A one year analysis of appeals made to mental health review tribunals in New Zealand.
OBJECTIVE
The aim of the paper is to present data on the first year of all appeals lodged with a Mental Health Review Tribunal against compulsory treatment orders of psychiatric inpatients.


METHODS
Two tribunals have been in operation in New Zealand since the introduction of a new Mental Health (Compulsory Assessment and Treatment) Act in 1992. The case records of all patients who had appeals heard by either the Northern or Southern regional tribunal from 16/12/92 to 7/12/93 inclusive were examined.


RESULTS
145 appeals were heard by the tribunals: 14.5% of appeal hearings resulted in the discharge of a patient from their compulsory treatment status. Discharge rates for the Southern Tribunal were found to be significantly higher at 22%, compared with 10% for the Northern Tribunal (p < 0.05). Application for appeal was initiated by the patient in 72% of cases; District Inspectors initiated the remaining cases. District Inspectors were found to initiate significantly more female review applications (47%) than male applications (22%) (p < 0.05). Of the appeals heard, 126 were lodged under s.79 of the Mental Health Act. The remaining cases were s.80 (special) cases: in no case was discharge from compulsory treatment recommended. Overall, 69% of appellants were represented by a lawyer. It was found however that engaging legal representation did not significantly increase patients' chances of successful discharge but did delay the hearings. Also considered in the study were the presence or absence of witnesses at hearings and the relationship this had to the outcome of the tribunal hearing.


CONCLUSIONS
Ambiguities within the Act need to be addressed in order that criteria used to judge a patient's fitness for discharge may be standardised. In addition, the Act stipulates a maximum delay of 14 days in reviewing a patient's case; however in practice a mean of 22 days elapses, indicating that this stipulation requires review.
O'Brien
T A
TA
Wellington School of Medicine, New Zealand.
Mellsop
G W
GW
McDonald
K P
KP
Ruthe
C B
CB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence; D008875:Middle Aged; D009520:New Zealand; D010351:Patient Discharge / Q000331:legislation & jurisprudence*; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*