him to express himself in a manner that is open and honest. Justice Action agrees with him entirely as the secrecy has allowed abuses to occur in the past without adequate accountability.


Saeed requests that section 162 of the MHA be waived and that he should be allowed to use his name in the campaign for his release. Furthermore, he intends to highlight the unfairness of his treatment and that of others by the Health Department.


He argues that section 162 is intended to protect him from exploitation and exposure by the media, but instead it is being used to protect the Health Department from being held accountable for the treatment of citizens entitled to care and assistance. It has been used to prevent the exposure of a system that allows the abuse of the human rights of nameless, faceless, dehumanised mental health consumers.


In short, he wants his right to have his own name returned to him, and for the provision intended for his benefit, and not used to allow an abuse of power against him as a human being. We believe Saeed has the right to have his name distinguished from others and recognised as a unique individual.



While Mr. Dezfouli did commit an act that violated the criminal justice system, it does not mean he should be subjected to abuse by the mental health system. The fourteen years he has spent in custody is well above the sentencing trends for the offences he committed. However, unlike the average prisoner, Saeed faces no concrete release date and is faced with the possibility that he may spend the rest of his life within the forensic prison system as the Mental Health Review Tribunal refuses to provide him with the answers that he is entitled to. Just because Saeed Dezfouli has a mental illness, as diagnosed by the Health Department, does not mean that his rights, as a consumer of the criminal justice system and as a member of the Australian community, are no longer valid.


Read More:

Media Releases and Resources

Campaign Documents

[1] http://www.austlii.edu.au/au/legis/nsw/consol_act/mha2007128/s68.html

[2] http://www.legislation.nsw.gov.au/viewtop/inforce/act+8+2007+FIRST+0+N/

Media Release: Saeed is refused computer and law access

Media release Wednesday May 16, 2018
As with Saeed Dezfouli, the callous disrespect exposed in Lismore Hospital to dying Miriam Merten will continue. Nothing in Health’s Implementation Plan will change the culture. There will be no ongoing objective accountability, no removal of legislative protections such as s.195 MH Act, no computers and phones in seclusion areas, no alternatives to forced treatment, and no independent consumer advocacy. The timetable shows no urgency for consumers getting on Committees and no structure for electing representatives. The endemic corruption of mental health, with noses in the NSW Health Department’s annual trough of $23 billion is disgraceful to all those who don’t demand structural changes after such an exposure.

The Review by the Chief Psychiatrist made very serious criticisms of the NSW Mental Health System. It said that the NSW Mental Health culture lacked compassion and humanity (p7) or real interest in the individual beyond risk management (p22). The System used coercive compliance, had no internal oversight even after the Merten death (p29), lacked guidelines, had little evidence of engagement with consumers and carers (p35), little involvement in care plans (p.36), had no examples of the necessary leadership required to give high-quality compassionate care (p24). The Review said that peer worker support was very limited with rare access despite being a vital resource to lessen seclusion and restraint (p33). It requires urgent action.

The case of Saeed Dezfouli shows that abuse of power is endemic to mental health, regarding the disabled as easy targets without rights. Locked in the Forensic Hospital Saeed has been refused access to a computer or legal information even though he has to argue for his freedom against the barristers of the Attorney General and Justice Health on a difficult point of law. The Medical Superintendent Dr Ellis stated that Saeed could handwrite his Submissions, would have no more than two hours a week with a computer, could borrow necessary books from public libraries, and would have no more than 30 minutes a week to access the internet, with a staff member using the mouse and keyboard. As a prisoner, he would get a computer and information.

Saeed’s case has international interest, where due process and the Rule of Law must be maintained. Justice Health submitted to the Mental Tribunal its concern about further criticism of Australia from the UN Committee of the Rights of Persons with Disabilities, with continuing media attention. It said that Saeed is costing them too much money and causing staff to be frustrated because he isn’t submissive despite being forcibly medicated. He and Miriam are examples of thousands of others where Health has lost its obligation to be person centred. It needs external and consumer monitoring as effective as the CCTV and media exposure for Miriam.

Iran tells Mental Tribunal: "Unfair"

Mr Saeed Dezfouli is a dual Iranian and Australian citizen who has been indefinitely detained in the clogged and inhuman mental health system of NSW since January 2002. He is protesting against being physically and mentally tortured, sexually harassed and assaulted by NSW prison officers and staff of Justice Health. In response, he renounced his Australian citizenship in August 2017 to repatriate to Iran, despite coming to Australia as a refugee in 1983.

Mr Dezfouli’s treating psychiatrist Dr. Sathish Dayalan and the President of the NSW Mental Health Review Tribunal Mr Richard Cogswell have set requirements in order to issue the repatriation order of Mr Dezfouli to Iran. The government of the Islamic Republic of Iran is to apprehend Mr Dezfouli on arrival in Iran and confine him to a secure mental health facility until released by due process of the law in Iran.

The Iranian embassy, in a letter to Richard Cogswell, has found this recommendation of the Mental Health Tribunal to be unlawful, unfair and concerning for the Iranian government to do this to its own citizen. Now, Mr Dezfouli remains indefinitely within the maximum security mental health system of NSW.

In his letter to Richard Cogswell, Mr Dezfouli has stated that, if by 1200 hours on the 7th of March, his unconditional repatriation order is not issued by the Tribunal, he will commence a dry hunger strike (nil by mouth) and refuse all of his cardiac medication, which will result in his death. Mr Dezfouli is asking for the support of all the kind people in NSW to contact the President of the NSW Mental Health Review Tribunal Mr Richard Cogswell and express their support and concern for him. We support his desperate plea for help.

Comments: Brett Collins 0438 705 003


Iranian Embassy Statements and Other Correspondence

Mental Tribunal snubs Iranian representatives

Media release 14th March 2017 

"In a move that exposed the dishonesty of the forensic mental health system, the NSW Mental Health Review Tribunal decided on March 10th to stall the repatriation of Mr. Saeed Dezfouli to Iran whilst it did more research into the Iranian mental health system and its adequacy. The decision demonstrates flagrant disrespect not only for the Iranian government, but also for Mr. Dezfouli’s family and the expert opinion of his care workers. In April 2016 the Tribunal stated that “we would do whatever we could.... To help get [Mr. Dezfouli] home” and emphasised that they desired a quick resolution to the issue. Now it realises that Saeed’s case and his mistreatment highlights the system’s endemic failure" said Justice Action Coordinator Brett Collins.

“The Tribunal’s justification for postponing its decision for another six months is that additional research into treatment in Iran is required. This information could be easily ascertained in a phone call, and has already been supplied several times. The Tribunal would rather drag its feet trying to look responsible than accept its failure and allow him to be supported by his family in his homeland. This is shameful conduct at the highest level” said Mr. Collins.

"The latest Tribunal decision, chaired by President Richard Cogswell, starkly shows that its priorities lie with justifying their ineffective treatment of Mr. Dezfouli. His sole wish is to reunite with his sister and ailing mother in Iran. The hearing on Friday was the second time representatives of the Iranian consulate have travelled from Canberra to assist in Mr. Dezfouli’s case, only to have their competency questioned by the Tribunal. The Iranians have made clear their and Saeed’s family’s commitment and ability to provide community-based, rehabilitative support to Mr. Dezfouli. They are also providing travel documents" said Mr Collins.

"Saeed Dezfouli featured in the ABC program ‘The man without a name’. He challenged disrespect for his rights and exposed the system’s lack of accountability in three cases to the Supreme Court. Saeed, a gentle man, has been held for 15 years following an act punishable by 3 years. He remains in the highest security hospital costing taxpayers $300,000 a yearMr. Dezfouli continues to be denied the opportunity to return to his homeland, instead being held indefinitely as not guilty due to mental illness" said Mr Collins.   

"During his ‘treatment’ Mr. Dezfouli has been forcibly medicated, trialling 9 different medications, causing side effects including diabetes and heart disease. In March 2014 the Tribunal recommended that he have access to a consumer worker and a computer. After those recommendations were ignored by the hospital, the then Tribunal President said he was ‘disappointed’ and that ‘sometimes the system needs a kicking’. Three years later Saeed still has neither and he continues to get the kicking" said Mr Collins.

I will renounce my Australian citizenship and return to Iran to escape the torture at the hands of these doctors. I am still shocked at the culture of abuse in Australia's so-called health care. I feel sick in my stomach waiting for their poison to hit my brain. I have been physically and mentally tortured, sexually harassed and assaulted by prison officers and staff at mental health facilities. I have been used as a guinea pig by testing psychotic medications" said Mr. Dezfouli (see full statement here).

Tribunal supports repatriation 28 April 1016

Below is the formal response submitted to the Mental Health Review Tribunal
The JA media release is here.

Formal Primary Carer/Justice Action Proposals and Response to Justice Health Report
Submitted to Saeed Dezfouli Mental Health Review Tribunal Hearing, 28 April 2016

The Justice Health’s Report is clearly and demonstrably unfair. It has a negative slant toward all of Mr. Dezfouli’s behaviour, even when other interpretations of his behaviour are equally viable. This negative bias undermines the value judgments the Hospital makes where their expertise and discretions are officially adopted. Justice Health was required to provide Mr. Dezfouli with this Report two weeks before the Hearing. We would like to draw attention to the Tribunal that the Report was a week late and disadvantaged Saeed.

The former Mental Tribunal President Professor Dan Howard previously expressed his disappointment in the Health Department’s failure to implement Tribunal recommendations for Saeed, stating that “sometimes the system needs a kicking.” Nevertheless, despite the Tribunal’s recommendations, the Report has dismissed Mr. Dezfouli’s lack of access to a consumer worker and a stand-alone computer as insignificant. This conduct by Justice Health is further evidence of an unfair and corrupt system, which misleads the people it is supposed to protect as well as the Tribunal itself.

Our Proposal

In response to the Report, Justice Action proposes that the Tribunal grants Mr. Dezfouli escorted leave from the Hospital; support for repatriation to Iran; access to a stand-alone computer; and access to a consumer worker.

1. Support from the Tribunal for Repatriation to Iran
Mr. Dezfouli expresses a strong desire to be repatriated to Iran. Mr. Dezfouli has already been detained within the forensic system for longer than he would have been detained following conviction. Mr. Dezfouli believes that being detained indefinitely is unfair and inhumane and that repatriation is his only solution (see NSW Law Reform Commission Report 138 pg xx states his situation as being unfair, and the current Senate Inquiry examining the same issue, ‘Indefinite detention of people with cognitive and psychiatric impairment in Australia’). Support from the Tribunal is required to facilitate the repatriation of Mr. Dezfouli to Iran.

2. Escorted Leave from the Hospital
The Justice Health Nursing Report refers to a request made by Mr. Douglas Holmes to grant escorted leave for Mr. Dezfouli from the Hospital (see p. 24.4 of the Justice Health Report). We propose Mr. Dezfouli is granted escorted leave with Mr. Holmes in the next period.

3. Access to Stand-Alone Computer
Justice Action has requested a stand-alone computer without Internet access for Mr. Dezfouli’s educational use (see email from Brett Collins to Tobias Mackinnon, 15 September 2014 6:42pm, Re: Saeed – computer access). The Tribunal provided that “Mr. Dezfouli’s said treating team give every due consideration to facilitating, as soon as practicable, Mr. Dezfouli’s reasonable access to a computer, without internet access, for the purpose of study in the context of any appropriate educational courses that he undertakes” (see 20 March 2014, Tribunal’s Reasons for Decision, at p.55). Justice Health has not reported back to the Tribunal as to why Mr. Dezfouli should not be given computer access. We propose Mr. Dezfouli is granted access to this computer in the next period.

4. Access to Consumer Worker
The Tribunal saw considerable merit in allowing support from a consumer worker, recommending that “support from a suitably qualified mental health consumer worker or workers as the treating team may think fit for the purpose of assisting and supporting Mr. Dezfouli’s recovery and rehabilitation” (see 20 March 2014, Tribunal’s Reasons for Decision, at p. 55). Mr. Dezfouli has not seen a consumer worker in his capacity as a consumer. We propose the Tribunal makes a recommendation that Mr. Dezfouli has access to a consumer worker to facilitate his recovery and rehabilitation.

Justice Health’s Report

The Report provides a very negative portrayal of Mr. Dezfouli and does not support his return to Iran. Justice Health has discredited itself through the slanted, misleading and dishonest information it has presented to the Tribunal, which is addressed below.

1) Determination to justify violent concerns
a. Heavy emphasis is made on Mr. Dezfouli’s violent threats on repeated occasions, however, at no time has Mr. Dezfouli been violent towards the staff or other patients (see pp. 2.6; 16.8; 18.1).
i. “Feels like Volcano Mountain which is calm outside but boiling inside” (p. 5.2).
ii. Reference to throwing a chair as an example of unprovoked aggression (see p. 6.9).
b. Hostility toward Dr. Sinclair by refusing to speak with her and regarding her in a hostile manner.
iii. In a phone call, Mr. Dezfouli stated that he does not talk to Dr. Sinclair, so she could not know what amount of time he is spending thinking about his perceived mistreatment by the Australian government and the Forensic Hospital.
c. Mr. Dezfouli is angry and frustrated but he is not violent.

2) Determination to justify mental illness
a. Cited that he was laughing to himself and covering his face with his shirt (see p. 14.3)
i. Mr. Dezfouli cites that the medication he was taking makes him gassy and he was amused by the noise and proceeded to cover his nose. The nurses made no attempt to communicate with him about the incident or allow him to explain himself; they immediately and erroneously attributed the incident to a mental illness and psychosis.
b. Dr. Keller’s provided a second opinion in a letter emphasising that Mr. Dezfouli had (see p. 9.5):
i. Ongoing delusions of persecution; and
ii. A negative, dismissive and disparaging attitude towards the psychiatrist.
c. Interpretation of his determination to be repatriated as a sign of Mr. Dezfouli’s lack of insight into his mental illness (see p. 14.6).
d. Treating Mr. Dezfouli’s belief that he can control the government and how they will treat him through his actions as acts of delusion (see p. 15.2).

3) Physical side effects
a. Evidence of forced medication side effects (see pp. 5.3; 7.9; 23.2).
b. Refusal to accept medication is evidence of self-harm (see p. 3.5).
c. In refusing to accept medication, Mr. Dezfouli is manifesting his own side effects (see p. 3.5).

4) Iranian repatriation (see pp. 10.7; 14.8; 18.6)
a. Mr. Dezfouli’s desire to be repatriated into Iran has been used as evidence of mental illness by:
i. unfairly using repatriation to effect indefinite incarceration as an NGMI patient; and
ii. unfairly using repatriation to show that he has a “lack of insight” into his mental illness because he does not understand the state of Iranian conditions in Iran (see p. 11.3).
b. Mr. Dezfouli believes that going to Iran is better than staying in Australia and being treated unfairly (see NSW Law Reform Commission Report 138 and Senate Inquiry on this issue).
i. In a phone call, Mr. Dezfouli stated that repatriation is his only solution
ii. Repatriation will require the assistance of the Tribunal. There is nothing in the report that indicates that the hospital will support his repatriation.
iii. In a phone call, Mr. Dezfouli stated that Australia does not want him to go to Iran because they would have one less “guinea pig” to test their medications on.
iv. Mr. Dezfouli does not want to comply with the Tribunal because he claims the Tribunal won’t fix the problem, as the problem is the whole system itself.

5) Consumer workers (see pp. 15.5; 9.2; 19.5)
a. Consumer workers are wrongly described as consumer advocates.
b. There is no reference to Tribunal recommendations.
c. This discredits the fairness and legitimacy of the Report because it is dishonest.

6) Computer access (see pgs. 7.2; 9.3; 15.5; 19.5)
a. The Report refers to Mr. Dezfouli having access to the Internet. We have not proposed for him to have access to the Internet, but rather that he have computer access for educational purposes.
b. There is no reference to Tribunal recommendations.
c. This discredits the fairness and legitimacy of the Report because it is dishonest.

Moving Forward
a. During the Tribunal hearing on 28 April, Mr. Dezfouli must discuss his personal history, which he has been avoiding thus far.
b. Mr. Dezfouli must work with the “system” in order to be released. If he continues to refuse to comply with his nurses he will not move forward with this Tribunal hearing. The Report shows that Justice Health wants the Tribunal to treat Mr. Dezfouli unfavourably.
d. Mr. Dezfouli must not lose his temper.
e. Mr. Dezfouli must be willing to discuss his personal history and index offence.

Mr. Dezfouli’s Opinions
Mr. Dezfouli opines that:
a. his psychiatrist is out to get him;
b. his psychiatrists distort the truth about what he says and falsely equate his thoughts with “delusions;”
c. the Tribunal will appeal to emotions rather than objective facts in order to keep him, as a “guinea pig” within the system;
d. he feels helpless in his situation;
e. he purposely inflames situations due to his frustrations; and
f. he will not accept that he must comply with ‘the system’ that he so hates.

Other Observations
a. The Hospital heavily relies on medication in order to treat Mr. Dezfouli and refuses to acknowledge his concerns about the side effects of the forced medication.
b. By not establishing good rapport with Mr. Dezfouli and by consistently undermining his lucidity, the Hospital is contributing to Mr. Dezfouli’s frustrations and setting back the treatment process. The Hospital sees these frustrations as validations of his mental illness and a reason to keep him there indefinitely, which is unfair.

22nd July 2015: New Attacks: Saeed renounces citizenship

New attacks: Saeed renounces citizenship

"Saeed Dezfouli who featured in the ABC program ‘The man without a name’ has been attacked again by the hospital. They have just doubled his forced medication, threatened me personally with their Emergency Response Team and to exclude me as his primary carer. The hospital needs to crush him as he challenges their disrespect for his rights and exposes the system’s lack of accountability" said Justice Action Coordinator Brett Collins.

I will renounce my Australian citizenship and return to the chaos of Iran to escape the torture at the hands of these doctors. The Iranian Consul-General just visited me for the purpose.  I am still shocked at the culture of abuse in Australia's so-called health care. I feel sick in my stomach waiting for their poison to hit my brain" said Saeed Dezfouli.  

"Over the last thirteen and a half years Saeed’s forced medication has been changed nine times.   On the 24th of June 2015, Saeed was injected with double the dose of Paliperidone on the order of psychiatrist Barbara Sinclair. On December 8th last year they injected him with Clopixol after he refused to meet with them. He had told them and the Mental Tribunal it was the drug he most feared. Have they no mercy or empathy?” asked Mr Collins.

"These attacks against Saeed are now being made against his support as well. Statewide Clinical Director Dr Tobias Mackinnon claimed that I had acted in a threatening manner by stamping my foot and pointing my finger, and that the ‘duress buttons’ were nearly pushed during a meeting. We had insisted that the Tribunal’s April 2014 recommended consumer worker support and computer access be given - still treated with contempt. The Emergency Response Team of ten nurses would have come in on me. He also threatened to remove our access to Saeed. Now the truth of their lies and brutality is seen. This correspondence is now exposed on our website” said Mr Collins. 

"Saeed is now preparing for his 4th Supreme Court appeal with a barrister currently being briefed. The Mental Health Review Tribunal is too weak to control the hospital, admitting that it has made no orders since 2009, despite Justice Lindsay’s decision that it was in a supervisory position over a patient’s detention, care and treatment. This job of ensuring mental health system accountability should not be left to an Iranian refugee” said Mr Collins.

Comments: Brett Collins 0438 705003

4th September 2014: MHRT Hearing

On 4 September 2014 the Mental Health Review Tribunal (MHRT) convened for Saeed Dezfouli. The hearing followed a series of meetings with the hospital that were held to address why key recommendations from the last MHRT hearing had not been implemented. Justice Health’s conduct during those negotiations demonstrated an absolute unwillingness to be held accountable for their actions and a cavalier approach to the implementation of MHRT recommendations. The Lindsay judgment giving power to the Tribunal had been ignored by the hospital. Here is our Media Release.

This report details the exchanges between Saeed, his primary carer and Justice Action Coordinator, Brett Collins, his treating team from Justice Health in the period between the publication of the MHRT decision on 2 May 2014 through to the most recent hearing on 4 September 2014. The first section of this report provides a background to the recent series of meetings and hearings, including an outline of media interest in Saeed and details of the meetings that occurred. Section 2 discusses the problems with with the MHRT report handed down on 26 August 2014. The third and final section details the issues with the subsequent Hearing on 4 September 2014.

1    Background                                    

1.1    ABC - Background Briefing

The ABC Radio program Background Briefing took an interest in Saeed’s case in early 2014. The program was particularly concerned with the policy reasons for the restriction under s 162 of the Mental Health Act 2007 (NSW) that prevents the publication of Saeed’s name. The program included opinions from legal experts stating that s 162 actually acts to “protect the mental health authorities who run the Forensic Hospital from public scrutiny.” The article quoted Sascha Callaghan from the Centre for Values Ethics and the Law in Medicine at Sydney University stating the policy reasons of vulnerability of patients “can actually be used to restrict someone’s ability to vindicate their rights.” The program illustrates growing public concern about the transparency of Mental Health Review Tribunal proceedings and the realisation that current procedures are not necessarily for the protection of the patient, but to deny the accountability of people working the system.

1.2    2 May 2014 MHRT Decision

The Tribunal reviewed Saeed’s case 20 March 2014 and the resulting decision was published on 2 May 2014. The decision gave two key recommendations under s 76A of the Mental Health (Forensic Provisions) Act 1990 (NSW):

i.    That Saeed’s treating team facilitate access to a consumer worker to assist with his recovery and rehabilitation “as soon as practicable.”

ii.    That Saeed’s treating team facilitate access to a computer for education purposes “as soon as practicable,” pursuant to Saeed’s existing educational courses.

1.3    Follow-up Meetings

After the decision and prior to the 4 September 2014 hearing, three follow-up meetings were held between Justice Health, Saeed’s treating team and Brett Collins, Saeed’s primary carer. These meetings revolved around whether progress was being made on the MHRT recommendations. The meetings took place on:

•    15 May 2014
•    30 June 2014
•    25 August 2014

Justice Health’s conducting the latter two meetings have been cause for serious concerns for Justice Action and Saeed.

1.3.1    30 June 2014 Meeting

The meeting on 30 June 2014 demonstrated the unwillingness of Saeed’s treating team to be held accountable for their failure to implement the MHRT recommendations. The treating team was aggressive and treated Saeed and Brett with contempt, hostility and rudeness throughout the meeting. The psychiatrist in charge said that the reason Brett was not kept up-to-date as Saeed’s primary carer (as he was entitled under the Mental Health Act) was because the psychiatrist in charge would not respond to emails that could be used against them. This was a flagrant example of the treating team’s aversion to being held accountable for their actions.

Justice Health’s failure to implement the two MHRT recommendations was raised at the meeting. The treatment team gave the excuse that access to a computer had not been implemented because Saeed had not directly asked for it. No reason was given as to why access to a consumer worker had not been implemented.

The non-implementation of an earlier recommendation was also discussed at this meeting. On 15 May 2014, it was agreed that the false accusations made against Saeed in his Management Plan would be removed. The treating team refused to correspond with Brett about the plan altogether because they said it was “private.” This runs contrary to an email from Dr. Mackinnon, stating that the team is “committed to engaging with consumers and their families, carers and advocates.” This is yet another demonstration of the treating team’s absolute unwillingness to take responsibility for the shortcomings in their treatment of Saeed.

At one point during the meeting the psychiatrist in charge threatened to double the dose of Saeed’s medication and also change to the use of Clopixol injections. Saeed’s reaction to this was mocked and accompanied by the response: “we don’t want you to kill anyone.” This statement was completely uncalled for and offensive to Saeed, who has a record of being a gentle patient for more than twelve years. This threat also adversely affected Saeed’s trust of the treating team. Brett emphasised that trust is something to be earned and not compelled by threats. To this, the psychiatrist in charge and the primary nurse laughed out loud and said Saeed “shouldn’t expect to be treated specially.” This illustrated that the treatment team believes that treating a patient with respect and decency amounts to special treatment. The lack of acknowledgement of the link between positive engagement and trust further indicates the damaging attitude of Justice Health personnel.

1.3.2    25 August 2014 Meeting

A second meeting was held on 25 August 2014 to address Brett and Saeed’s concerns over how they were treated and the frustrating non-conclusive outcome of the 30 June 2014 meeting. Brett had to write numerous emails before a follow-up meeting was finally called. Unfortunately, the 25 August 2014 meeting proved as ineffective as the preceding meeting. The meeting merely went through the motions of allowing Saeed and Brett to discuss their concerns, but the lack of cooperation from Justice Health precluded any real results. Again, Saeed and Brett were left frustrated and confused with the surprising lack of compassion and capability shown by the treating team.

2    26 August 2014 Report by The Forensic Hospital for the MHRT        

On 26 August 2014 the Forensic Hospital published a Report on Saeed and distributed it to the MHRT. The report included numerous problems, both in procedure and substance.

The report indicated the date of the MHRT Hearing was to be 4 September 2014. The first problem was that Saeed, Brett and other representatives were not given reasonable time to respond to the report – a basic requirement of procedural fairness. The two-week period previously agreed to was completely disregarded, leaving Saeed and Brett unable to put together the evidence required to respond to the report. Speaking to Saeed to produce this evidence would have required an application for leave from the hospital. Despite being referred to on page 46 of the 2 May 2014 MHRT decision, the 26 August 2014 Report made no mention of this – a direct contradiction with the information in the earlier MHRT decision. An adjournment was requested because of the timing issue, but the Tribunal refused to grant one.

The Report equates Saeed’s voluntary submission to treatment with his being safe in the community. Further, on pages 2 and 16 the Report Saeed is painted as a violent person, a baseless claim that is of no substance. On page 5 the Report mentions Saeed being “highly socially isolated.” However, a long list of people have applied to visit Saeed and have had their applications denied. If he is isolated, it is because of the way the Forensic Hospital restricts his visitors. Justice Action has numerous emails to Justice Health in an attempt to have specific names cleared to visit Saeed, but no action has been taken in response.

The Report also made no mention of the psychiatrist in charge’s threat to double Saeed’s medication dosage occurred at the previous hearing. Since Saeed had put this threat in a blog entry it appears that that specific suggestion has been abandoned. This sequence of events might explain why Justice Health has objected so strongly to Saeed’s blog in the past – as an open channel of communication it allows some accountability in a system that seems to be severely lacking transparency.

The Report makes no mention of the second recommendation in the 2 May 2014 MHRT decision to provide access to consumer workers. Saeed has not seen a single consumer worker in his capacity as a consumer. With regard to the first recommendation of access to a computer for a reasonable time, Saeed had been given very limited access with no additional programs and was not even told the computer was available until Justice Action followed up to ask what was happening. Given these failings, it is clear that no genuine attempt to facilitate the recommendations of the MHRT has been made by Justice Health. The Report omits to mention any of these systemic failures, or the significant effort that has been required to engage with Justice Health on these issues. It was clear contempt for the Tribunal.

3     4 September Tribunal Hearing                                

3.1    JA Member Denied Visiting Access to Tribunal Hearing

Shontelle Standen, friend of Saeed and Justice Action Team Member, was arranged to attend the hearing on 4 September 2014. On the morning of the hearing, Shontelle rang the hospital to confirm that she was still cleared to attend the hearing. Shontelle was advised her visit had yet to be approved. In a follow-up call by Justice Action at 12:30 on the same day, the hospital took down Shontelle’s details but advised it would take a couple of days for approval to be granted. Hospital staff stated that internal processes such as this this take time and approval would not be given in time for the hearing later that day.

Having friends of Saeed attend Tribunal hearings has never a problem in the past. No one was notified that the procedure had changed and that special approval was now required. Luke the NUM for Dee Why admitted that the system had broken down for notification of visitor approval. Brett had raised the continual problems with the entry of visitors in an email to the Hospital Director Adrian Keller on 30 June 2014, without a response.  None of Saeed’s friends were subsequently notified that they could visit him, and after seven phone calls and emails following up the applications, and no decision being made, Justice Action assumed that approval for normal visits was deliberately being delayed.

3.1    The Hearing

The hearing itself was telling of the treating team’s failures and general lackluster approach towards Saeed. The failure to implement the two key recommendations regarding Saeed’s access to reasonable time on a computer and access to consumer workers was raised at the Hearing. The MHRT President said he was disappointed that these recommendations were not acted upon and that “sometimes the system needs a kicking.”

3.1.1    Access to Computer Recommendation

The excuse given for the delay Saeed’s recommended right to access to a computer was that there were issues of security and safety to be addressed. The hospital’s apparent concern was that having access to cables might increase Saeed’s capacity for self-harm. Brett raised the point that the Dee Why Ward was a rehabilitation medium security ward that allows CD players among other electrical equipment. It is not a place where people will commit self-harm with electrical cords, and that electrical cords were already present regardless.

The psychiatrist present said that if Saeed made an effort to be more compliant and speak openly with her,  she would assist with the computer access. However, Saeed’s solicitor was quick to dismiss this suggestion, arguing that the recommendations made by the MHRT were not to be used as inducements to force Saeed to be submissive. The MHRT President agreed, and said the issues of Saeed’s getting on with the psychiatrist and his access to a computer and education resources should be dealt with separately, and instructed Justice Health to do so, and to report back to him with any reason why computer access shouldn't happen in the ward.

3.1.2    Access to Consumer Workers

The failure to implement Saeed's access to consumer workers, as the Tribunal had recommended, was then raised at the Hearing.  The hospital said that they were in the process of bringing them in, but that security protocols were delaying the process. Brett highlighted that many of the sixty consumer workers employed by the Health Department already had access to high security areas in other hospitals, so the extra protocol was not a time-consuming task. The Forensic Hospital’s tactic of hiding behind procedural excuses demonstrated that they were unwilling to obey Tribunal direction in good faith at all. The Tribunal looked ineffectual and Saeed's complaints were proved justified.

3.1.3    Saeed’s Blog

The President said that he'd received complaints from the Hospital about Saeed's blog on the JA website. It was suggested that entries might contravene s 162 of the Mental Health Act 2007 (NSW) because it included the names of people working in the hospital. Justice Action undertook to make a careful analysis of the content of Saeed’s blog after the hearing, and concluded that none of the information was in breach as it complained of staff behaviour in the hospital as Saeed was entitled to do, and nothing revealed at Tribunal hearings. It reported that to the Tribunal.

3.1.4    Decisions

The hospital was asked to report to the Tribunal on progress with the Tribunal recommendations in its 2 May decision. Further, it was decided the MHRT would reconvene in six months instead of a proposed twelve months to monitor progress with hospital undertakings.

The hearing demonstrated Justice Health’s cavalier approach towards Saeed and others in their care. The defensiveness of the Forensic Hospital was evident throughout, from the record of their treatment of Saeed and Brett in meetings to their total failure to implement key recommendations handed down from the MHRT. The problems with the system were accurately captured by the MHRT President’s obvious frustration, and comments about how disappointed he was at the persistent failures and that “sometimes the system needs a kicking.”

Justice Action will make sure that those employed to assist in Saeed and others' treatment start to see their obligations differently, and raise their effort to a higher standard than has been demonstrated so far. Saeed is entitled to support, to be treated honestly and with respect as the law requires. At least the Tribunal got a whiff of what Saeed has endured.

Last modified on 26 September 2014

16th July 2015: Hospital doubles dosage and attacks Carer

Saeed Dezfouli who featured in the ABC program ‘The man without a name’ has been subjected to a series of new attacks against his personal support and bodily integrity.

On the 24th of June 2015, Saeed was injected with double the dose of Paliperidone on the order of psychiatrist Barbara Sinclair. On December 8th last year they injected him with Clopixol after he refused to meet with them. He had told them it was the drug he most feared said Mr. Collins.

Over the last thirteen and a half years, Saeed’s forced medication has been changed nine times. These attacks against Saeed are now being made against his supporters as well.

In a letter dated 28th May 2015, Clinical Director, Dr. Tobias Mackinnon claimed that Saeed’s Primary Carer, Brett Collins acted in a threatening manner and that the ‘duress buttons’ were nearly pushed during a meeting. This would have resulted in a team of ten nurses to be despatched to deal with a potentially violent threat. Dr. Mackinnon threatened to bring the Primary Carer relationship under review, and to exclude our access to Saeed and the forensic hospital said Mr. Collins.

This is an outrageous intimidation. Here is my response and what Dr. Mackinnon and the psychiatrist, Barbara Sinclair said. 

Saeed is now preparing for his 4th Supreme Court appeal with a barrister currently being briefed. The Mental Health Review Tribunal refuses to control the hospital not having given any orders since 2009.  It is clear that the Mental Health Review Tribunal’s refusal to make orders in the best interests of Saeed’s care and treatment suggests a failure to abide by their statutory obligations and an inability to act for the benefit of forensic patients.

I will renounce my Australian citizenship and return to the chaos of Iran in order to escape the torturous hands of these doctors. I met with the Consul-General this week. Feel sick in the stomach waiting for their poison to hit. It is such an abuse, and I need help from outside” (Saeed Dezfouli, 24th June 2015)

Justice Action will steadfastly support Saeed’s right to bodily integrity without interference, and pressure the Forensic Hospital to provide Saeed with consumer worker support and access to a computer – which it continues to neglect more than a year after the Tribunal made those recommendations on March 2014.

Professor Dan Howard, President of the Tribunal said in frustration that sometimes the system needs a kicking. Six months later when nothing had happened.


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