The Role of the District Inspector for Mental Health Rosemary Thomson*
This is a copy of a speech that Rosemary delivered at an ADLS Mental Health Law Kōrero in relation to the Role of the District Inspector. It is republished with the consent of the author. Appointment process A District Inspector is appointed by the Minister of Health under s 94 of the Mental Health (Compulsory Assessment & Treatment) Act 1992, for a term of three years. The position is advertised and any qualified barrister and/or solicitor can apply. They must demonstrate that they fulfil the criteria in terms of knowledge of mental health law. The role of the District Inspector is triggered when a person is detained under the Mental Health (CAT) Act 1992 (MHA), commencing with the s 9 assessment onwards,1 to ensure proper adherence to law and procedure, and that the rights of the patient are protected and respected. District Inspectors, when attending the inpatient units, are the eyes and ears on the ground. They are not advocates but act as a watchdog to ensure that the service provider is fulfilling their obligations appropriately for the patient’s benefit. A person who is a voluntary patient does not come within the ambit of the District Inspector role, unless they have signed a written consent document and this has been provided to the District Inspector. The role of the District Inspector was carried over from the 1969 Mental Health Act but was strengthened and given increased functions under the 1992 Act. This Act has now recently been amended and will eventually be replaced once a full review and consultation has been completed. The role of the District Inspector under the MHA resulted in a more proactive role rather than a reactive one. This proactive role is encouraged in the following ways: • • •
Assist patients to seek s 16 judicial reviews. A District Inspector is not permitted to lodge a s 16 within the first five-day assessment period (s 11) but can advise the patient of this right. The District Inspector does not initiate contact with the patient until after they receive the s 12 five-day certificate of further assessment, at which point the s 16 review is raised.
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Monitor clinical reviews including facilitating and obtaining second opinions under s 69 if challenging diagnosis or medications. Visitation and document checking. Following a s 76 clinical review, make contact and discuss with the patient the right to lodge an application for review to the Mental Health Review Tribunal.
Access to the District Inspector The Ministry of Health has emphasised that District Inspectors’ names and contact details are prominently displayed in the Inpatient Units for patients to be able to access District Inspectors for assistance. The District Inspector role has often been referred to as that of a mental health Ombudsman. Although a qualified lawyer, the District Inspector is not counsel and cannot act for an individual. Patients and nursing staff are often not aware of this and it is important to explain and distinguish the role between District Inspector and counsel. It is important to note that the District Inspector does not give clinical advice; this is the domain of the medical team. The District Inspector’s role is a facilitator assisting and supporting patients in terms of lodging reviews, ensuring appropriate legal representation by counsel and following up any concerns that they raise.
Judicial hearings and Mental Health Review Tribunal hearings The roster of legal counsel was previously administered by the ADLS, but that changed several years ago when the NZLS assumed responsibility. There was an expectation by NZLS that the District Inspector would arrange counsel for the hearings. However the reality is that this is done by the Mental Health Administrator Office within the District Health Board (DHB). The District Inspector has a duty to oversee and ensure that patients are seen at least the day before their scheduled hearing, so that adequate instructions are obtained in advance. Mental Health Review Tribunal (MHRT) hearings are available once the first s 76 three-month review of the
APRIL / MAY 2022
