Ships in the Night
Ten days ago Kate Raue was moved from Rangipapa to Te Whare Ahuru. For privacy reasons Rangipapa weren’t telling anyone where she’d gone, only that she’d ‘left the Unit’. I thought at the time that the construction of the explanation was an interesting one so I had my doubts about whether she’d been released to go home.
It turns out, those doubts proved correct. Kate had been shipped out to Te Whare Ahuru, an acute mental health inpatient unit that use a variety of strategies, including the concept of a ‘wellness centre’ and is located in Lower Hutt. The Unit has been in operation for over 10 years.”
Historically, the Unit had a high incidence of the use of seclusion and restraint, a high staff turnover and a lack of sufficient medical staff. There was little opportunity for people sent there to engage in meaningful therapy. So if you’re like me, you’ll have wondered what the point to being there was if therapy wasn’t it!
Te Whare Ahuru
“In 2007, a process of change was begun. A year later staff had embraced a philosophy of intensive nursing. A more holistic approach to care, influenced by the Maori mental health model developed by Mason Durie, Te Whare Tapu Wha.
In essence, Māori health is underpinned by four dimensions representing the basic beliefs of life: Te Taha Hinengaro (psychological health); Te Taha Wairua (spiritual health); Te Taha Tinana (physical health); and Te Taha Whānau (family health). Each wall is necessary to the strength and symmetry of the building.
These four dimensions underpinned the opening of the intensive care unit (ICU) where Kate was first admitted to in this facility and the next day permitted to enter ‘Te Rangimarie’, the low stimulus environment that focuses on low key activities and creating a calm environment.”
Now to ordinary me, Kate’s move begs the question doesn’t it, of why, since both facilities are acute mental health inpatient units. Was this the nod back to reclaiming her life again? Rangipapa is a Forensic Mental Health Service, whose role is working at the place where Mental Health, Corrections and the Courts interact with each other.
By way of a brief explanation, forensic psychiatry as practiced at Rangipapa is a sub-speciality of psychiatry and a support science of criminology. It’s the juncture between law and psychiatry. A forensic psychiatrist, (as Jacqueline Short is and with the added string of a Consultant) provides services such as determining a person’s competency to stand trial in a court of law. They help in the legal process of resolving a dispute.
Mental Disorder Definition
So I’m wondering about Rangipapa releasing Kate to another facility. Does this mean she no longer meets the definition of having a mental disorder as defined in s2 of the Mental Health (Compulsory Assessment and Treatment) Act 1992? And if so, why then shouldn’t she be free to leave any and all facilities to resume her life before she was “improperly detained.”
Just to remind you, a mental disorder there is defined as “an abnormal state of mind (whether of a continuous or an intermittent nature), characterised by delusions, or by disorders of mood or perception or volition or cognition, of such a degree that it: (a) Poses a serious danger to the health or safety of that person or of others; or (b) Seriously diminishes the capacity of that person to take care of himself or herself.”
The definition is constructed in two separate parts. The first part requires a person to have an ‘abnormal state of mind’ (the law seeking to establish whether a mental disorder is in fact present?) characterised by delusions, or by a disorder of mood or perception or volition or cognition.
Harm must be evident, not just an extreme of usual conduct. New Zealand case law maintains that the notion of abnormality here be determined objectively: that is, by reference to what is normal in society as a whole, not just what is normal for the individual. It’s a lot to take in isn’t it, so I’ll continue with the second part of the mental disorder definition tomorrow. In the meantime, here’s something to chew on overnight. In law, would Kate be regarded as having a mental disorder?
Ships in the Night
The rest of the proverb goes like this:
“There are those who pass like ships in the night, who meet for a moment, then sail out of sight with never a backward glance of regret; folks we know briefly then quickly forget. Then there are friends who sail together, through quiet waters and stormy weather, helping each other though joy and through strife. And they are the kind who give meaning to life.”
UPDATE
On 25/5/2011 and 26/5/2011 Kate was threatened with a knife and as a result BE visited her late in the evening yesterday. She was allegedly assaulted by the same woman. The incident occurred in the dining room of the facility. Police were notified: Ref. No P008190980.
On BE’s enquiry, it appears there was no follow up of the threat with the knife incident by staff. Is this common practice? It shouldn’t be and at the very least an Incident Report should have been made. These incidents lead one to wonder if an environment where intimidation is not investigated is in fact permitted. Surely not! Kate is not alleged to have contributed to the assault or following harassment.”
NOTE
* Interesting to note that the ‘The Article: ‘Introducing the Public Defence Services to the Wellington, Lower Hutt and Porirua Criminal Courts’ has been removed. Dated Noted: 17/09/11
RELATED DOCUMENT
1. Barbara Joy Mosley: Seclusion Management in an Acute In-Patient Unit
RELATED POSTS
1. Alone Alone All All Alone 2. Systems that take the Kate 3. Model Citizen: A Piece of Kate 4. A Twist of Kate: The Castaway 5. Throwing Out the Lifelines 6. An Anchor in the Social World 7. Rights of Passage 8. Katherine 9. Ships in the Night
