Singh S
Cumberland Hospital, Westmead, Australia.
Med Law. 1996;15(3):441-6.
The Mental Health Act 1990 replaced the 1958 Act and brought in many innovations which will be discussed. Mental illness is now defined therein but to be mentally ill under the Act additional criteria of being a danger to oneself or others has to be fulfilled. As a result many patients who are obviously suffering from a mental illness but not posing a danger cannot be compulsorily detained in hospitals and treated, much to the frustration of doctors, other staff and carers. The legislators had the view that a person has the right to go silently mad. Obviously such patients will not admit themselves voluntarily as Informal patients. Were it not for a certain vocal consumer group (Manic Depressive Self Help Group) who strongly lobbied the politicians to force changes to the Act (to specify that a person suffering from a severe disturbance of mood and who arising out of such disturbed mood could bring on serious financial harm or serious damage to his/her reputation could also be detained and treated) a significant number of maniacs (who weren't posing a serious risk of harm to themselves or others) would have gone untreated with disastrous consequences. The new Act creates a new category of Mentally Disordered Person (no matter what the underlying stresses/precipitants may be a person who poses a temporary serious risk of harm to himself or others) where such person can be admitted and treated for up to 3 working days. All mentally ill or mentally disordered persons have to have certification from at least one psychiatrist and one other doctor. The mentally ill persons have to be finally seen by a magistrate at a hearing at the hospital and the magistrate can either order adjournment, detention for up to maximum of 3 months or discharge. Appeal provisions to Mental Health Tribunal and Supreme Court exist. The Act also contains guidelines for the use of E.C.T. and medication. Whilst a useful piece of legislation, obviously it is not without problems. It sets out to protect (with measurable success) the rights of the mentally ill but some of its restrictive provisions deny many mentally ill persons a basic right (the right to prompt and early treatment) and cause great anguish to affected families and mental health professionals.
1990年《精神健康法》取代了1958年的法案,并引入了许多创新举措,这些将在下文讨论。该法案对精神疾病进行了定义,但要依据该法案判定为患有精神疾病,还必须满足对自己或他人构成危险这一附加标准。结果,许多明显患有精神疾病但不构成危险的患者无法被强制住院治疗,这让医生、其他工作人员和护理人员倍感沮丧。立法者认为,一个人有权默默发疯。显然,这类患者不会自愿作为非正式患者入院。若不是某个有影响力的消费者团体(躁郁症自助团体)强烈游说政客迫使修改该法案(明确规定患有严重情绪障碍且因这种情绪障碍可能导致严重经济损失或对其声誉造成严重损害的人也可被拘留和治疗),大量躁狂症患者(对自己或他人不构成严重伤害风险)就会得不到治疗,后果不堪设想。新法案设立了“精神错乱者”这一新类别(无论潜在压力/诱因是什么,只要此人对自己或他人构成暂时的严重伤害风险),这类人可被收治并接受长达3个工作日的治疗。所有精神疾病患者或精神错乱者都必须至少有一名精神科医生和另一名医生出具的证明。精神疾病患者最终必须在医院听证会上接受治安法官的审查,治安法官可以下令休庭、最多拘留3个月或予以释放。存在向心理健康法庭和最高法院上诉的规定。该法案还包含使用电休克疗法和药物治疗的指导方针。虽然这是一项有用的立法,但显然并非毫无问题。它旨在(并取得了一定成效)保护精神疾病患者的权利,但其一些限制性条款剥夺了许多精神疾病患者的一项基本权利(及时和早期治疗的权利),并给受影响的家庭和心理健康专业人员带来极大痛苦。