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HA

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Law delays schizophrenia help

University of Sydney
Friday Dec 14 07

A group of Sydney researchers has shown that mental health law which focuses on "dangerousness" rather than the right to treatment can delay proper care for up to six months.

Schizophrenia affects one in one hundred Australians. People with schizophrenia may hear voices or wrongly believe that they are in danger or that others are trying to harm them. The illness often strikes in the teens or twenties and goes on to invade all aspects of its victim's life. One in ten will eventually commit suicide.

Schizophrenia can be treated, but early in their illness, suffers often don't recognise that they are unwell and may not agree to getting help.

In Australia, people with mental illnesses may only receive involuntary treatment if a doctor certifies that they are "a danger to themselves or others". Not all mental health law demands proof of dangerousness. In the United Kingdom, for example, it is only necessary to show that the person needs treatment.

The study, 'Mental health acts that require dangerousness for involuntary admission may delay the initial treatment of schizophrenia', which is published online in the medical journal Social Psychiatry and Psychiatric Epidemiology, looked at the results of nearly 50 studies that had been published in 14 countries over the last 30 years.

The Sydney-based researchers (three psychiatrists and a lawyer) calculated how long people with schizophrenia went without treatment in places where the law demanded proof of dangerousness to receive involuntary treatment and compared that with how long treatment took in places that did not.

They found that, on average, people who had just become ill with schizophrenia went without treatment nearly six months longer if they happened to live in an area with a law that demanded a dangerousness certification.

University of Sydney Psychiatrist, Dr Chris Ryan, said: "Before this study, we knew already that when a person first suffers the symptoms of schizophrenia he may be sick for about a year before he gets treatment. That figure was distressing enough. Now we know that if that person happens to live in an area where doctors need to prove dangerousness to provide involuntary treatment, that person will wait 18 months, on average, before he gets proper care."

"Behind these statistics are thousands of stories of patients who become more and more unwell before getting help. A patient of mine, a former university student, began hearing voices in his early twenties. He dropped out of his course, lost his friends and eventually ended up living on the street. He could not see that he was ill though, and he only finally got treatment after he threatened a passer-by with a knife. That is how bad it had to get before he could get better. Only now, two years after his illness began, is he getting his life back on track".

"We know that doctors are not good at judging whether or not someone is dangerous. The problems of judging dangerousness in mental illness was one of the key points revealed in the inquiry into the Virginia Tech shootings. It would be better if people with these illnesses could receive the treatment they need before dangerousness becomes an issue".
 
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