Dr. Jacqueline Montwill:

That is what I am concerned about. For example, I have heard that there is a reduction in time to 72 hours. The Bill is proposing that the period be seven days. If a person presents as being acutely suicidal, mental illness will respond to treatment, but only over time. If the person has severe depression or psychosis, antidepressants normally take four to six weeks to take effect. That is the nature of the disorder. We do not know how long acute crisis and adjustment reactions take, as it depends on a person's circumstances and how they present. Sometimes patients present with acute adjustment reaction on Friday evening and by Saturday morning, if they are in hospital with one-to-one support from nurses, they feel much better. It can be a wonderful thing. A young female came to me one morning and said she could not believe she was not suicidal. I had told her the treatment would work but she did not believe it at the time, although it worked. We have to hold with our patients while the treatment works. That is what we do. If a woman is acutely suicidal, she should get full and proper assessment and she should have the full assessment of the team. She should be admitted to hospital only if she needs to be admitted, as she may have psychosis or severe depression. She may have overwhelming anxiety or a partner who is abusive or violent or is coercing her to have an abortion. This assessment must provide that knowledge to her treating doctor, or else she is being skimped on and is not receiving proper assessment. That is the issue.

There are no different views in how we deal with patients. We always deal with patients in a non-judgmental way, and a psychiatrist cannot be shocked, as we have heard it all before. There is no problem at all in hearing alternative life views or choices, as it does not matter. Our only role is to see whether there is a treatable psychiatric illness and to ensure it is treated promptly and appropriately.

Senator Burke spoke about the X case judgment. The problem is that the judgment was made with full integrity because the worst-case scenario presented itself. This was a 14-year-old girl who had been violated and raped and who stated she was suicidal, which is completely understandable. The girl went on to have a miscarriage, but the X case legislation was enacted for the C case, which was again a worst-case scenario of a suicidal girl. Our immediate instinct is to make it better; we say to junior doctors that they should not treat their own anxiety but rather that of the patient. What, in hindsight, was the best treatment for the patient? It was to manage her pregnancy in a safe and protected place, probably a hospital but perhaps a supported house or with her family. We now have the evidence, in hindsight, that she stated she never wanted an abortion and was never told about it. It happened, and she has been suicidal since. We must stick to best practice clinical guidelines and medicine, regardless of how distressing the presenting complaint.