Submission 2
Mental Health Legal Centre
Mental Health Legal Centre
Consultation Questions
1. Tell us about your organization and its role in disability and/or responding to
the needs of victims of crime?
2. What services does your organisation provide?
-
MHLC provides legal services to people with a psychiatric disability/mental illness
where their legal issue relates directly to their mental illness, including through
individual advice, casework and advocacy, as well as systemic law reform and
legal education work.
3. Are you aware of any cases where people with disabilities were victims of
crime?
4. What happened in these cases?
5. How often does your organisation see these types of cases?
-
MHLC’s legal assistance in this area is usually limited to advice and referral of
victims of crime matters. Whilst we do not have significant casework experience
in the area of victims of crime, key areas of our systemic advocacy work include
police interaction with people with a mental illness, safety for women in
psychiatric inpatient units and oversight and accountability of mental health
services more broadly.
-
MHLC’s submissions are based significantly on our systemic advocacy and law
reform work, rather than client case studies
6. How prevalent do you think crimes against the person for people with
disability are?
7. Where do crimes against the person occur against people with disabilities?
8. Are you aware of people being targeted for a crime because they have a
disability?
-
According to an international research study that reviewed crime victimisation
research in people with disabilities worldwide, people with mental illness are
around four times more likely to be a victim of violence than people without a
mental illness, and higher than for people with intellectual impairments and non1
Submission 2
Mental Health Legal Centre
specific impairments.1 The study noted that, ‘The underlying reasons are
complex, but several factors are common ground: exclusion from education and
employment, the need for personal assistance with daily living, reduced physical
and emotional defences, communication barriers that hamper the reporting of
violence, societal stigma, and discrimination’.2
-
The true extent of crime against people with psychiatric disability is difficult to
gauge. Despite the fact that people with mental illness are more likely to come in
contact with police, evidence suggests that crime and violence against people
psychiatric disabilities often goes undetected by, or unreported to, police.3
-
Insofar as reports are made to police or other agencies that monitor the
conditions of mental health and other care facilities, MHLC is concerned in
particular about the prevalence of sexual and other assault of women in
psychiatric inpatient units – in particular mixed sex wards, and about violence
and assault within supported residential services (SRSs).
-
Historically these are areas of high prevalence of violence and abuse, which are
unreported and/or not responded to adequately. In particular, MHLC is
concerned that:
o It is well-known that women are particularly vulnerable to abuse and
violence in psychiatric inpatient facilities and to being re-traumatised,
given up to 70% have past experience of physical or sexual abuse
o Recent research by the Victorian Mental Illness Awareness Council4
indicates that 45% of women have experienced sexual assault during their
admission to a psychiatric inpatient unit. These findings echo previous
studies by the Women’s Mental Health Network Victoria5 which found 61%
of women had experienced harassment or abuse
1
Karen Hughes, Mark A Bellis, Lisa Jones, Sara Wood, Geoff Bates, Lindsay Eckley, Ellie McCoy, Christopher Mikton, Tom
Shakespeare, Alana Officer, ‘Prevalence and risk of violence against adults with disabilities: a systematic review and metaanalysis of observational studies’, Lancet journal Vol 379 April 28, 2012, 162
3
Breaking the Cycle (2012) Office of the Public Advocate, p 38, available at
http://www.publicadvocate.vic.gov.au/file/file/Report/2012/OPA_BTC_FReport_Web.pdf
4
The VMIAC surveyed 50 women from 9 mental health services around Victoria about their experiences of safety, harassment
and assault during admission to psychiatric in-patient units. The report, ‘Zero tolerance for sexual assault: A safe admission for
women’ was published in May 2013 and is accessible here: http://www.abc.net.au/reslib/201305/r1115028_13591277.pdf
5
See for example the VWMHN 2006 survey of 75 women, cited in the VWMHN’s 2007 report ‘Nowhere to be safe: Women’s
experiences of mixed-sex psychiatric wards’, available at
http://www.vicserv.org.au/uploads/documents/general%20docs/Nowhere%20to%20be%20Safe%20Final%20layout.pdf
2
Submission 2
Mental Health Legal Centre
o Research conducted by the Alfred Hospital found women are six times
more at risk of assault in mixed-sex psychiatric units than in female-only
areas6
o Community visitors report an increase in reported cases of violence,
abuse and assault in SRSs7 and, whilst not all reported cases involve a
person with mental illness, most SRS residents are referred by their
mental health service and DHS 2008 Census data reveals 62% of
pension-level residents have a psychiatric disability.
-
MHLC is not aware of people with mental illness being deliberately and
specifically ‘targeted’ for a crime because of their disability.
9. Do you think people with disabilities who are victims of crime are likely to
report the crime to Victoria Police?
10. If not, why do you think people may not report crime to police?
-
People with psychiatric disability often need support to report a crime, whether to
police or other agencies. MHLC is aware that existing guidelines to support a
person in reporting crime, responding to allegations of sexual assault and
promoting safety and preventing harm, are not always consistently followed. The
Chief Psychiatrist’s guidelines for acute in patient units for example, are not
always followed by staff and MHLC has called for better staff training and
oversight and monitoring of safety, particularly of women, in psychiatric units.8
-
if the crime occurred on or around the time a person was unwell and detained in
an inpatient unit, or otherwise incarcerated in the criminal justice system, there
can be a delay in reporting and/or pursuing redress options, which can have an
adverse affect on gathering of evidence and the outcome of the case;
-
MHLC often hears from clients who are reluctant to report crime or violence
because of fear they will not be believed by police or workers because of their
diagnosis, feeling that there’s ‘no point’ reporting to police, or fearing it would be
‘used against them’ somehow, often based on the person’s past interaction with
6
See for example ‘High risk in mixed wards’ The Age 28 April 2013, available at: http://www.theage.com.au/victoria/high-riskin-mixed-wards-20130427-2ilpi.html
7
See the Community Visitors’ Annual Report 2012.
8
See MHLC’s letter to the Minister for Mental Health, December 2012 available at:
http://www.communitylaw.org.au/mhlc/cb_pages/files/Letter%20to%20the%20Minister_sex%
20assault%20%26%20female%20wards%20211212.pdf
3
Submission 2
Mental Health Legal Centre
police. Police have distinct and wide-reaching powers to apprehend and detain a
person under the Mental Health Act, to enter premises and transport a person to
hospital, including by force.9 This can have broader impacts on the person’s
subsequent engagement with police, court and the legal system, as well as
mental health services.
-
These issues are supported by and reflected in research into the experiences of
crime victimization in rural Victorian communities10 which found a fear of
retribution and rejection within the community was common for marginalized
groups of victims, impacting on whether they would report. The study found that
for people with mental health issues, specific barriers to reporting crime and
pursuing victim support services included:
o Fear of consequences of reporting a crime, including the impact of
reporting on custody decisions and access to children, particularly for
women;
o Distrust of police, which is exacerbated when the person has had past
negative interactions during a psychotic episode, for instance;
o Need to feel supported within the system;
o Fear that reporting might expose them to further problems, rejection or
judgement by the mental health service system.
-
In specific settings, eg in a SRS, crime may go unreported because:
o The victim lacks other available supported accommodation options and
may fear a complaint or report will jeopardise this accommodation which,
for many people, is an option of last resort;
o Consumers may be unclear of their rights and the process for reporting,
and workers may be unclear about their obligations. We note that new
standards and regulations for SRSs have been in effect for only around
18months and it is not yet clear whether and to what extent they have had
a positive impact in reporting of and responding to crimes committed in
SRS’s. We also note that the Departmental protocol for responding to
9
S9B and s10 MHA
10
Murphy, Angela and Ollerenshaw, Alison, ‘Victims won’t even report the crime let alone use support services”: The
complexities of building pathways to victim support services for marginalised people’ Presentation at ‘Meeting the needs of
victims of crime’ conference, Sydney, 18 May 2011, available at www.aic.gov.au/events/aic upcoming events/2011/victim.html
Murphy et al, ‘ Mapping access and referral pathways for marginalized victims of violent crime in rural and regional Victoria’
University of Ballarat, October 2011, pp 100-101. Available at: http://www.centacareballarat.org.au/uploads/file/UB%204
%20BSSH%20Report%20Nov2010.pdf
Submission 2
Mental Health Legal Centre
allegations of sexual assault in SRSs is likewise only very recent –
October 201211
11. Do you think people with disabilities are treated fairly by police?
12. In your experience, do police have good knowledge of disability?
13. What do you think police need to know when they attend an incident where
the victim of the crime has a particular disability?
-
In MHLC’s experience, people with mental illness are not always treated fairly by
police, including their credibility as witnesses and victims of crime.
-
MHLC is concerned about the use of information on the police LEAP database,
including the accuracy of information about a person’s mental health and the
potential for inaccurate or misleading information to prejudice police attitudes
towards and interaction with people with mental illness, including those who
report crime.
-
The effect of prejudice based and stigma about people with mental illness, in
particular their credibility is demonstrated by a Victorian study examining police
responses to victims of rape who had a psychiatric disability/mental health issue
found that “cases involving victims with a psychiatric disability or mental health
issue were the least likely to result in charges being laid against the offender
even though the demographics of the victims and offenders do not differ
significantly from the overall sample.”12 The authors noted that, despite some
improved training for police, more improvements are needed.
-
MHLC supports improved police training overall in dealing with people with
mental illness. Police should be mindful that, depending on the person’s
circumstances, even the presence of uniformed and armed officers can increase
a person’s anxiety or distress, or even paranoia.
-
In responding to allegations of sexual and other assault in psychiatric wards,
police and other workers, including mental health clinicians need to adopt a
trauma-informed care approach, particularly given the majority of women inpatients (up to 70%) have experienced past physical or sexual abuse, including
11
Available at:
http://docs.health.vic.gov.au/docs/doc/9D7764ADF8CF97F2CA257A91007FF11A/$FILE/CASA%20PROTOCOL%20FINAL%2024%
20SEPT%2012.pdf
12
Murray, Suellen and Melanie Heenan, ‘Reported rapes in Victoria: police responses to victims with a psychiatric disability or
mental health issue’, Current Issues in Criminal Justice, March 2012, Vol. 23, No.3, pp 353-368.
5
Submission 2
Mental Health Legal Centre
child sexual assault13. This can impact on both their experience of violence in
mental health facilities, reporting and their support needs throughout the process.
14. What would improve the likelihood of people with disabilities reporting crimes
against the person to police?
-
in both inpatient units and in SRSs staff and other workers play a critical ‘gatekeeping’ role in the reporting of crime, and by their actions can facilitate reporting
of crime and responses to allegations, and provide or facilitate appropriate
support to the victim
-
training of staff in implementing existing protocols, including demonstrating
competency, is critical.
15. Do you have any other general comments you would like to include about the
way police respond to crimes against people with disabilities?
16. Any other questions as appropriate.
13
6