Mental Illness !

It took the tragic death of art curator Nick Waterlow and cookbook author Chloe Heuston to finally get legislation before the New South Wales parliament to address the need for the compulsory medication of those suffering from a psychotic illness.  In November 2009, the son and brother of this pair refused to take the medication that was keeping his paranoid schizophrenia under control - and in a rage stabbed them to death.

We have seen similar scenarios before the courts, and in most cases the finding is that the person is unfit to stand trial because of mental illness, and is then placed in involuntary care in a mental institution.   The sad thing is that earlier intervention could have prevented this mental illness reaching a critical point.

Families visited by mental illness know the despair of trying to get help - and finding that way blocked by the reluctance of doctors, the police, hospitals and all manner of services to grasp the nettle and make what is in many cases a " life or death " decision.    The law allows for involuntary medication - but it is such a grey area that few wish to put their reputation on the line be making a positive decision.

In many cases the unwell has been prescribed medication that is keeping this illness under control, but then for some reason the patient stops taking the drugs and refuses all entreaties.   In a lot of cases, this involves no threat of physical danger to either the patient or others, but it can present chilling scenarios to loved ones - and sometimes the balance between deranged behaviour and homicide can be wafer thin !

This new legislation will need to be carefully crafted.   Refusal to conform to ethnic values can be seen as mental illness by some traditionalists and too liberal an interpretation of interdiction can cut across legal lines. We do not wish to create a monster that will see mildly depressed people refused their liberty and this would be a good time for a round table with the medical people, the law - and the drug companies that medicate those with mental illness.

A lot of progress has been made with slow release medication.   In particular, this has progressed well with " under the skin " capsules that last a matter of months.    This innovation could be a boon if it could be linked to anti psychotic drugs to eliminate the need for a daily conscious decision to continue the treatment.   It is possible that such a solution could provide the balance that stops patients slipping over the edge and becoming totally irrational.     That would be a worthy aim for the drug people to strive for.

It is clear that the system in place is not working.   The politicians are tasked with finding a new way to ease this problem and that will only be achieved if a clear pathway emerges that can be easily understood by those who have the authority to implement it.   It will obviously need checks and balances to ensure that it is not abused, but medical intervention appears essential if we are not to see a continuation of tragic events linked to the refusal to continue medication.

Getting it right will require wise decisions and innovative thinking !