Recent amendments to Queensland legislation make mental health presentations to hospital emergency departments more difficult to scrutinise

Abstract

The Queensland Police Service (QPS) and Queensland Ambulance Service may detain and transport persons experiencing major disturbances in their mental capacity to an ED for urgent care. Queensland's new mental health legislation (March 2017) makes this legal intervention difficult to scrutinise. For a large nonmetropolitan region, QPS records for emergency examination orders (EEOs) and emergency examination authorities (EEAs) were compared with annual reports of Queensland's Director of Mental Health and Chief Psychiatrist. From 2009-2010 to March 2017, QPS-registered EEOs totalled 12 903 while annual reports attributed 9441 to QPS (27% fewer). From March 2017 to 2019-2020, QPS-registered EEAs totalled 6887. Annual reports declared 1803 EEAs in total for this period, without distinguishing those registered by QPS from the Queensland Ambulance Service. Past year proportions of EEOs, however, indicate perhaps ~1100 originated with QPS (84% fewer). Information crucial for considered emergency mental healthcare responses for thousands of people is no longer readily available.

Emergency examination authorities in Queensland, Australia

“…Annual reports of the Chief Psychiatrist for 2017–2018 to the present declared 2529 EEAs in total for the study region 9–12 . However, perhaps four times this number were made out by QPS and QAS officers, according to our previously‐published estimates 6 . It is therefore possible that the sample represents perhaps 10% of all EEAs made out during the observation period.…”

“…Around 720 000 people live in the study region where almost one in five are Aboriginal and Torres Strait Islanders 6 . Larger hospitals in major centres in the ‘outer regional’ locational category 8 service the bulk of the study region's population; 664 735 (92.4%).…”

“…Around 720 000 people live in the study region where almost one in five are Aboriginal and Torres Strait Islanders. 6 Larger hospitals in major centres in the 'outer regional' locational category 8 service the bulk of the study region's population; 664 735 (92.4%). Smaller hospitals with inpatient capacity situated in 'very remote' 8 parts of the region service a population of 54 810 (7.6%).…”

“…In a recent perspective in this journal, we suggested that a diminution of publicly‐available information about emergency examination authorities (EEAs) under Queensland's new legislation has made it more difficult to analyse patterns, trends and regional variations in mental healthcare needs and more difficult to formulate suitable responses 6 . This paper examines the scope and significance of information contained in the ‘approved form’ required for an EEA by the PHA 7…”

“…5 In a recent perspective in this journal, we suggested that a diminution of publicly-available information about emergency examination authorities (EEAs) under Queensland's new legislation has made it more difficult to analyse patterns, trends and regional variations in mental healthcare needs and more difficult to formulate suitable responses. 6 This paper examines the scope and significance of information contained in the 'approved form' required for an EEA by the PHA. 7 Section 157D requires the 'approved form' to be used when a person is taken to a 'public sector health service facility', including a hospital ED, where the QPS and QAS officers 'must immediately make an authority (an emergency examination authority)' and give it to 'a health service employee'.…”