Archive for February, 2010

The mental patients no one cares about

The Daily Telegraph - February 16, 2010

The situation has inflamed tense relations between frontline police, paramedics and hospital staff forced to deal with the constant influx.

Paramedics are reluctant to restrain and transport violent patients and hospitals refuse to admit them if they show signs of intoxication.

“I didn’t sign up to arrest people,” one paramedic said. “I didn’t get into this job to be smacked in the mouth by a mental health patient.”

Figures reveal that from January to November last year paramedics used medical restraints 128 times.

From January to December police responded to 22,926 mental health incidents, often having to baby-sit patients overnight in police custody cells which were not equipped to accommodate them.

Latest Australian Institute of Health and Welfare figures show 77,699 mental health patients went or were taken to NSW emergency departments, 43.5 per cent of the 178,595 mental patients presenting in Australia and more than twice that of any other state or territory.

But the figures, collected in 2006-07 and only released late last year, could be much worse.

Given a diagnosis is only reported in 72 per cent of all patients going to emergency, it is estimated the figure could be closer to 100,000.

Mental Health Council of Australia boss David Crosbie said of those presenting only about 21,000 were later admitted.

“So . . . what happens to the other people?” he said.

Most, he said, were sent away until they deteriorated to the point where:

*THEY were forced to return to hospital emergency points;

* THEY hurt themselves; or

* THEY committed a crime and ended up in jail where, according to NSW prison data, 80 per cent of inmates have a mental illness.

Mental health experts argue the alarming rise in these numbers reflects a glaring failure of the NSW mental health system.

They blame the Government of trying to play catch-up by ploughing billions of dollars into hospital-run psychiatric beds instead of investing in community-based residential care.

Community-based residential care employs trained on-site staff to rehabilitate, treat and care for patients for up to 24 hours a day.

Mr Crosbie said adequate community-based care - 30 beds per 100,000 people - could cut emergency visits by 40 per cent.

NSW announced a record $1.171 billion spend on mental health in 2009-10, trebling the state’s mental health budget over the past 15 years.

But NSW Mental Health Consumer Advisory Group executive officer Karen Oakley said it was not just a case of the Government spending more money.

“We have become such a crisis-driven system that people usually only get seen during a crisis and at that point it’s too late,” she said.

At the same time, NSW Police figures show a huge rise in the number of incidents they attended involving the mentally ill - from 2882 in 2000 to 39,352 in 2007.

Anecdotal evidence suggested this figure had since fallen after mental health intervention teams were set up with officers who are specifically trained in mental illness.

Richard Noone, The Daily Telegraph - February 16, 2010

Tuesday February 16th, 2010 in News | Comments Off

Thinking of Writing to a Minister or your Local Member?

If you’re thinking of writing to a Minister, our Local Member of any one of our politician following is an extract from ‘Bernard Keane’s guide to writing to Ministers’ publish in Crikey.com.  It’s well worth reading before starting and has many handy tips.

Bernard Keane - Crickey.com

Let me explain some facts about writing to ministers, drawn from my sordid, blood-soaked and adventure-filled time as a public servant.

For a start, understand that few ministers if any read their correspondence. It’s not that they don’t care, it’s that it’s not humanly possible to read even a fraction of the amount of emails, faxes and letters they get. So the chances of you directly influencing a Minister with your particularly brilliant insight into the issue are zip. Deal with it. Things don’t work like that.

Their staff will read correspondence, but only when considering a reply prepared by their Department.

And that is only a small proportion of the actual volume of correspondence received.  Some is answered directly by bureaucrats. But much of it is simply binned. Don’t waste your time sending off a letter pre-prepared by some enthusiastic online advocacy group, where you sign at the bottom, endorsing the nicely-phrased sentiments at the top. They’re called “campaign” ministerials and are binned without being read or replied to (but please don’t tell the Friends of the ABC, who rely heavily on that technique, and haven’t had a letter to Canberra read for two decades).

Most non-campaign letters and emails - some departments still won’t reply to emails but demand your snail mail address, perhaps out of residual loyalty to Australia Post - are answered using what’s called “standard words” - a reply that ostensibly covers the issue raised but which normally says as little as possible. They say as little as possible because the mindset of bureaucrats and ministerial advisers is to keep as many options open as possible, except when there is a particular message that the Government wants to hammer.

Standard words are worked up by bureaucrats and edited and signed off by the Minister’s staff when they’re happy the words are risk-free or convey the desired message. In most departments, they are then loaded into electronic ministerial correspondence systems. This means a bureaucrat doesn’t even need to cut-and-paste into a Word document, merely tell the system to use a particular set of standard words under the name, address, salutation and opening paragraph, which have all been electronically entered already.

So if you send off an angry email or letter about net filtering, all you’ll likely get is an automatically-generated reply giving you the standard words on the issue. There’ll be minimal human involvement in the writing of it until it is stuffed into an envelope and dispatched.

You may not think it’s very democratic or consultative, but it’s a damn sight more efficient than processing correspondence by hand.

But if you can’t have any impact on policy, you can have an impact on the level of resources used to answer your letter. And that resource is the time of bureaucrats - the same bureaucrats who advise Conroy on policy, and implement his decisions. In most Departments, ministerial replies have to be approved by SES Band 1 officers before being sent to the Minister’s office, which means many replies consume the precious time both of senior bureaucrats and ministerial advisers. Many Departments also have formal agreements with Ministers that a certain proportion of correspondence will be answered within a certain period of time. If they’re not, more people have to be put into answering correspondence.

So if you want to consume as much of the Department of Broadband’s time as possible, here’s what to do. There’s not much you can do to avoid receiving a standard reply. But you don’t have to confine your missive to net filtering. Throw in some other topics. That means someone will have to put together a reply using standard words from different areas, which is a lot more complicated and can’t be done automatically. Ask about the rollout of the National Broadband Network (NBN). That means someone in the NBN area has to provide some words.  Ask about Telstra. That’s another area entirely that has to provide input. If there’s three or four topics in your letter, bureaucrats will start arguing to avoid having to be responsible for it. The NBN area will tell the net filtering area it’s their responsibility to collate the response. The net filtering area will try to off-load it to the Telstra area. A Band 1 in one area will make changes and the whole lot will have to be re-approved by a Band 1 in another area.

Throw in something on Australia Post. Ask about something obscure. They may not have standard words at all and someone will have to actually prepare a proper reply.

You see, once your letter stops being a standard rant about filtering and requires actual work, the amount of time taken to prepare a response can snowball dramatically.

You can also use the Government’s system for allocating correspondence. As a start, always write to your MP first, even if it’s a Coalition MP. They will send the letter to Conroy and ask for a response to provide to you. MPs - even Opposition MPs - must get a response no matter what, as part of the civilities of politics, and it normally has to come from the Minister himself. But write to other Ministers as well. Ask Kim Carr what the impact of filtering will be on Australia’s IT industry. Ask Jenny Macklin what impact she thinks it will have on families. Ask Robert McClelland what the penalties will be for breaches of the mandatory filtering requirements. And ask Kevin Rudd how a Government that understands the need to bring Australia’s online infrastructure into the 21st century wants to drag it back to the 19th when it comes to content regulation.

All of those letters will have to go from the recipient’s department to Conroy’s Department for a response, then back to the originating Department, where they might add some additional material of their own. If you come up with a particularly complicated issue, the bureaucrats might start disagreeing with each other. Innovation bureaucrats might think Broadband’s net filter standard words doesn’t quite answer your question and want something else.

And don’t ask the same questions in different letters, otherwise they’ll bin them and tell you they understand you’ve separately written to your MP/another Minister/Kevin Rudd and here’s your job lot reply. Ask different questions and raise different issues.

And be pleasant. Apart from anything else, if there’s too much abuse in a letter, it gets thrown out (quite rightly). But these are decent, hard-working bureaucrats and regardless of what you think of Stephen Conroy, they deserve civility and respect.

Most of all, get your friends, acquaintances, family members, work colleagues, passing strangers, all writing. The bureaucratic capacity to handle ministerial correspondence is a lot like the net filters trialled earlier this year. At low levels of traffic they work OK, but once the traffic picks up, things start to choke up. That’s when Stephen Conroy and his office might start to notice that things are slowing down.

Bernard Keane’s guide to writing to Ministers

Sunday February 7th, 2010 in News | Comments Off