Quis custodiet ipsos custodes? An audit of records of involuntary detention

Australas Psychiatry. 2016 Jun;24(3):264-7. doi: 10.1177/1039856215604489. Epub 2015 Sep 23.

Abstract

Objectives: To determine the appropriateness and utility of the certificates issued under the New South Wales Mental Health Act (MHA) and compliance with the requirements of the MHA. The analysis also compares MHA documentation by different groups of health professionals and police.

Methods: The MHA certificates associated with 100 consecutive involuntary Emergency Department presentations were audited.

Results: Considerable variability exists between professional groups in the level of detail, appropriateness, clinical utility and compliance of MHA certificates. Over 10% of Schedule 1s failed to meet the requirements of the MHA, potentially invalidating the involuntary detention of these patients. Information provided by police was typically superior in informing initial risk assessment and emergency management.

Conclusions: A number of patients are presently being detained under incomplete MHA certificates. Educational initiatives that aim to improve awareness of the MHA's requirements, and the potential uses of the information contained in MHA certificates, could encourage professionals to complete these certificates in a more appropriate and clinically useful manner.

Keywords: audit; documentation; involuntary detention; mental health act.

MeSH terms

  • Clinical Audit
  • Commitment of Mentally Ill / legislation & jurisprudence
  • Commitment of Mentally Ill / standards
  • Commitment of Mentally Ill / statistics & numerical data*
  • Documentation / standards
  • Documentation / statistics & numerical data*
  • Emergency Service, Hospital / legislation & jurisprudence
  • Emergency Service, Hospital / standards
  • Emergency Service, Hospital / statistics & numerical data*
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Involuntary Treatment, Psychiatric / legislation & jurisprudence
  • Involuntary Treatment, Psychiatric / standards
  • Involuntary Treatment, Psychiatric / statistics & numerical data*
  • Mental Health / legislation & jurisprudence
  • New South Wales
  • Practice Guidelines as Topic