title: Quis custodiet ipsos custodes? An audit of records of involuntary detention.
abstract: OBJECTIVE
  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.
authors.affiliation: Clinical Director, North Shore Ryde Mental Health Service, Northern Sydney Local Health District, Sydney, NSW, and; Clinical senior lecturer, Department of Psychiatry, University of Sydney, Australia nick.oconnor@health.nsw.gov.au.
authors.forename: Nick
authors.initials: N
authors.lastname: O'Connor
authors.affiliation: Psychiatry registrar, Northern Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Belford
authors.affiliation: Consultant psychiatrist, South Coast Private Hospital, Wollongong, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Corish
authors.affiliation: Clinical nurse consultant, Northern Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Colleen
authors.initials: C
authors.lastname: Olmstead
mesh_terms: D054869:Clinical Audit; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000592:standards / Q000706:statistics & numerical data*; D004282:Documentation / Q000592:standards / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence / Q000592:standards / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D000076083:Involuntary Treatment, Psychiatric / Q000331:legislation & jurisprudence / Q000592:standards / Q000706:statistics & numerical data*; D008603:Mental Health / Q000331:legislation & jurisprudence; D009517:New South Wales; D017410:Practice Guidelines as Topic
keywords: audit; documentation; involuntary detention; mental health act