Mental health broadly describes the level of our psychological well-being and inherently provides a basis to an understanding of our own identity, whether it be as a citizen of society or as an individual within a circle of family and friends.
The status of our psychological well-being however is conditional to an infinite range of factors. From basic daily anxiety to the more serious problems of alcohol and drug addiction to suicide, mental health continues to be an issue of concern today more than ever.
The increasing problems and lack of proper awareness of mental health has generated a class of individuals that have had their voices and rights dismissed. This has evoked an active need for the proper and necessary treatment of individuals concerned with mental health problems.
Justice Action decided to focus on the mental health area after it had become apparent that a new strategy was required to defend community interests and prisoners’ rights against the law and the added effects of tension, boredom, powerlessness and isolation occurring in imprisonment.
Many prisoners become forensic patients or remain in prison under medication: the rates of major illness in prisons have been found to be three times higher than that of the general population.
In mental health, the focus is on making patients well, without the elements of guilt and punishment, while retaining state control of citizens. Patients (consumers) had been asking for our assistance, and we saw the chance of a forward defence for mental health patients’ rights. If we could not defend patients’ human rights, what chance did we have with prisoners?
Upon examination we discovered that forensic (incarcerated) mental health consumers receive even less respect for their dignity and humanity. In practice it is definitely better to be bad than mad. Lawyers who have enticed clients with a psychiatric defence are cursed from the dungeons. In both prisons and mental health wards, almost everyone smokes, but it is the forensic consumers who have lost their tobacco.
Prisoners are regarded as normal people who have made mistakes, have to pay a penalty and then return to their former status. Forensic consumers however, are treated like children, unable to take responsibility for decision-making sometimes for the rest of their lives, depending on the psychiatric diagnosis. Total arbitrary control contrary to consumers’ wishes is cloaked as euphemisms of expressions of care. The industry’s culture creates professionals lacking empathy for patient; stumbling glassy-eyed humans are seen as effective work practice. In the new Long Bay Forensic Hospital, all patients are medicated. Patient resistance is construed as sickness.
The consumer focus in mental health has been hijacked. Stated rights have become valueless in the face of this culture. External service providers dependent on government money are part of the problem. Patients are dehumanized and exploited to yield budgets of over $205,000 per forensic patient per year. Privacy and security mean hiding from examination. Visitors are discouraged and refused. Social support for patients is seen as causing disturbance rather than a community right, a necessary measure and an alternative to medication. A “clinical decision that the patient’s mental health might be affected” is enough for a refusal. There are no stated rules.
A long line of reports, including the 1992 ‘Burdekin’ Report, the 2005 Mental Health Council of Australia (MHCA) (in association with the Human Rights and Equal Opportunity Commission) ‘Not for Service’ Report, as well as the Australian Medical Association (Treatment, Not Prison) (AMA) all express the failure in the treatment of mental health and the need for change. However, nothing has changed on the ground despite billions of taxpayers’ dollars being spent.
The problem lies in the powerlessness of those for whom the services are provided: identified by the World Health Organisation (WHO) as one of the key barriers to consumer participation. Authorities have used the stigma of mental illness FALSE STIGMA OF VIOLENCE and abused the trust of the public purse. They have taken control, redefined the services provided Prisons and mental Illness Link for the sick and bought the silence of those who should protest.
Patients’ opinions and contributions to their own wellbeing have been de-legitimised by those whom society has trusted to help them, despite involvement being essential to good health. Further, enforced medication is often used contrary to international standards to fill the gap.