Predicting the Risk of Future Terrorism: Lessons for Mental Health Experts from the Benbrika Case.

Risk assessment is an important component of judicial decision-making in many areas of the law. In Australia, those convicted of terrorist offences may be the subject of continued detention in prison or extended supervision in the community if there is an "unacceptable risk" of them committing future terrorism offences. Forensic psychologists and psychiatrists may provide evidence of risk through identifying and measuring risk factors with the aid of tools that use scales based on statistical or actuarial risk prediction.

Interdisciplinary Collaboration in the Mental Health Sector: Legislating the Victorian Collaborative Centre for Mental Health and Wellbeing.

This column explores how the law might support interdisciplinary collaboration in research and practice in the mental health sector. It provides an overview of the Victorian Collaborative Centre for Mental Health and Wellbeing which was established by statute to support collaboration across multiple disciplines and services for the benefit of mental health consumers. It suggests that interdisciplinary collaboration, which has the lived experience and knowledge of mental health consumers at its heart, has the potential for transformative and beneficial systemic change.

Human rights promotion and the 'Geneva impasse' in mental healthcare: scoping review.

Background: The World Psychiatric Association recently emphasised that the protection of human rights in mental healthcare was a 'central concern'. This paper examines recent literature on human rights and mental healthcare.

Aims: To (a) outline how international human rights law distinguishes between the protection and promotion of human rights; and (b) explore the literature on promoting human rights in mental healthcare which avoids what has been termed the 'Geneva impasse' between those who argue that compulsory care and treatment can never comply with human rights law and those who argue that they can if certain conditions are met.

An analysis of arguments for the retention of the defence of mental impairment.

This article summarises the main arguments for the retention of the defence of mental impairment presented in an online debate that took place in August 2021. It canvases the justifications for the defence, rebuts human rights arguments for its abolition and outlines why there is a lack of viable alternatives. It concludes that advances in knowledge should lead to the reform of the defence rather than its abolition.

Seizures, Postictal States and Criminal Responsibility.

This column provides an overview of how courts have taken into account seizures and postictal states in terms of assigning criminal responsibility. In England, New Zealand and Australia, courts have generally treated evidence of epileptic seizures and postictal states as raising the defence of mental impairment which often results in indefinite detention. In comparison, there is a series of Canadian cases that have resulted in acquittals after evidence of seizures has been accepted as negating voluntariness or the fault element of the offence.

Human Rights Law and the Defence of Mental Impairment.

This article provides an overview of recent scholarship calling for the defence of mental impairment to be abolished on the grounds that it breaches international human rights law. It outlines how differing interpretations of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) suggest that arguments for abolition will continue to be contested. On a practical level, no Australasian law reform body has called for the abolition of the defence and it seems unlikely that government policy will shift towards this in the absence of such a recommendation from these bodies.

Mental health, mental capacity, ethics, and the law in the context of COVID-19 (coronavirus).

The emergence of the COVID-19 (coronavirus) pandemic in late 2019 and early 2020 presented new and urgent challenges to mental health services and legislators around the world. This special issue of the International Journal of Law and Psychiatry explores mental health law, mental capacity law, and medical and legal ethics in the context of COVID-19. Papers are drawn from India, Australia, the United Kingdom, Ireland, Germany, Portugal, and the United States.

Preventing Harm to Others as a Criterion for Compulsory Treatment: An Overview of Criticisms and Current Research.

Mental health legislation, which enables compulsory detention and treatment of those with severe mental health conditions, usually contains criteria that include the need to prevent harm to self or others. This column provides an overview of criticisms of the harm to others criterion and recent research investigating the association between violence and severe mental health conditions. It argues that despite several criticisms and research indicating only a modest association between violence and certain mental health conditions, there is little momentum for omitting this criterion.

Electroconvulsive Therapy without Consent: The Influence of Human Rights Law.

The use of electroconvulsive therapy (ECT) is highly regulated across Australia. Its use on those under compulsory mental health treatment orders remains controversial and the United Nations Special Rapporteur on Torture and Other Cruel and Inhuman Treatment or Punishment has called for a ban on its nonconsensual use. Mental health tribunals must consider whether or not the person concerned has capacity to consent to ECT and there have been different understandings of just what capacity means in this regard.

Community Treatment Orders and Supported Decision-Making.

This paper presents findings from an interdisciplinary project undertaken in Victoria, Australia, investigating the barriers and facilitators to supported decision-making (SDM) for people living with diagnoses including schizophrenia, psychosis, bipolar disorder, and severe depression; family members supporting them; and mental health practitioners, including psychiatrists. We considered how SDM can be used to align Australian laws and practice with international human rights obligations. The project examined the experiences, views, and preferences of consumers of mental health services, including people with experiences of being on Community Treatment Orders (CTOs), in relation to enabling SDM in mental health service delivery.

Alternatives to Compulsory Detention and Treatment and Coercive Practices in Mental Health Settings.

Informed consent to medical treatment is generally presumed to be central to the provision of good quality health care. Despite this presumption, legislation exists in many countries that enables the compulsory detention and treatment of people with severe mental health conditions regardless of their wishes. This column discusses global efforts to reduce, prevent and end compulsory detention, treatment and coercive practices in mental health and community settings.

Computational Modelling, Social Media and Health-Related Datasets: Consent and Privacy Issues.

Computational modelling is now being used to analyse posts on social media to predict the emergence of mental health conditions. While the aim is to develop tools for early detection and treatment of such conditions, computational modelling raises issues of user consent and privacy. The European Union has moved to regulate automated profiling of large databases and Australia has introduced a data breach notification scheme for cases where personal information held by an organisation is lost or subjected to unauthorised access or disclosure.

International Human Rights and Mental Health: Challenges For Law and Practice.

The World Health Organization and several United Nations bodies and personnel have called for a human rights perspective to be integrated into mental health and community services. While there are ongoing debates about what this means for law reform and practice, the World Health Organization QualityRights program provides a starting point for educational training in human rights that may be of benefit for mental health practitioners. This column explores some of the challenges for integrating a human rights perspective into mental health treatment and care and outlines the QualityRights program.

Supported decision-making from the perspectives of mental health service users, family members supporting them and mental health practitioners.

Background: Supporting the decision-making of mental health service users fulfils professional, ethical and moral obligations of mental health practitioners. It may also aid personal recovery. Previous research on the effectiveness of supported decision-making interventions is limited.

Community treatment orders: towards a new research agenda.

Objectives: The aim of this study was to report on a half-day multi-stakeholder symposium on community treatment orders (CTOs) hosted by the Melbourne Social Equity Institute (MSEI), which identified research gaps and opportunities, and produced an agreed agenda for future CTO research.

Methods: The MSEI convened a symposium for 22 experts in CTO research to discuss research priorities in this field in Australasia. An independent moderator elicited views and recommendations and produced a report detailing possible research projects.

DEFINING SECLUSION AND RESTRAINT: LEGAL AND POLICY DEFINITIONS VERSUS CONSUMER AND CARER PERSPECTIVES.

The practices of seclusion and restraint may be used in a variety of health settings to control behaviour. Laws and policies that seek to regulate these practices define seclusion and restraint in various ways and there are gaps as to which practices are regulated and in what circumstances. This column provides an overview of consumer and carer perspectives as to what is meant by these practices.

Consumers' and their supporters' perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings.

Objective This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings. Methods Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings.

Erratum to: Consumers and their supporters' perspectives on poor practice and the use of seclusion and restraint in mental health settings: results from Australian focus groups.

[This corrects the article DOI: 10.1186/s13033-016-0038-x.].

Consumers and Carer perspectives on poor practice and the use of seclusion and restraint in mental health settings: results from Australian focus groups.

Background: Seclusion and restraint are interventions currently permitted for use in mental health services to control or manage a person's behaviour. In Australia, serious concerns about the use of such seclusion and restraint have been raised at least since 1993. Consumers and their supporters have also expressed strong views about the harm of these practices.

Current Challenges for the Regulation of Chemical Restraint in Health Care Settings.

Various forms of restraint may be used in a variety of health care settings to control behaviour. Laws and policies regulate the use of physical and mechanical restraint across health care settings, but there is a gap in relation to the regulation of chemical restraint. This may partly be because of problems in defining the term and partly because of a lack of information as to the extent of the use of drugs aimed at controlling behaviour rather than ameliorating a medical condition.

Making defensible decisions in the era of recovery and rights.

Objectives: Our aim was to develop a framework for clinical decision-making that can be used to take into account risk in an era of recovery and rights.

Conclusion: We developed a framework influenced by civil liability law to develop a guide for clinical decision-making which emphasises collaboration, clarification of the available information and communication of decisions as essential components of recovery-oriented risk management.

SUPPORT FOR THE EXERCISE OF LEGAL CAPACITY: THE ROLE OF THE LAW.

In 2014, the Australian Law Reform Commission released a report dealing with recognition before the law and legal capacity of people with disability. The report recommended that "supported decision-making" should be introduced into relevant Commonwealth laws and legal frameworks. This column explores what is meant by "support" to exercise legal capacity and what role the law may play in attempting to move beyond the traditional substituted decision-making model for those with mental and intellectual impairments.

The concept of capacity in Australian mental health law reform: Going in the wrong direction?

The six Australian states and two territories each have legislation that enables the involuntary detention and treatment of individuals diagnosed with mental illness who are considered in need of treatment and where there is evidence of a risk of harm to self or others. A number of governments have undertaken or are currently undertaking reviews of mental health laws in light of the Australian Government's ratification of the Convention on the Rights of Persons with Disabilities. While United Nations bodies have made it clear that laws which enable the detention of and substituted decision-making for persons with disabilities should be abolished, debates in Australia about the reform of mental health legislation have largely focused on Article 12 of the CRPD and what is meant by the right of persons with disabilities to enjoy legal capacity on an equal basis with others.

Locked mental health wards: the answer to absconding?

A recent decision by the Queensland government to lock its 16 mental health inpatient facilities has met with condemnation by a number of professional bodies. This column canvasses some of the legal and ethical issues relating to locked wards and provides an overview of the literature on whether or not locking wards reduces absconding. It is argued that any benefits in preventing absconding through locking all mental health inpatient facilities is outweighed by the adverse effects locked wards have on those detained.