Restricted patients in New Zealand: A failed social experiment with a hybrid form of civil/forensic compulsory mental health treatment

2022 ◽  
Vol 80 ◽  
pp. 101762
Author(s):  
Susanna Every-Palmer ◽  
Alice Dunn ◽  
James Foulds ◽  
Iris Reuvecamp ◽  
John Dawson
2011 ◽  
Vol 42 (4) ◽  
pp. 421-436 ◽  
Author(s):  
K. M. Scott ◽  
J. Kokaua ◽  
J. Baxter

Objective: The comorbidity of mental disorders with chronic physical conditions is known to have important clinical consequences, but it is not known whether mental-physical comorbidity influences mental health treatment seeking. This study investigates whether the presence of a chronic physical condition influences the likelihood of seeking treatment for a mental health problem, and whether that varies among ethnic subgroups in New Zealand. Methods: Analyses were based on a subsample ( n = 7,435) of The New Zealand Mental Health Survey, a nationally representative household survey of adults (response rate 73.3%). Ethnic subgroups (Maori and Pacific peoples) were oversampled. DSM-IV mental disorders were measured face-to-face with the Composite International Diagnostic Interview (CIDI 3.0). Ascertainment of chronic physical conditions was via self-report. Results: In the general population, having a chronic medical condition increased the likelihood of seeking mental health treatment from a general practitioner (OR: 1.58), as did having a chronic pain condition (OR: 2.03). Comorbid chronic medical conditions increased the likelihood of seeking mental health treatment most strongly among Pacific peoples (ORs: 2.86–4.23), despite their being less likely (relative to other ethnic groups) to seek mental health treatment in the absence of physical condition comorbidity. Conclusion: In this first investigation of this topic, this study finds that chronic physical condition comorbidity increases the likelihood of seeking treatment for mental health problems. This provides reassurance to clinicians and health service planners that the difficult clinical problem of mental-physical comorbidity is not further compounded by the comorbidity itself constituting a barrier to mental health treatment seeking.


Laws ◽  
2018 ◽  
Vol 7 (3) ◽  
pp. 30
Author(s):  
Alison Schneller ◽  
Katey Thom ◽  
Peter Adams

In this paper, we use a constructed scenario to illustrate making a compulsory community treatment order in the New Zealand context. Drawing on publicly available documentation, we outline the existing mental health law framework that produces community treatment orders and emerging complex problems of their high, increasing and disproportionate use. We provide examples of human rights, indigenous and clinical effectiveness research that appear to be destabilising the existing mental health law framework. We argue assemblage theory (Deleuze & Guattari) is a useful theoretical tool to unpack the making and continued use of compulsory community treatment orders in the context of complex destabilising and stabilising influences. This is followed by an outline of the concept of assemblage with reference to the constructed scenario, focusing on processes, practices, places, types of knowledge, roles, documents and how they connect to produce certain effects that both enable and constrain participants’ actions. In the New Zealand context, we examine the potential for assemblage theory to generate new ways of thinking about compulsory mental health treatment in community settings by challenging perceived limitations and revealing opportunities for participants to act otherwise. We conclude with a proposal for further research shaped by this theory that explores the making of actual community treatment orders to reveal where there is potential to change existing relations towards more positive effects for participants.


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