Examining the role of psychiatrists in involuntary admissions under the Mental Health Act in New Zealand.

Abstract

ObjectivesThis perspective examines the role of psychiatrists in section 10 assessments under the Mental Health Act (MHA) in Aotearoa New Zealand, focusing on their involvement, concordance with preliminary assessments, and implications for service delivery. It also explores the potential impact of a capacity-based model.MethodsData was requested from all 20 District Health Boards (DHBs) on section 10 assessments completed between July 2022 and July 2023, including how many resulted in a section 11 certificate. Response rates and concordance between section 8(b) and section 10 assessments were analyzed.ResultsData from six DHBs showed over 95% of section 10 assessments led to a section 11 certificate, demonstrating high concordance. Psychiatrists conducted most section 10 assessments. However, approximately 1 in 20 cases involved non-concordance, suggesting psychiatrist-led assessments serve as a critical safeguard.ConclusionsHigh concordance rates suggest inefficiencies, yet the 1 in 20 non-concordance highlights an important safeguard. Given psychiatrist shortages and after-hours workload, reconsideration of the MHA process is warranted. Possible reforms include streamlining assessments, enabling non-psychiatrist practitioners to conduct final evaluations in some cases, and adopting a capacity-based model to optimize service delivery while maintaining safeguards.