a Web newsletter for psych. cønsumers in Australia
29 May 1998
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[NATIONAL] THEMHS is an annual conference for mental health services AND cønsumers in Aussie land & NZ. Papers will be given by cønsumers. The AGM of the Aussie MH Cønsumer network usually happens during this conference. THEMHS 1998 will be held September 7 - 11 at Wrest Point Hotel (yes, near the Casino) in Hobart, Tasmania. Cønsumer issues to be covered : "the national Cønsumer Network, escaping poverty, mainstreaming, self-esteem, employment, peer programs, rehabilitation, the Clubhouse model, migrant and indigenous (people).. " The cønsumer day will be Sunday September 6. The Network has a sub-committee working on a website for this day now.

If you can reach Melbourne and you want to visit THEMHS this year, VMIAC may be organising a transport/accomodation package for a group of cønsumers - phone (03)93878317BH.

Or you can join another group from Melbourne, who are making arrangements now for the trip . Registration with THEMHS for the cønsumer day [Sunday Sept. 6] is $10. Any cønsumer can attend these sessions. THEMHS are also offering a conference concession registration at $150 if you want to go all the way.

[ NZ ] an issue of informed consent ... in 1995 a social worker in a NZ hospital decided that one of his clients was entitled to refuse treatment. Complications followed; here's the story. The social worker is referred to here as Q.

Q thought that one of his clients, a young man, was beginning to show early signs of schiz. - he had a strong feeling that everyone was trying to control him. So Q backed off, gave him his informed consent rights to refuse treatment; and monitored the situation via his care-givers. His mother (not a care-giver) thought he ought to see a psychiatrist whether he wanted to or not, and made a complaint that Q was doing the wrong thing.

At that point, the hospital managers ordered Q off the case, and told the care-givers that they had to take the cønsumer to a psychiatrist. Sadly, after the second visit to the latter, the cønsumer committed suicide.

The hospital sacked Q, and wrote a report blaming him; Q wasn't allowed any input into this. The mother of the cønsumer arrived on his doorstep with a 20/20 television crew. At the time, Q was in the employment court for wrongful dismissal and due to sub judice couldn't say anything publicly (the employment court said wrongful dismissal). 20/20 broadcast their show, vilifying Q. Q is now lining up a case of libel against the producers of this programme, who intend to contest the issue.

The NZ Psychologists' Board heard the case recently .. and merely found Q guilty for not keeping adequate notes - he keeps notes in the form of copies of letters he'd written to the people who consulted him, after each meeting. Q was not attracted to the traditional professional "file-speak" used for "cases". However the Board has decided that NZ psychologists are expected to write down an opinion about every person who consults them, if not a diagnosis.

As for the rest of the case on the way Q handled the family of the suicidal cønsumer, they decided he was not guilty. Q has told the Board that there is some interest in this question from cønsumer groups, and not just in NZ. He asked if he may publish their decision about this issue. The Board has now ordered that their decision be made public if there are no objections...

The hospital psychiatrist was contacted; he said he didn't get "written informed consent" from the cønsumer .. he has not commented on verbal informed consent. Q complained to the NZ Medical Council about the psychiatrist's lack of "informed consent" ... the President of the Council responded, saying that the psychiatrist had discussed the medication he was going to prescribe with the family before prescribing - therefore "informed consent" had occurred.

What of the question of whether the cønsumer in question wanted treatment at all? The actions of the psychiatrist seem coercive .. in fact many professionals normally take this approach.

The Royal Australian and NZ College of Psychiatrists also rejected Q's complaint about the psychiatrist not getting informed consent. It would be an interesting exercise for readers to write to RANZCP (in Melbourne) and ask them if psychiatrists in NZ and Australia must get informed consent from their clients, before treatment.

... Q comments " in NZ we have a Health & Disability's Commissioner, who has a list of health cønsumer's rights. This includes the right of informed consent, and informed refusal. Now it seems to me that this person is in quite a powerful position with regards to cønsumer rights. Unfortunately here in NZ the ANOPS group does not seem to be as well organised as (in Australia). However it occurs to me that if you have an equivalent person in Australia, then there would be some merit in writing to him/her and asking the Commissioner to write to the various professional bodies, especially the College of Psychiatrists and your Medical Council, about the details of their informed consent and informed refusal policies for their members. I am thinking that this Commissioner is in a more powerful position to put pressure on the professional bodies to tighten up their procedures with regards to acts which currently are allowing a lot of "forced" treatment to occur due to ignore-ance of correct protocols."

"The History and Theory of Informed Consent, by Beauchamp & Faden, outlines the protocols for fully informed consent decisions .. I have referred to a lot of what does go on as "passive implied consent" .. the cønsumer just passively goes along with what the professional says .. we have been brought up with the idea that "doctor knows best". These authors make it clear, using a lot of USA Court decisions to back their argument, that informed consent has only occurred when the cønsumer has fully understood the proposed treatment, and has actively requested the professional to proceed down a particular treatment track..."

" I think that the Cønsumer movement has got to put as much pressure as possible on the professional bodies to demonstrate that they are fully prescribing to informed consent protocols. And the first protocol has got to be - the professional will find out if the person actually wants any treatment."

More developments in later issues.

[VIC] H&CS are advertising a tender for "development of survey tools, methods, means of analysis and reporting for the measurement of cønsumer/carer satisfaction with psych. disability support services in Victoria". Enquiries to Tracey at (03) 96168726. This tender closes on 4 June.

[ VIC ] On 8 May, the Minister for Health, Rob Knowles, opened a new "WelcomeInn" and signed services protocols at the Ballarat Psychiatric Fellowship centre. Collaboration between Centacare Ballarat and the fellowship has generated a better service for cønsumers needing supported accomodation and respite. The services protocols signed will cover all psych. services in the Central Highlands ( from Kairos )

[ VIC ] Youth suicides have been linked to acne treatment. Depression and mood swings have been listed for more than 10 years as possible side-effects of a drug which combats acne, Roaccutane (isotretinoin). In the USA, there have been 12 cases where Roaccutane users suicided ... recently in NSW the death of a guy was linked to the drug. There are other known side-effects. Roche, the manufacturer upgraded the warnings shown on the packaging earlier this year; a spokesperson has attributed the depression of users to their perceptions of acne itself. (from the Age )

[ VIC ] A panel of the Med. Practitioners' Board was told this month that a Melbourne psychiatrist had indulged in sex with his patients. Three women who were his patients made statements about their experience and reactions. They said he used codes to contact them after they left his treatment. The psychiatrist practised in Richmond. The Board's decision will be released in June. (from the Age )

[VIC & SA] Consumer youth groups - are there any successful cønsumer-led support groups specifically for young people in Melbourne or Adelaide? I am interested in finding out more in order to start a support group for young people (15-25) up here in Brisbane ... I was going to Melb. sometime in June and was hoping to visit a group or someone who might have some information I could use. If anyone knows of anything it would be appreciated .. e-mail Michael at qamh-michael@powerup.com.au

[ NATIONAL ] Seen in a recent class for psych. support workers: the role of cønsumers when helping SPs will be
1...as advisors only
2...to provide guidelines only
3...not owned by one group
4...on call (rather than taking the initiative)

[ VIC ] VICSERV is requesting cønsumer involvement for their 1998 conference in Caulfield, Melbourne [August 13-14] .. the conference theme will be "reconnections" (?).. sorry, too late for sending Abstracts

[ VIC ] Allan Pinches is trialling a homepage on the Internet. Topics covered will include: community development, social justice, MH cønsumer advocacy, psychiatric disability support, and innovative solution-seeking for social problems.

[ FUTURE EDITIONS ] will include a story about the intriguing cønsumer intiatives in Caboolture, Queensland.

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