Introduction
Mental illness is a medically diagnosed condition that significantly hinders a person’s ability to think, feel, or interact socially (Fusar‐Poli et al., 2021). In Western Australia, 450,000 individuals experience mental illness in one year (WA Health, 2019). Those with severe disorders are placed in inpatient settings for close monitoring and personalised care. However, while these facilities serve a crucial role, it is imperative to protect the rights of the inpatients’. The legislation that ensures this is the Mental Health Act 2014. This paper will review this welfare law to explain how it protects the rights of mental health inpatients. It will further explain why this legal protection is needed and detail the relevant principles of the legislation. Finally, the paper will criticise the application of this law in protecting the rights of mental health inpatients.
Analysis of The Reasons Why Legal Protection is Needed
One reason for legal protection is to uphold the rights and dignity of mental health inpatients. Their rights include humane and dignified treatment, communication, and access to advocacy, among others (WA Health, 2019). These rights are protected by legislation and regulations to ensure quality care and respect for individuals’ autonomy and well-being. Additionally, those who fail to respect it can be charged with a criminal offense under various mental health acts and human rights legislation (WA Health, 2019). Therefore, this will ensure that the inpatients are treated respectfully throughout their treatment journey (Sashidharan et al., 2019).
Another reason for legal protection is to eradicate abuse and discrimination among this group. According to Kurs & Grinshpoon (2018), mental health inpatients are susceptible to abuse, neglect, and discrimination. This is because there are few witnesses to potential abuse within facilities (Kurs & Grinshpoon, 2018). In addition, a survey done last year by Mental Health Commission asked mental health service users about their service experience (Mental Health Commission, 2023). The respondents shared a concern that they were not involved in the decisions concerning their treatment.
Moreover, some felt their choices, preferences, or views were ignored throughout their care (Mental Health Commission, 2023). This displays systemic discrimination, which can negatively affect the mental health of inpatients. Therefore, legal protection of their rights must ensure that healthcare providers respect and value the patients’ requirements.
Another reason for legal protection is to avail of support services that will speed up recovery. In April 2021, mental health inpatient facilities in Western Australia participated in the Mental Health Inpatient Snapshot Survey (MHISS) (Mental Health Commission, 2023). This purpose was to give a snapshot of the statewide population of mental health inpatients who could be eligible for discharge if appropriate housing, treatment, and support services were made available (Mental Health Commission, 2023).
Results showed that 152 of the 647 clients would have been discharged from the facility if they had access to appropriate housing, treatment, and support services. Additionally, 88% of these participants required appropriate housing to be discharged (Mental Health Commission, 2023). However, with legal protection, inpatients acquire quality care and timely interventions making support services more accessible. It also accelerates post-discharge planning, speeding up the recovery process and enhancing social integration.
Overview of the Relevant Principles of the Mental Health Act 2014
The Mental Health Act 2014 outlines principles that mental health services must adhere to when delivering care to individuals experiencing mental illness. One example is the principles of human rights. This requires that mental health services uphold clients’ rights at all times. It also requires that they act by national and international norms for mental health care (Charter of Mental Health Care Principles, 2021).
Another principle is the attitude towards people experiencing mental illness. This holds that a mental health service must treat patients with respect, decency, equality, kindness, and compassion. They must never stigmatise or discriminate against them. Another principle is diversity, which holds that mental health services must accommodate various clientele and circumstances. This includes a person’s gender, sexual orientation, lifestyle choices, age, spiritual beliefs, family, and disability (Lerner, 2018).
Another principle is choice and self-determination. Mental health care should encourage self-determination and cooperation and include the clients in decision-making processes. One step towards this goal is recognizing that people can make their own decisions.
Furthermore, the law establishes a principle for people of ATSI descent (Charter of Mental Health Care Principles, 2021). Workers must provide mental health treatments that respect and align with their cultural and spiritual values. They should also respect the perspectives of ATSI elders, traditional healers, and mental health workers (Sashidharan et al., 2019).
Another principle is co-occurring health needs. A mental health provider must comprehensively address all needs of a mental health patient, not just their mental illness (Charter of Mental Health Care Principles, 2021). The health provider must ensure that the patient is in good physical, medical, and dental health and does not have alcohol and substance addiction to satisfy these standards (Barr et al., 2019).
The final relevant principle is the provision of information about rights. Any mental health service should be readily available and explain their legal rights to clients. They should know their rights to things like adequate counsel, complaints procedures, advocacy, and access to their personal information (Charter of Mental Health Care Principles, 2021). This will make them learn about and demand the support they are entitled to.
Critique of the current application of the legislation
The Mental Health Act of 2014 provides treatment, protection, and rights for individuals with mental illness, particularly involuntary patients (Mental Health Act 2014, 2018). Since it commenced its operation on November 30, 2015, it has helped protect the rights of those undergoing inpatient treatment for mental health disorders. For instance, it has effectively ensured that appropriate mental health treatments are provided across Western Australia (Mental Health Act 2014, 2018).
The Mental Health Commission surveyed in 2021 to learn the overall satisfaction of patients using mental health services (Mental Health Commission, 2023). The Commission asked consumers to rate their experience of care with this service. The majority of respondents (70%) said their overall impression was either “very good” or “excellent.” Furthermore, 81% of respondents said they would “likely” or “very likely” recommend the service to friends, family, and colleagues (Mental Health Commission, 2023).
Moreover, a range of programs is being implemented to protect the rights of people receiving mental health treatment in institutions and improve their well-being (Mental Health Act 2014, 2018). One of the services is the Homelessness Service for Youth with Mental Health and Substance Use Disorders. This program will prioritise those between the ages of 16 and 24 with significant mental health issues (with or without alcohol and other drug issues (s) (Mental Health Act 2014, 2018). Another program is the Community Care Unit (CCU). This institution will provide twenty beds and community-based rehabilitation for people facing severe and persistent mental health challenges (Mental Health Act 2014, 2018).
Additionally, there has been a recent budget hand-down by the Treasurer of the WA State Budget. The Treasurer will deliver more than a billion dollars ($1.358 billion) to mental health, alcohol, and other drug services in 2023-24. This is an increase of 7.2% ($91 million) from the previous budget. This significant increase will favorably influence mental health inpatients in funding. It will provide improved services, increased staffing, and improved facilities, contributing to more holistic and high-quality care.
However, there have been limitations to the application of this legislation. For instance, in the statutory review done by the mental health commission, a concern was raised that voluntary inpatients are not granted their rights (Mental Health Commission, 2023). Voluntary inpatients are individuals who are willingly admitted to a mental facility (Curley et al., 2022). Their rights are various, including access to communication and free movement (Curley et al., 2022). However, concerns are that older adults are primarily admitted as “voluntary” patients to locked wards. They are confined in a facility with locked doors, which limits their mobility and ability to communicate with one another (Mental Health Commission, 2023). Therefore, an amendment to this Act should be introduced to declare that a voluntary patient has the right to leave the ward or hospital at any time without permission, regardless of whether the patient is placed in a locked or unlocked ward.
Another limitation is that the Act does not currently identify ATSI status on the approved forms (Mental Health Act 2014, 2018). This has been raised as an issue by the Mental Health Advocacy Service (WA Health, 2019). It has been identified that the provisions are not being complied with, and overall, ATSI people are not consistently being offered their rights (WA Health, 2019). Additionally, failing to identify ATSI status on forms overlooks the importance of culturally sensitive care for Indigenous individuals. Therefore, an amendment to the Act should be made to include the identification of ATSI status on the Act’s Approved forms. This will ensure that the mental health system in Western Australia provides culturally sensitive care to the ATSI community (Lerner, 2018).
Conclusion
Protecting the human rights of inpatients with mental health issues is crucial to providing respectful and sufficient care. The Mental Health Act 2014 in WA has been proven successful in delivering appropriate care and protecting patient rights. Positive feedback from service recipients validates the effectiveness of mental health care. However, challenges remain, such as the lack of ATSI status recognition on official paperwork, making it harder to deliver culturally appropriate care to indigenous populations. For the sake of improving the effectiveness of Western Australia’s mental health system, the legislation must be updated to give better protection of rights and specific attention to the cultural requirements of patients.
References
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