Loading...

Mental Health

Reports: First Visit to Saeed/MHRT hearing

Breakthrough – First Visit for Saeed’s Friends 29/09/11

Visiting Saeed – An Outsiders Perspective

Rosie – JA worker

When Dani, Adriana and myself first arrived at the forensic hospital within the Long Bay Correctional facility we approached the security staff who seemed reasonably helpful as they cleared us through the initial security measures. We were asked to show photo identification, had our photo taken and had our fingerprints and retina scans taken. As we arrived early we had time to wait before going through to see Saeed and a security staff member even took us through to the staff-only area to get a coffee while we waited.

Read more

History of Attempts to Visit Saeed

History of Attempts to Visit Saeed Dezfouli

20th April 2009

Report provided to mental health legal representative, who was told to wait three weeks to gain approval to visit:

We've followed this up and contacted the Forensic Hospital.

 

The position is:

The 3 week period you mentioned can be substantially shortened if requested.  In particular, anyone who has been permitted by DCS to visit a patient in the old prison hospital will automatically be permitted to visit the patient in the Forensic Hospital.  Although it is not relevant to you because you have been previously approved, the sole criteria they use to assess whether someone should visit is whether the visit is 'in the clinical best interests of the patient'.  To determine that, amongst other things they will ask the patient whether they want to see the visitor.

Visits take place from Monday to Sunday. Allotted times are:

                  9.30 - 10.30

                  11 - 12

                  1.30 - 2.30

                  3 -4

There are 5 wards and one person is permitted to visit in each ward during each allotment of time.

Once you are approved as a visitor you need to book a time the day before to enable the guards on the front gate to be aware of your intended visit;”

Read more

Denial of Visiting

Community Access to Mental Health Patients (read as pdf)

Denial of Visiting

From April 2009 until September 13, 2011, several dozen citizens of good character including psychiatrists, lawyers and other people of goodwill were blocked access to visit and help Saeed Dezfouli after nine and a half years locked in a closed hospital. This is one of many issues dealt with by Saeed. An issue, which is so significant, that it was raised before the NSW supreme court. The Mental Health Review Tribunal was also asked to intervene. Nobody responded.

Read more

Timeline of Saeed’s Case

1958

  • Saeed Dezfouli born in Iran. 

1983

  • Migrated to Australia. Immediately began studying a Bachelor of Arts, majoring in political sciences. 
 1986
  • Saeed became a citizen of Australia, and began working as a court interpreter for the Ethnic Affairs Commission NSW,

2001

  • Throughout 2001, Saeed received death threats. Decided to take action, and thus warned authorities on his concerns prior to committing the crime. 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. 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.

Read more

About Saeed

scan2


“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

INTRODUCTION 

 

The NSW Health Department’s mental hospital is getting exposure through the window of patient Saeed Dezfouli. His case significantly highlights the issue with government bureaucracies dealing with challenging people at the individual level, lacking compassion, concern, or rational behaviour.

 

HISTORY 

 

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.

Read more

The Treatment of Saeed Dezfouli

History of Treatment


In February 2002 Saeed was transferred to Long Bay Prison Hospital and in 2004 he was found not guilty due to mental illness. Since that time he has been held indefinitely and subjected to continuous abuse. His mistreatment by the staff of Justice Health and the department of corrective services at Long Bay hospital can be seen through the following examples.

  • A number of times they kept Saeed naked in a solitary confinement cell for days to "break him down".
  • The first time, when they forced medication into him by injection they broke two of his ribs. The second time they left him bruised all over and in severe physical pain for days.
  • Twice they left him in a cell without toilet paper for four (4) days.
  • DCS Officers broke a number of his bones in LBH-1.
  • In January of 2005 Saeed got brutally assaulted by DCS Officers and as a result got a permanent back injury. Saeed was taken to Prince of Wales Hospital Emergency Room for the injuries inflicted upon him by DCS Officers.
  • Saeed now is suffering from heart condition, ulcers and diabetes as a result of the side effects of anti-psychotic medications combined with going through a daily oppressive and suppressive regimen.

    Read more

Success of Mental Health Tribunal Hearing: December 2018

On the 29th of November 2018, Malcolm Baker appeared before the Mental Health Review Tribunal to review his treatment order. Mr. Baker’s previous hearing on the 16th of August 2018 ordered a cease of forced administration of medication, and consequentially, Mr. Baker has been without medication since June 2018. Despite the implementation of these changes, Mr. Baker’s treatment order has not been formally amended. The purpose of this most recent hearing was to review the need for an ongoing treatment order. The Tribunal considered our Personal Management Plan for Malcolm Baker - the submission can be read here. 

Opening the Tribunal, the lead psychiatrist’s opening statement proved that Mr Baker is mentally stable, drawing emphasis to the fact that he is not delusional and has not displayed any new psychotic symptoms since receiving the active order. The psychiatrist explained that Mr Baker’s experiences of paranoia are a result of traumatic events that have occurred both during his childhood and his imprisonment. Whilst Mr Baker may experience episodes of paranoid thinking after a traumatic or stressful event, it is important to note that these symptoms are transient and diminish within a few hours, rather than being serious signs of mental instability. 

At the Tribunal, there appeared to be unanimous agreement that Mr Baker is  not “a risk of serious harm to himself or others”, thereby exempting him from the legal definition of a ‘mentally ill person’ under s14 of the Mental Health Act. Consequentially, therapeutic intervention was agreed to be the preferred form of treatment for Mr Baker, rather than an ongoing plan for forced medication.

All persons at the hearing stressed the importance of ensuring Mr Baker would reside in a safe environment, and there was lengthy discussion about whether this will be best provided at Long Bay Hospital where Malcolm is currently held, or within the mainstream prison system. The lead psychiatrist advocated for psychological treatment within the hospital to assist Malcolm in building skills to re-enter the prison system. However, the psychiatrist also pointed out the benefits of Mr Baker returning to the mainstream prison system including access education, work, and the opportunity to effectively “make a life for himself”.

Nevertheless, the Tribunal has reserved making a formal judgement. They are expected to do so upon further deliberation in the next few weeks. Justice Action believes that it is possible to guarantee Mr Baker a ‘safe living environment’ in the prison system provided negotiation is constant between judicial and corrective NSW services. Mr Baker will continue to receive support from Justice Action and his family - the Tribunal agreed that Mr Baker would benefit from regular visits with renowned mental health consumer advocate Douglas Holmes. Justice Action deems the hearing a success and is optimistic about the outcome for Malcolm Baker's future. 

Analysis of Malcolm Baker's diagnosis (September 2018)

On 16 August 2018, the Mental Health Review Tribunal accepted evidence from psychiatrist Dr. Jeremy Resnick, that Malcolm Baker is not delusionsl and that his forced medication was to be stopped immediately. The psychiatrists' report challenged previous psychiatric assessments of Malcolm. In the past, Mr. Baker was diagnosed as having schizoaffective disorder, or a "chronic psychotic illness," primarily substantiated by the apparent persistence of delsional ideations.

Dr. Resnick's report concluded that Mr. Baker's alternative points of view were not delusions, and were instead based on "rational explanations to be found in research literature such as the Nexus magazine." The psychiatrist told the Tribunal that Mr. Baker will be gradually phased off the medication and will instead undertake cognitive behavioural therapy at Long Bay Hospital.

Although the Tribunal accepted that Mr. Baker did not suffer from delusions, they neglected to remove him from the mental health facility where he was kept. The Tribunal did not receive substantial evidence that Mr. Baker did not pose a risk of causing serious harm to himself or others, meaning that their decision not to remove Mr. Baker from the facility did not meet the requirements of s14(1) of the Mental Health Act. Health services have a duty to treat all consumers with respect and must provide assistance free of coercion. The health professionals' sudden backflip suggests an effort on their part to avoid confrontation with the Supreme Court. This raises serious questions about the quality of Mr. Baker's initial "diagnoses" and subsequent treatment and perhaps more frighteningly, how many others are suffering from similar abuses in the mental health system?

Below is the histroy of Mr. Baker's diagnoses and an analysis of the decision. Whilst it is important to celebrate this victory, the fight isn't over yet, and we ask for your assistance in preventing further abuses within the mental health system.

Diagnosis History of Malcolm Baker
Below are some relevant extracts from Mr. Baker's history of incarceration. Justice Action has appeared with Mr. Baker before the Mental Health Review Tribunal on six separate occasions to fight for his right to refuse medication. Justice Action believes that Mr. Baker was misdiagnosed, forced into a vicious cycle of medication and re-admission based on symptoms caused by the very treatment he received while incarcerated.

A timeline of Malcolm Baker's diagnosis history:

  • October 1992: Malcolm Baker sentenced to life after being declared fit to stand trial and free of mental illness by two separate psychiatrists.
  • 21 November 2007: Dr. Matthew Hearps: "There was a persistence of delusional material."
  • September 2009: CT brain scan, no abnormalities detected.
  • 20 August 2010: Dr. Jeremy O'Dea: "Mr. Baker was readily arouse and animated when discussing apparent systemised delusional thoughts re mind control." (p.3)
  • 18 August 2012: Mr. Baker was "irritable and expressed delusional ideas." (p.3)
  • December 2014: Evidence of psychosis on background of schizoaffective disorder per Dr. Dayalan (Psychiatrist at Nowra CC).
  • January 2015: Untreated psychotic illness per Dr. Chew.
  • May 2015 - May 2016: "He also appeared to have delusions of reference interpreting the actions of those around him as threatening." (p.4)
  • June 2015 - June 2016: Off medication and no behavioural issues.
  • 24 January 2018: "No formal thought disorder" but "poor insight into his condition."
  • 19 April 2018: "Remains insightless, hostile, suspicious; paranoid however did not display any dangerous ideation."
  • 28 June 2018: The Mental Health Review Tribunal Report summarised Mr. Baker's psychiatric histroy as having a 'long-standing diagnosis of schizoaffective disorder."

What is schizoaffective disorder?
Schizoaffective disorder is characterised by persistent psychosis (e.g. hallucinations, delusions) and mood episodes of depressive, manic, and/or mixed types. This disorder will likely affect a person's thought, emotions and actions. Additionally, it is reflective of two common psychiatric illnesses, namely schizoprenia and a mood disorder (major depressive disorder or bipolar disorder).

Is schizoaffective disorder reversible?
Currently, there is no cure for schizoaffective disorder. It is a life-long illness but its symptoms may be managed and controlled with treatment, especially medications.

The Relationship between Delusions and Schizoaffective Disorder:
Delusions are understood as 'fixed forms of belief that do not change regardless of evidence to the contrary.' The delusions appear to be false or not based on reality. Additionally, "delusions are deemed bizarre if they are clearly implausible and not understandable and do not derive from any ordinary life experiences." 
According to DSM guidelines, in order to meet the criteria to be diagnosed with schizoaffective disorder a person must experience an uninterrupted period of illness where a major depressive, manic or mixed episode is concurrent with 2 or more of the following symptoms for at least one month:

  • Delusions
  • Hallucinations
  • Disorganised speec (e.g. frequent derailment or incoherence)
  • Grossly disorganised or catatonic behaviour
  • Negative symptoms (e.g. affective flattening, alogia, avolition)

However, only one symptom is required in the case of delusions being bizarre. During the period of illness, delusions or hallucinations must persist in the absence of prominent mood symptoms. In order for this condition to be diagnosed, the symptoms experienced by a person must be not better explained by the use or abuse of a substance (alcohol, drugs, medications) or a general medical condition (such as a stroke).

Applying this to the case of Malcolm Baker
Malcolm Baker's diagnosis for schizoaffective disorder was fundamentally justified and substantiated by persistent delusions (as per the statements in the timeline, on dates 20 August 2010, 18 August 2012 and May 2015-May2016). This line of diagnosis has proven to be incorrect given the recent report by Dr. Jeremy Resnick. He is of the opnion that Mr. Baker's beliefs are "not delusional in a psychiatric sense" and "aside from his 'alternative views' discussed above, my own exmaination currently does not find true delusional ideation in his thinking."
Mr Baker's beliefs originate from rational explanations as summarised by Dr. Resnick (Mental Health Review Tribunal, 10/08/2018):

"Mr. Baker has for many years been fascinated by alternative points of view, which may sound bizarre and impossible. However, it appears for many of these ideas, there are legitimate, rational explanations to be found in alternative research literature such as the Nexus Magazine...Mr. Baker at times links these ideas with his own coincidental experinces in prison, drawing conclusions that are self-referential, paranoid and at time superficially delusional."

Dr. Resnick provided another alternative explanation to Mr. Baker's behaviour, particularly that of his mistrust for people which has been heavily impacted by his personal history:

"It is apparent...he remains affected by memories of his traumatic childhood in terms of emotions, attitudes and beliefs in relation to others and himself which could be described as paranoid (i.e. mustrustful/suspicious, fearful...hostile, angry and comabtive...)."

 

 

Victory! Malcolm’s Forced Medication Stopped: August 2018

IMG 0910On 16 August, Malcolm Baker won his case at a hearing before the Mental Health Review Tribunal. He will no longer be forcibly medicated.

In the past, Justice Action has appeared with Malcolm before the Mental Health Review Tribunal on six separate occasions to fight for his right to refuse medication. His last hearing took place on 28 June, but was adjourned without decision as Justice Health had failed to produce the medical certificates that were required as evidence.

Malcolm was supported at his 16 August hearing by two members of the Justice Action team, whilst another two members were refused entry despite previous arrangements.

A new psychiatric report provided by Justice Health was revealed, contradicting previous assessments of Malcolm. Previous psychiatrists had commented that Malcolm’s beliefs are “abnormal to the point of delusional”, concluding that he therefore had a “chronic psychotic illness.” However, the leading psychiatrist of the team now said, “Mr Baker has for many years been fascinated by alternative points of view, which may sound bizarre and impossible. However, it appears for many of these ideas, there are legitimate, rational explanations to be found in alternative research literature such as the Nexus magazine.”

Under s 16 of the Mental Health Act 2007, a person cannot be considered mentally ill merely on the basis of a particular philosophy, political beliefs, or opinions. Malcolm’s personal beliefs therefore cannot constitute a mental illness, and do not justify the use of forced medication.

“My own examination currently does not find true delusional ideation in his thinking,” stated the leading psychiatrist. According to him, medication would not have any impact on Malcolm’s personal beliefs, which had been the causes of controversy with previous treatment teams. The psychiatrist also noted that Malcolm has had no behavioural issues and has never displayed aggression, threats, or a “need to control him.”

Therefore, upon inspection of the evidence, it became clear that Malcolm did not meet the requirements articulated in s 14 of the Mental Health Act, which allows involuntary treatment in situations where a mentally ill person poses a serious risk of harm to himself or others.

As a result, Malcolm will be taken off the medication. He will remain in the hospital at Long Bay prison for the next three months whilst the medication is gradually discontinued. A psychologist will be allocated to Malcolm for cognitive behavioural therapy, which the leading psychiatrist says will allow him to “develop interpersonal skills and strategies that enable him to cope better.”

Justice Action is also applying to find Malcolm a job and educational opportunities. The psychiatrist agrees that work, education and socialisation is “very important” for Malcolm’s long-tem care and safety. 

His next hearing will take place in three months’ time, and will determine his future resettlement and a long-term strategy for care, treatment and control.

Subcategories

 

  • get involved2
  • donate
  • breakout-logo2

 

 

Justice Action
Trades Hall, Level 2, Suite 204
4 Goulburn Street
Sydney NSW 2000, Australia

T 02 9283 0123
F 02 9283 0112
E ja@justiceaction.org.au
© 2017 Breakout Media Communications
breakout-logo  womens justice network icon logo-community
donate2