Secure Mental Health Facilities — Smoking Bans
Date:Thursday, November 3, 2011
Hon Ljiljanna Ravlich; Hon Helen Morton; Deputy President; Hon Alison Xamon
HON LJILJANNA RAVLICH (East Metropolitan) [11.45 am] — without notice: I move —
That this house expresses its concern about the adverse impact of smoking bans in secure mental health facilities on the occupational health and safety of mental health workers and patients and calls on the Barnett government to lift the smoking bans in secure mental health facilities and introduce instead designated smoking areas.
HON ALISON XAMON (East Metropolitan) [12.22 pm]: I also rise on behalf of the Greens (WA) to indicate support for this motion. That means we are looking at tripartite support for this motion. I thank Hon Ljiljanna Ravlich for moving this motion because it addresses an important issue that needs to be discussed. It is an issue that has come to my attention quite often since I have taken my seat in Parliament and been the Greens spokesperson on mental health. It has been brought to my attention primarily by carers of people who are currently being detained in facilities, in particular Graylands Hospital, but it has also been brought to my attention by employees within these mental health centres as well. In no uncertain terms, people who are part of these places are very clear that the ban on smoking has simply not had the outcome I think was intended when it was first introduced.
I want to say that at the time Hon Jim McGinty brought these regulations into Parliament, the Greens were reluctantly supportive of them. My understanding is that at that point, my colleague Hon Giz Watson had received extensive briefings, and she has indicated to me that she also shared many of the concerns that have been articulated by Hon Helen Morton. At that point Hon Giz Watson was apparently given quite extensive undertakings about how the regulations would be rolled out and how they were intended to work. I think two problems have emerged. Firstly, it would appear that the regulations do not operate in practice in the way that it had been relayed that they would. Also, I think there have been a series of unforeseen consequences. Perhaps the seriousness of the withdrawal from smoking for quite a few of the patients in this situation was just not understood as comprehensively at the time as now.
It is true that the Council of Official Visitors has been consistent in voicing its concerns about the outcomes of these regulations, as has the Health Consumers’ Council. The Council of Official Visitors has repeatedly called for a reassessment of these regulations in its reports. The Health Consumers’ Council has had contact with me to talk about its concerns and the impact that the regulations are having on the involuntary consumers of mental health services in these facilities. Some of the issues that have arisen have already been touched on, but I think it is worth pointing out the extent. We know that there have been reports within the media that are not reflected in the official reports from the Council of Official Visitors. There have been allegations of the exchange of sex for cigarettes, which are deeply concerning, and I imagine everyone in this place would be concerned about those allegations. We also know about concerns about nicotine patches in tea and the impact that they are having. There are concerns about more desperate measures that some people are resorting to to try to light cigarettes, such as using quite dangerous mechanisms on electricity outlets or the removal of wall heaters in order to be able to gain a spark. I share the Minister for Mental Health’s concerns about suggestions that smoking is being used as a method to keep people involuntary; that is deeply concerning, as is consumers being denied ground access.
Ground access is often one of the main mechanisms that patients need in order to cope in these environments. I am also very concerned about the lack of support received by these people once they leave hospital. Patients have basically been put into this regime of trying to force them from the smoking habit but that is not being upheld once they leave the mental health facility. I am also very concerned about the impact that these regulations are having on the staff in mental health facilities. Staff talk about violence that is emerging and the pressure that that is placing on them. Clearly, I do not think any of these outcomes were seriously contemplated or anticipated at the time that the regulations were agreed on and supported. It seems to me quite apparent that we need to urgently reassess them.
It was not a surprise to hear the minister say that she supported this motion. This is an issue I verbally raised with her quite some time ago, and quite a long time ago it was clearly indicated to me that this was an issue that the minister had at that point commenced reviewing, and she was looking at how the regulations would be able to be reversed. I note the minister’s comments that a cabinet submission to discuss reversal is ready to go. I was really pleased to hear that; it sounds like the groundwork has been done. Therefore, I urge those people in cabinet, who are capable of making that decision, to support the minister, because this has cross-party support and support within some of the peak groups and from people who deal with these issues. I was pleased to hear that Mike Daube has taken the position he has. Also, importantly, it has the support of people who have to work in these conditions as well as involuntary patients and their families. This should be one of those no-brainer issues. I really hope that people recognise that there were good intentions in implementing these regulations. Nicotine is obviously a very addictive and dangerous substance. It would be nice if nobody smoked and it would be nice if we could reverse smoking. I am sure that all of us are concerned that people with mental illness have dramatically reduced life expectancy and smoking actually contributes to that, and I am sure all of us would like to see strategies to reverse that. However, simply making people go cold turkey, particularly when they are in a very vulnerable situation and have been made involuntary, is not the way to do it. I am also very concerned about the issues that have been raised with me about the potential impact that nicotine patches can have, particularly on people who are on psychotropic drugs. That is a very serious issue that we need to be aware of.
I am supportive of all the measures that the federal government is taking to try to stop people from taking up smoking in the first place. I am supportive of Nicola Roxon’s attempts to introduce plain packaging for cigarettes. I hope that members opposite would also be supportive of that, because it is important that we try to stop people from smoking.
But we need to remember that although the people I am talking about are involuntary patients, they are people who have rights. Often cigarettes are the least of their concerns in terms of drug use. If we are allowing people who have been convicted of offences and are in prison to smoke, I do not think we have any reason to deny these people the opportunity to cope as best they can. If smoking is part of the mechanism by which they can cope with the situation they find themselves in, we really do not have the right to decide that they are not entitled to do that. We certainly do not have the right to put them through the pain of having to quit cold turkey.
Debate adjourned, pursuant to temporary orders.