Reasons behind the rise in involuntary psychiatric treatment under Mental Health Act 2016, Queensland, Australia – Clinician perspectives
Overview
Study examines Queensland clinicians' perspectives on rising involuntary psychiatric treatment rates despite 2016 legislative reforms promoting less restrictive options. Focus groups revealed six themes explaining overuse: risk aversion, service deficiencies, lack of voluntary alternatives, increased substance use, legislative shortcomings, and implementation barriers. Legislative reform alone proves insufficient without adequate resources and culture change.
Individual authors
Authors:
- Kimbali Wild (School of Medicine and Dentistry, Griffith University & Division of Mental Health, Metro South Health)
- Jappan Sawhney (Mental Health and Specialist Services, Gold Coast Health)
- Marianne Wyder (Division of Mental Health, Metro South Health)
- Bernadette Sebar (School of Medicine and Dentistry, Griffith University)
- Neeraj Gill (School of Medicine and Dentistry, Griffith University & Division of Mental Health, Metro South Health) - Corresponding author
Key insights
Key Insights:
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Risk aversion drives overuse - Fear of blame after adverse events increases involuntary treatment
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Resource constraints force restrictive practices - High workloads and limited services necessitate coercive measures
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Legislative reform alone fails - Implementation requires adequate training, resources, and culture change
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Capacity assessment poorly understood - Clinicians lack training in proper decision-making capacity evaluation
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Substance use complicates presentations - Limited addiction services increase involuntary treatment for protection
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Review tribunals maintain status quo - Independent bodies rarely challenge treating team recommendations
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Hierarchical systems impede change - Psychiatrists bear responsibility but junior staff lack advocacy power
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Paternalistic culture persists - Medical dominance undermines dignity of risk and patient autonomy
Did this resource draw on transformative evidence?
This document is significantly based on experiential expertise. The research specifically gathered perspectives from 14 frontline mental health clinicians across multiple disciplines (psychiatrists, nurses, social workers, psychologists) who have direct experience working with involuntary psychiatric treatment under Queensland's Mental Health Act 2016. Their lived professional experiences implementing the legislation formed the core data through focus group discussions about practical barriers and challenges.
This document is heavily based on practice wisdom. The research captures collective insights from experienced mental health clinicians across different disciplines and teams who identified practical barriers to implementing less restrictive treatment. Their observations about risk-averse culture, resource constraints, implementation challenges, and systemic deficiencies reflect accumulated professional knowledge gained through daily practice rather than formal research or theory alone.
This document is based on research and evaluation insights. It employed qualitative research methodology using focus groups and reflexive thematic analysis to systematically investigate clinician perspectives on involuntary psychiatric treatment rates. The study followed established research protocols, obtained ethical approval, used purposive sampling, and applied rigorous data analysis techniques. However, it evaluates practice experiences rather than measuring intervention outcomes or conducting experimental research.
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Resource type
Literature Review