Five mental health experts with wide reaching clinical and lived experience will join NSW Chief Psychiatrist Dr Murray Wright to begin a review of the practice of seclusion, restraint and observations across the NSW mental health system.
Health Minister Brad Hazzard and Mental Health Minister Tanya Davies confirmed the review will consider whether existing legislation, policy, clinical governance and practice standards are consistent with national standards, international best practice and the expectations of patients and the community.
“We need to know appropriate policies are in place in our hospitals and mental health facilities and the extent to which staff actually adhere to existing policies and protocol,” Mr Hazzard said.
“No stone will be left unturned, to ensure people living with mental illness in this state are receiving the best possible care and treatment in the least restrictive environment.”
Mrs Davies said the independent panel had been carefully selected. The expert team, led by Dr Wright, will include:
“The diverse panel brings together views of those with lived experience of mental illness, international experience on pathways for reducing seclusion and restraint, and a deep understanding of the NSW mental health system,” Mrs Davies said.
“We are keeping an open mind on the best way forward until we receive expert advice on how improvements can be made in ways that do not jeopardise the quality of care or the safety of staff and other patients.”
The Panel will visit NSW Hospitals, acute mental health units, mental health intensive care units, and declared emergency departments and review past cases of seclusion and restraint. The public will be able to make submissions and there will be the opportunity for face-to-face consultations through public workshops.
“It is critical that we ensure the mental health system treats patients with dignity, and respect and that their clinical needs are being met,” Mrs Davies said.
A final report and recommendations on a pathway for the reduction of seclusion and restraint practices in NSW will be completed by early December. The full Terms of Reference for the review can be found at Terms of reference.
Dr Murray Wright is a graduate of the University of Sydney Medical Faculty, completed his post graduate training in Psychiatry in South Eastern Sydney, and has worked in a range of metropolitan, rural and regional centres, as a clinician and, increasingly over the last 10 years, in various leadership roles, including Director of Mental Health services and, since October 2014, NSW Chief Psychiatrist.
His clinical interests include consultation-liaison psychiatry, emergency psychiatry, psychiatric and substance misuse comorbidity, and psychiatric impairment among health professionals and police officers.
Dr Wright has had a longstanding interest in service improvement, quality and governance, and played a significant role in the introduction of the first Maintenance of Professional Standards program by the RANZCP in the early 1990s.
In addition to his public sector roles, Dr Wright has maintained a private practice since 1990, with a focus latterly on general adult psychiatry, and assessment and treatment of health professionals and police.
Dr Wright has also worked in a consultant capacity with the Medical Council of NSW in a number of roles over the last 20 years, including the provision of assessment reports as a Council Appointed Psychiatrist, participation as a Performance Assessor, and as a panellist for the Impairment Programme, Professional Standards Committees and Section 150 Hearings. He is a Peer Reviewer for the HCCC and a part-time member of the NSW Medical Tribunal.
Dr Wright was the Chair, Psychiatry State Training Committee HETI from 2007-13, and has had a number of roles with the RANZCP, including membership of the Quality Assurance Committee 1990-95, Exams Committee 1996-02, Exemptions Sub-committee 1996-05, Consultation-Liaison Working Party 1992-94, NSW Branch Rural Psychiatry Steering Group 2002-08.
Dr Wright’s role as NSW Chief Psychiatrist includes an oversight of quality and safety for mental health services, investigation/ review of critical incidents associated with mental health services, and contributing to improvements in patient safety.
Karen Lenihan is the Principal Official Visitor for New South Wales under the NSW Mental Health Act 2007. She has held this position since February 2016.
With a background working as a clinician, educator, manager and executive, Ms Lenihan has broad working experience in health service delivery and policy. Her prior positions include Executive Director of Nursing and Midwifery for the former Greater Southern Area Health Service, Director of Alcohol, other Drugs and Corrections Health at ACT Health and Manager, Population Health in NSW Health. In these roles, the dominant focus was on service improvement and reorientation toward excellence in patient care.
Initially she trained as a general registered nurse and then a psychiatric registered nurse in the UK before moving to Australia. She then gained a social science degree (BSocSc) with majors in political science and sociology, a management master degree (MBA) with a major in human resource management and a postgraduate degree in mental health practice (GradCertMentalHealthPrac). She is also trained as a women’s health nurse with specialisation in the area of domestic violence.
She recently spent several years at Charles Sturt University where she focused on organisational development and change management. Having now returned to work in Health, this experience has enhanced her knowledge base and broader her capacity to achieve effective results in reform and change environments.
Ms Lenihan’s career is characterised by her work with fringe populations who experience high levels of social stigma and disadvantage. She is passionate about quality service provision, is a strong advocate for social justice and believes in equity of access to the resources available in contemporary society.
Dr Kevin Huckshorn is CEO of a behavioural health consulting business, Kevin Huckshorn & Associates, Inc. that she initiated in December of 2014.
Dr. Huckshorn served as the past Director of the Division of Substance Abuse and Mental Health (DSAMH) for the state of Delaware (2009-2014). The position oversaw the planning, program development, fiscal responsibilities, contractual obligations, contract monitoring, licensure, federal block grants, operations of the state mental health hospital, and all DSAMH community provider contractors. This position managed a budget of over $120 million, 600+ state staff, and a variety of community mental health and substance use service providers. Dr. Huckshorn was also the lead on the DE USDOJ Settlement Agreement (signed in 2011) and, in that role, was able to lead Delaware toward substantial compliance, along with her team, with the targets in that settlement agreement by October of 2014.
Dr. Huckshorn is a licensed and certified mental health nurse and substance abuse clinician with practical knowledge from 38 years of professional frontline experience working in a variety of public and private behavioural health organizations and substance abuse programs. She has extensive experience in both inpatient and outpatient program development, including developing and managing peer-run projects; leading state hospital service re-design; and directing recovery-based mental health and substance abuse services. She is published on adult and youth topics including violence, treatment adherence, trauma-informed care, and workforce development. She serves on the editorial board of one U.S. peer reviewed mental health-nursing journal and consults with two others; and co-authored a book with William Anthony, PhD, titled “Principled Leadership in Mental Health Systems and Programs” (2008).
Dr. Huckshorn was the past Director of the Office of Technical Assistance for the National Association of State Mental Health Program Directors and the National Coordinating Center for Seclusion and Restraint Reduction where she led the development of an evidence-based model to prevent violence and the use of seclusion and restraint titled “Six Core Strategies” that is on the federal NREPP database of approved models (2001-2009). Dr. Huckshorn has also worked internationally in Canada, Finland, United Kingdom, United Kingdom, Ireland, New Zealand and Australia on issues related to seclusion and restraint, trauma-informed care, compliance with the ADA and Olmstead, and implementing recovery-oriented systems of care.
Dr Shields has worked in the mental health sector for many years and is now undertaking specialist training as a psychiatry registrar.
Since her career started in mental health, Dr Shields has concentrated on raising the status of people experiencing mental illness in the public consciousness, talking about trauma informed care and recovery, as well as developing new models of care for mentally ill people for the most disadvantaged groups, particularly Aboriginal people and forensic patients.
As a proud Aboriginal woman, Dr Shields is acutely aware of the need for communities to design and control their own services.
Julie Mooney has extensive experience in leadership positions and mental health service delivery. She has participated in a number of complex external clinical reviews. She originally trained as a mental health nurse in Goulburn and currently holds the position of Executive Director, Nursing and Midwifery at Southern NSW Local Health District.
Jackie Crowe is dedicated to encouraging greater understanding, compassion and respect for people affected by mental ill health, the suicidal mind and the families, friends and carers who journey with them. Ms Crowe has been involved in mental health and suicide prevention issues in various advocacy, advisory, public speaking, research, consultancy and commissioner roles – at the local, state, national and international levels over many years.
Ms Crowe works to help create a better world that values all people, social justice and ends discrimination. Her work is always grounded in the perspectives of people affected by mental ill health and suicidal concerns. She is solution focused and has an enthusiastic vision about what is possible. She enjoys engaging in differing opinions and views which inform her work.
Ms Crowe combines her lived experience, understanding of the grass roots and knowledge of high-level strategic policy and planning, with her familiarity with recovery and well-being to shift thinking about mental illness and suicide.