Director Forensic Disability annual report (002) · Director of Forensic Disability Annual Report 2015‐16 Table of contents MESSAGE FROM THE DIRECTOR OF FORENSIC DISABILITY

Director of Forensic Disability Annual Report 2015–16

Director of Forensic Disability Annual Report 2015‐16

© The State of Queensland 2016

Copyright protects this publication. Excerpts may be reproduced with acknowledgment to the State of Queensland.

Director of Forensic Disability GPO Box 806 Brisbane Q 4001 Telephone: 3247 5080 Email: directorforensicdisability@communities. qld. gov. au


30 September 2016

The Honourable Coralee O’Rourke MP

Minister for Disability Services,

Minister for Seniors and

Minister Assisting the Premier on North Queensland

Neville Bonner Building

75 William Street

Brisbane Qld 4000 Dear Minister

I am pleased to present the fifth Annual Report of the Director of Forensic Disability for 2015‐16.

This report is made in accordance with the requirements of section 93 of the Forensic Disability Act 2011. The annual report provides information on the key activities of the Director of Forensic Disability from 1

July 2015 to 30 June 2016 and highlights the ongoing strengthening of response to some of Queensland’s

most marginalised and vulnerable citizens. Yours sincerely

Vanda Wieczorkowski

Director of Forensic Disability


Table of contents

MESSAGE FROM THE DIRECTOR OF FORENSIC DISABILITY ........................................................................................... 3

OVERVIEW ............................................................................................................................................................... 4

THE ROLE OF THE DIRECTOR OF FORENSIC DISABILITY ................................................................................................................... 4

WHAT DOES THE DIRECTOR OF FORENSIC DISABILITY DO? ............................................................................................................. 4

FORENSIC DISABILITY SERVICE ........................................................................................................................................... 6

Administrator of the Forensic Disability Service .......................................................................................... 6

Gender and cultural profile ......................................................................................................................... 7

Offence history ........................................................................................................................................... 7

Age profile ................................................................................................................................................... 7

Authorised Mental Health Services ............................................................................................................. 8

Forensic Disability Clients ........................................................................................................................... 8

SECTION 87(1) (A) ENSURING THE PROTECTION OF THE RIGHTS OF FORENSIC DISABILITY CLIENTS UNDER THE ACT ….. 9

CLIENT COMMITTEE ...................................................................................................................................................................... 9

CLIENT VISITS ...................................................................................................................................................................... 9 COMPLAINTS AND OTHER INVESTIGATIONS ................................................................................................................................. 9

Complaints .................................................................................................................................................. 9

PROGRAMS ..................................................................................................................................................................... 10

Therapeutic and clinical interventions ..................................................................................................... 10

TREATMENT PROGRAMS ..................................................................................................................................................... 10

Wise Choices (problematic sexualised behaviour program) ..................................................................... 10

Everybody Needs to Know (sexual health and relationships program) .................................................... 10

Anger Management ................................................................................................................................. 11

HABILITATIVE PROGRAMS (SKILLS‐BASED AND DIVERSIONAL) ....................................................................................................... 11

Literacy and numeracy program .............................................................................................................. 11

Gardening program .................................................................................................................................. 11

Cooking program ...................................................................................................................................... 11

Art program .............................................................................................................................................. 11

Indigenous Art and Cultural program ....................................................................................................... 11

SECTION 87(1)(B) ENSURING THE INVOLUNTARY DETENTION, ASSESSMENT, CARE AND SUPPORT AND PROTECTION OF FORENSIC DISABILITY CLIENTS COMPLY WITH THE ACT ....................................................................................... 12

CLINICAL GOVERNANCE ....................................................................................................................................................... 12

SECTION 87(1) (C) FACILITATING THE PROPER AND EFFICIENT ADMINISTRATION OF THE ACT .................................... 13

LEGISLATIVELY COMPLIANT OPERATION OF THE FORENSIC DISABILITY SERVICE ................................................................................. 13 THE PROVISION OF LEGAL REPRESENTATION AND ADVICE .......................................................................................................... 13 TEMPORARY ABSENCE APPROVALS ........................................................................................................................................ 14 NOTICES UNDER SECTION 237 OF THE MENTAL HEALTH ACT 2000 .............................................................................................. 14


FORENSIC INFORMATION ORDER NOTIFICATIONS ..................................................................................................................... 15 REVIEW OF POLICIES AND PROCEDURES .................................................................................................................................. 15 SUBMISSIONS TO INQUIRIES ................................................................................................................................................. 15

April 2016 – Submission on the Inquiry into the indefinite detention of people with cognitive and psychiatric impairment in Australia .......................................................................................................... 15

REVIEW OF THE MENTAL HEALTH ACT 2000 (QLD) COMPLETION ................................................................................................ 15

SECTION 87(1) (D) MONITORING AND AUDITING COMPLIANCE WITH THE ACT ......................................................... 16

MONITORING COMPLIANCE OF THE FORENSIC DISABILITY SERVICE ................................................................................................ 16

Compliance audit of the Forensic Disability Service ................................................................................. 16

SECTION 87(1)(E) PROMOTING COMMUNITY AWARENESS AND UNDERSTANDING OF THE ADMINISTRATION OF THE ACT ....................................................................................................................................................................... 17

MENTAL HEALTH COURT .................................................................................................................................................... 17

Mental Health Court matters ................................................................................................................... 17

Mental Health Court references and the National Disability Insurance Scheme (NDIS) ........................... 19

Capacity Building ...................................................................................................................................... 19

FUTUREDIRECTIONS .............................................................................................................................................. 22

APPENDICES .......................................................................................................................................................... 23

Tables and Figures

Table 1: Age range of clients ...............................................................................................................................7

Table 2: Activity of the director at the Mental Health Court .............................................................................17

Table 3: Regional breakdown of references ..................................................................................................... 18

Figure 1: Index offences by offence type by clients detained to the Forensic Disability Service .........................7

Figure 2: Types of offences ........................................................................................................................................... 18


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Message from the Director of Forensic Disability

I am pleased to present the 2015‐16 Annual Report of the Director of Forensic Disability (the Director).

This report outlines the function and operation of the Forensic Disability Service (FDS) and its compliance with the relevant legislative provisions, governance and administration as contained in the Forensic Disability Act 2011 (the Act).

During 2015‐16 I have worked closely with the Administrator of the FDS, Mr Ian Wilson, to ensure the protection and rights of forensic disability clients and that the involuntary detention, assessment, care, support and protection of forensic disability clients comply with the Act.

In January 2016 the Director’s office commenced an audit of the FDS over the quarter October – December 2015. The purpose of the audit was to assess compliance with the legislative requirements of the Act and key clinical areas that fall within the Director’s statutory responsibility. The audit identified opportunities for improvement. An action plan has been developed by the Administrator to implement these improvements.

The Director has continued to make representations on behalf of people with an intellectual disability or cognitive impairment who find themselves before the Mental Health Court. The Principal Legal Officer has appeared for the Director in the Mental Health Court and the Court of Appeal in a range of proceedings, and also provided legal advice on a variety of matters as required. The Director elected into 65 matters relating to people with an intellectual disability who appeared before the Mental Health Court to make appropriate determinations for a number of these alleged offenders.

My office has advised Department of Communities, Child Safety and Disability Services (DCCSDS) personnel on specialist forensic disability matters, and I have continued to work in partnership with the Director of Mental Health on complex case matters involving clients subject to Forensic Orders (Mental Health Court ‐ Disability). My office has started the process of reissuing policies and procedures about the detention, care, support and protection of forensic disability clients at the FDS.

Training in the area of forensic disability has been provided by the Director to staff of the DCCSDS, non‐ government disability service providers, and other Queensland Government departments such as Corrective Services. In 2015‐16 the Director provided training to approximately 210 staff from across the state and across a range of government departments. Two staff members, one from the FDS and one from the Director of Forensic Disability Office, were sponsored to undertake a Specialist Certificate in Criminology (Forensic Disability) at the University of Melbourne. This training has built the capacity of the Forensic Disability staff and staff of the Office of the Director of Forensic Disability to meet the needs of individuals with an intellectual disability detained to the FDS or on orders in the community.

In the coming year, a review will take place of all clients who have been continually detained for a period of five years at the FDS. The review will consider client benefit from the care and support provided by the FDS and whether benefit is likely to continue if the client remains at the service. Reports outlining the findings of the review will made available to the Mental Health Review Tribunal. My staff and I will also continue to work to ensure that clients have employment and community participation options available to them whilst preserving their own safety and the safety of others.

As the current year concludes, I would like to express my sincere appreciation to our colleagues in Queensland Health, the Mental Health Court and all DCCSDS regions and central office. Your collegiality and willingness to provide carefully considered advice is invaluable and ultimately contributes to better outcomes for some of Queensland’s most vulnerable citizens.

Vanda Wieczorkowski Director of Forensic Disability

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Overview

The role of the Director of ForensicDisability The Director of Forensic Disability is an independent statutory position appointed by the Governor in Council under the Forensic Disability Act 2011 (the Act).

The Director is responsible for the proper and efficient administration of the Act, including ensuring the FDS complies with the Act.

The Act includes provisions for:

safeguarding the rights and freedoms of

forensic disability clients

balancing their rights and freedoms with the

rights and freedoms of other people

promoting individual development

enhancing quality of life and maximising

opportunities for reintegration into the

community.

Under section 87 of the Act, the main functions

of the Director are:

ensuring the protection of the rights of

forensic disability clients under the Act

ensuring the involuntary detention,

assessment, care, support and protection of

forensic disability clients comply with the Act

facilitating the proper and efficient

administration of the Act

monitoring and auditing compliance with the

Act

advising and reporting to the Minister on any

matter relating to the administration of the

Act

any other function under the Act.

Section 88 provides the Director with the power

to do all things necessary or convenient to be

done in performing the Director’s functions

under the Act.

The Director is supported to perform the statutory functions by officers appointed under the Public Service Act 2008 (Qld). Throughout 2015‐16, the Director was supported and assisted by the following staff:

Principal Legal Officer –

Scott Dullaway

Principal Legal Policy Officer – Susan Louden

Principal Clinical Advisors – Elizabeth Lane and Daniel Pollock

Program Support Officer ‐ Carl Thorning.

What does the Director of Forensic Disability do? The Act and the Mental Health Act 2000 provide

for two types of forensic orders for persons

charged with an indictable offence. Where the

defendant is found to be of unsound mind due

to mental illness – with or without intellectual

disability – a Forensic Order (Mental Health

Court) may be imposed. For persons found unfit

for trial due to an intellectual or cognitive

disability, a Forensic Order (Mental Health Court

– Disability) may be put in place. The inclusion of

a Forensic Order (Mental Health Court –

Disability) in the Mental Health Act 2000 provides

the means to clearly identify people with a

diagnosis of an intellectual or cognitive disability

with a view to better meeting their needs.

The Act provides for the involuntary detention,

care, support and protection of individuals placed

on a Forensic Order (Mental Health Court –

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Disability) by the Mental Health Court who have

been detained to the FDS. In addition, there are a

number of other individuals with intellectual

disabilities or cognitive impairments who are on

forensic orders but detained to other Authorised

Mental Health Services. These individuals are

either detained on Forensic Orders (Mental

Health Court – Disability)1 or on Forensic Orders

(Mental Health Court). 2 The Director works in

partnership with the Director of Mental Health

through a Memorandum of Understanding, to

ensure a coordinated response to their care and

support.

The Director is entitled to elect in as a party to

Mental Health Court proceedings involving

individuals with intellectual or cognitive disability.

The role of the Director is to assist the Mental

Health Court, including making submissions

regarding the appropriateness or otherwise of

forensic orders for these individuals, and

submissions regarding their future placement and

management.

The Director of Forensic Disability coordinates

outcomes for individuals with intellectual or

cognitive disability who appear before the court

by liaising with DCCSDS regional offices to

coordinate Mental Health Court reports and

other documents required by the Mental Health

Court.

Partnership between the DCCSDS regions and the

Director continues a strong collaborative practice

and relationship. The process for developing the

Mental Health Court reports can be found in

Appendix 1.

1 These individuals have been found unfit for trial primarily because of their intellectual disability.

2 These individuals have been found of unsound mind or unfit for

trial primarily because of a mental illness but they have a dual diagnosis (a co‐existing intellectual disability or cognitive impairment).

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1. Forensic Disability Service The FDS is in its fifth year of operation and is

funded to accommodate 10 clients with an

intellectual or cognitive disability on a Forensic Order (Mental Health Court – Disability). During 2015‐16, nine clients resided in the FDS and one client was detained to the FDS but accommodated on 24/7 limited community treatment elsewhere.

In January 2016 one forensic disability client detained to the FDS passed away and as of June 2016 there was one vacant place at the FDS.

The FDS provides medium secure accommodation to residents. Clients engage in rehabilitatative and habilitative activities specifically tailored to their individual needs. Examples include anger management, sex education and sex offender treatment programs, art, gardening and cooking sessions, and limited community treatment where the client is escorted in the community to engage in tasks such as grocery shopping and banking.

1a. Administrator of the Forensic Disability Service The Administrator of the FDS is appointed by the Director, pursuant to section 96 of the Act. The primary functions of the Administrator are to give effect to the:

i) policies and procedures developed by the Director

ii) forensic orders of forensic disability clients.

The Administrator is also responsible for the day‐ to‐day operations of the FDS.

Mr Ian Wilson has been the Administrator of the FDS since 19 February 2015. In reflecting upon 2015‐16, Mr Wilson reports:

In the past year the Forensic Disability Service has continued its focus on supporting Aboriginal and Torres Strait Islander clients to maintain connection to family and country, regardless of distance, including meeting the costs of travel to enable face‐to‐face contact. Three clients were able to be visited by family members from North Queensland, and on four occasions through the year, assistance and

escorts were provided to individuals to enable them to travel to North Queensland to take part in sorry business.

The Forensic Disability Service was pleased to have opportunities to extend the high profile which it gives to the importance of supporting and safeguarding the exercise of people’s rights, through activities such as the Public Advocate presenting at the induction of new employees, and site visits by the Acting Public Guardian and the South Australian Public Advocate.

On World No Tobacco Day, 31 May 2016, smoking by clients became prohibited and the Forensic Disability Service became totally smoke free. This change proceeded smoothly and without adverse consequence, due in no small part to the preparatory work that had been undertaken during the preceding months, including the individualised support that Inala Indigenous Health Service provided to clients to assist them to realise their smoking cessation goals. The Forensic Disability Service has greatly appreciated the Inala Indigenous Health Service’s contribution to these health outcomes.

The Forensic Disability Service has appreciated the leadership, partnership and support provided throughout the past year by the Director of Forensic Disability, the Regional Executive Leadership Team in the South West Region and the Centre of Excellence for Clinical Innovation and Behaviour Support.

Mr Ian Wilson

Administrator, Forensic Disability Service

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1b. Gender and cultural profile During 2015‐16 there were nine males and one

female detained to the FDS, until the death of

one male client. Five of the clients detained to

the FDS identify as Indigenous.

The visiting service provided by traditional elders continues to provide opportunities to strengthen cultural connections for clients who identify as Indigenous. The inclusion of the South West Region Aboriginal and Torres Strait Islander Practice Leader as a member of the FDS Clinical Governance Committee continues to provide the opportunity to strengthen cultural capability at the FDS.

1c. Offence history Nine of the 10 clients were charged with committing multiple types of offences. The complete offence histories of the 10 clients detained to the Forensic Disability Service during 2015‐16 include sexual assaults and other sexual offences, deprivation of liberty, break and enter, unlawful use of motor vehicles with circumstances of aggravation, physical

assaults and arson. The index offences3 for the 10 FDS clients are presented in Figure 1.

Figure 1: Index offences by offence type committed by the clients detained to the Forensic Disability Service

1 1 4

4

Sexual Assault

Assault

Enter dwelling and commit indictable offence

Willful damage

The above information pertains exclusively to the index offence; that is, the most serious offence that carries the longest sentence. In some cases clients were charged with multiple counts of the index offence, as well as being charged with other lesser offences in addition to the index offence.

1d. Age profile The following table shows the age range of the clients detained to the Forensic Disability Service during 2015‐16.

Table 1: Age range of clients

Age (in years) Number of clients

18 to 30 3

31 to 35 4

36 to 65 3

3

The term index offence refers to the most serious offence which the clients were charged with committing.

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1e. Authorised Mental Health Services In addition to the 10 individuals detained to the

FDS during 2015‐16, there were 54 individuals on

a Forensic Order (Mental Health Court – Disability) who were detained to Authorised Mental Health Services as either inpatients, or outpatients granted limited community treatment.

In the circumstance where an individual is detained under a Forensic Order (Mental Health Court – Disability) to an Authorised Mental Health Service, the Director actively negotiates and consults with both the DCCSDS and the Director of Mental Health, to advise and make recommendations on appropriate supports and services.

The services provided to individuals by the DCCSDS depend upon their disability support needs and risk profile and can include funding for:

Therapeutic interventions such as: o treatment programs – problem solving,

coping skills and sex offender programs.

Accommodation supports and community access supports such as: o skills development such as personal

care, activities of daily living o behaviour management programs

within a Positive Behaviour Support framework

o case management services.

1f. Forensic Disability Clients People subject to a Forensic Order (Mental Health Court – Disability) are able to be detained by the Mental Health Court to the FDS, another Authorised Mental Health Service as an inpatient, or another Authorised Mental Health Service as an outpatient.

When the Mental Health Court or the Mental Health Review Tribunal grants limited community treatment to an individual, the individual remains detained to the FDS or an Authorised Mental Health Service, but may be granted the privileges of an outpatient.

When capacity is available at the FDS, adults placed on Forensic Order (Mental Health Court – Disability) may be detained there. Placement is based on the client being able to benefit from the specialist care and support provided by the FDS. Placement at the FDS only occurs where treatment can be tailored for individuals. The FDS is specifically for individuals with an intellectual disability or cognitive impairment.

The FDS currently has one vacancy but during the period of this report, no suitable referral has been received.

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Section 87(1) (a) Ensuring the protection of the rights of forensic disability clients under the Act

Clientcommittee The Director regularly attends the FDS Client Reference Group which has continued to meet on a quarterly basis, in line with its terms of reference. A pictorial format for the minutes of this meeting is used as a means of communication to support participants’ understanding.

Client visits The Director has used a range of formal and informal arrangements to remain engaged with the clients of the FDS and provide them with the opportunity to keep the Director informed of their experiences and aspirations.

In the course of conducting a close working relationship with the FDS, the Director has also had the opportunity to personally observe the provision of services to forensic disability clients.

Complaints and other investigations

Complaints Two complaints from clients residing at the FDS were received by the Director in 2015‐16. The first related to a client’s request for a second opinion in relation to his psychiatric care. This request has resulted in a review by an independent psychiatrist being sought. This request has been actioned by the Director and is ongoing. The second complaint involved a client’s grievance in relation to alleged excessive noise from night staff when he was trying to sleep. This matter was conveyed to the administrator of the service and dealt with in accordance with internal policy and procedure. No formal investigations have been undertaken during 2015‐16.

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Programs Therapeutic and clinical interventions The development of FDS programs has been

guided by the principles articulated in the

original Forensic Disability Service Clinical

Framework. This framework emphasises the

need for a holistic approach to client

rehabilitation, including a range of skills‐based

and diversional programs, in addition to

individualised therapy and group‐based,

offence‐specific programs.

Treatment programs aim to address problematic

behaviours either directly (e.g., therapy for

problematic sexual behavior) or indirectly (e.g.,

providing sex education). Habilitation programs

aim to develop skills and activities of daily living,

and provide interest and occupation.

A Clinical Governance Sub‐Committee oversees

the implementation of the Clinical Governance

Framework, and is attended by the Director. This

Committee ensures evidence‐based

interventions are delivered to the benefit of

forensic disability clients.

Treatment programs

The services provided to clients at the FDS depend upon their needs and risk profile. The following programs were delivered during 2015‐16:

Wise Choices ‐ sex offender treatment program

Everybody Needs to Know ‐ sexual health and relationship education

Anger management

Arson treatment program

Wise Choices (problematic sexualised behaviour program) The Wise Choices program is a sexual offending

treatment program designed for adult males who

have either offended sexually or have exhibited

inappropriate sexual behaviours. The program

specifically targets the needs of individuals whose

level of literacy, abstract thinking skills and/or

disabilities prevent them from participating in

mainstream programs.

The Wise Choices program uses cognitive

behaviour change principles and utilises the Risk

Need Responsivity (RNR) and Good Lives Model

(GLM) therapeutic frameworks. The program was

facilitated by trained and clinically supervised

staff. Additional liaison with support staff, family

and other stakeholders occurred regularly to

ensure successful completion of the program.

The program was delivered to forensic disability

clients and community clients. The program was

delivered twice weekly in group format with

individual one‐on‐one sessions conducted

weekly to consolidate skills, knowledge and

understanding for the participants.

Everybody Needs to Know (sexual health and relationships program) The Everybody Needs to Know program is a sexual health and relationships education program developed by Family Planning

Queensland specifically for the needs of individuals with an intellectual disability.

The aim of the program is for participants to learn about appropriate relationships, reproduction and sexual health.

The program was delivered to forensic disability clients and community clients in a group‐based format twice weekly, and individually where required.

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Anger management The anger management program is a cognitive behavioural therapy intervention program designed specifically for individuals with intellectual impairments who have difficulty in managing their feelings of anger.

This program was delivered in a group‐based format to forensic disability clients twice weekly and individually where required.

Arson treatment program The arson treatment program for individuals with intellectual disability was developed by Griffith University. It is delivered once a week over a six‐month period.

Habilitativeprograms (skills‐ based and diversional)

During 2015‐16 the following habilitative programs were delivered to forensic disability clients:

Literacy and numeracy program The literacy and numeracy program continues to be delivered to one client. It is a self‐paced program with a view to developing not only literacy and numeracy, but also self‐confidence and self‐esteem. Information from this program is reinforced during other programs, such as gardening and cooking.

Gardening program Gardening provides the clients with a sense of

purpose, and vegetables/herbs that are grown

are used in the cooking program. The gardening

program helps clients to develop skills in

growing, harvesting and preserving foods.

Other skills that are developed and/or enhanced

by the gardening program include socialising,

working together, task completion and increasing

physical activity. Five clients participate in the

program with good levels of attendance and

evident enjoyment. An additional benefit of

developing client budgeting skills and enhancing

their understanding of diet and health has been

seen.

Cooking program The objective of this program is to promote and

support clients’ health and wellbeing by

encouraging healthy eating practices. The

cooking program is designed to teach clients

about cost‐effective and easy‐to‐prepare recipes

and incorporates physical and occupational

goals, including motor skills development and

personal care skills for independent living.

Additional benefits of this program include

planning, organisation, task completion skills,

social and emotional skills development and

confidence in food preparation.

Art program The art therapy program is conducted for one

hour on a weekly basis with clients at the FDS.

The objectives of the program include improved

fine motor skills, increased creativity, relaxation

through the use of art as a mindfulness

technique, increased social skills through group

work, improved general knowledge and

increased sense of mastery and self‐esteem.

A range of specific ‘themes’ are embedded within

the program, for example, the creation of

artwork in preparation and planning in the lead

up to NAIDOC Week, Australia Day celebrations,

International Women’s Day and Reconciliation

Week. The program builds art skills, including

conceptualisation and visualisation of thought,

working together, socialisation and learning to

have fun in an appropriate way.

Indigenous art and cultural program The primary objective of the Indigenous art and

cultural program is to strengthen the clients’

sense of cultural identification and connection for

those identifying as Indigenous. The program

provides a vehicle for clients to engage with

conversation and storytelling about Indigenous

culture.

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Section 87(1)(b) Ensuring the involuntary detention, assessment, care and support and protection of forensic disability clients comply with the Act

Clinicalgovernance The Clinical Governance Framework of the FDS is predicated on the principles of maximising positive client outcomes through improving the effectiveness of services, reducing adverse events and reducing variability of service quality.

The framework is based on the Clinical Governance Framework for Disability Services and consists of five domains:

• Client and family participation

• Clinical effectiveness

• Effective, reliable and resilient workforce

• Safety and risk management

• Information management.

As part of the implementation of the Framework, the FDS reports specific clinical and operational data to the Director in response to set performance indicators. The service began reporting on these indicators in April 2014.Clinical performance at both an individual and whole‐of‐service level will continue to be monitored longitudinally, and data for regular reviews will be provided.

The framework is overseen by the FDS Clinical Governance Committee, which meets monthly. The committee is chaired by the Regional Director, South West Region, Disability and Community Services, DCCSDS.

The standing membership of the committee includes:

Regional Director, South West Region,

the Director of Forensic Disability

senior staff of the FDS

a cross‐section of experts and other

interested stakeholders.

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Section 87(1) (c) Facilitating the proper and efficient administration of the Act

Legislatively compliant operation of the Forensic Disability Service In addition to conducting formal audits of the FDS, the Director provides regular advice to assist the service to ensure day‐to‐day operation of the service is compliant with the Act.

This includes the provision of advice by the Principal Legal Officer on a number of issues relevant to statutory compliance.

The Provision of Legal Representation and Advice During 2015‐16, the Principal Legal Officer, who is a Barrister‐at‐Law, appeared as Counsel for the Director in the Mental Health Court and the Court of Appeal, which are constituted by Judges of the Supreme Court of Queensland on matters.

The Principal Legal Officer, in addition to providing legal representation, provided legal advice with regard to:

• making a submission to the Senate Community Affairs References Committee for the inquiry into the indefinite detention of people with cognitive and psychiatric impairment in Australia

• provision of updates on forensic disability clients regarding oversight by the Director

• the use of seclusion of forensic disability clients at the FDS

• provisions of the Act, Mental Health Act 2000, and the Police Powers and Responsibilities Act 2000 in relation to securing police assistance to move forensic disability clients within the FDS

• FDS staff acting in self‐defence in response to physical confrontations or threatened violence at the FDS

• the conduct of audits at the FDS

• the entitlement of the Director to appear in the Mental Health Court

• the legislative provisions of the Act which concern the appointment of the administrator and senior practitioners

• the legislative review of forensic disability clients required to be undertaken if detained at the FDS for five years

• the operation of limited community treatment, including suspension, pursuant to forensic orders (Mental Health Court – Disability)

• information release with regard to Special Notification Clients at the FDS

• the application of the Disability Services Act 2006 in relation to Disability Services clients attending the FDS for rehabilitative programs

• the legislative provisions that pertain to the regulation of smoking at the FDS

• the legislative provisions that concern the licensing of vehicles and certification of modified vehicles

• the provision of information pertaining to rehabilitative programs conducted at the FDS to their legal representatives

• engagement of consultants at the FDS

• provision of personal information pursuant to the Information Privacy Act 2009.

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Temporary Absence Approvals Section 41 of the Act allows the Director, by

written notice, to approve the temporary

absence of a forensic disability client from

the FDS:

to receive medical, dental or optical treatment or

to appear before a court, tribunal or other body or

for another purpose the Director considers to be appropriate on compassionate grounds.

During 2015‐16 the Director approved 11 temporary absences for six clients from the FDS. These temporary absences were granted for:

eight absences to receive medical, dental or optical treatment

three absences for another purpose the Director considered appropriate on compassionate grounds.

Notices under section 237 of the Mental Health Act 2000 Chapter 7 Part 2 of the Mental Health Act 2000 (Mental Health Act) regulates the process that applies when a forensic disability client is charged with an offence by the Queensland Police Service.

Once a client is charged, the Administrator must immediately notify the Director in accordance with section 237(1) of the Mental Health Act.

The Director determines if Chapter 7 Part 2 of the Mental Health Act applies, and if the Director decides it does, then the Director gives written notice (Director’s Notice) of it to the Administrator, the Chief Executive for Justice and the Mental Health Review Tribunal.

Once the Administrator receives the Director’s notice, the Administrator must

immediately tell the client of the application of Chapter 7 Part 2 (required by s. 237(3) of the Mental Health Act 2000).

Section 237A of the Mental Health Act 2000 grants the Administrator the power to then ask the prosecuting authority to provide the Administrator with copies of certain documents relating to the offence.

Also, as soon as practicable after the Administrator receives the Director’s Notice, the Administrator must arrange for the client to be examined by a psychiatrist and obtain a report from the psychiatrist (s. 238 of the Mental Health Act 2000).

The Administrator must give the report to the Director within 21 days of receiving the Director’s Notice (s. 239 of the Mental Health Act 2000). The Director may after receiving the report obtain a further report (s. 239A).

The Director then considers the type of offence, the reports from the psychiatrist, and the subject matter in sections 240, 241 and 242, to determine whether to refer the matter to the Mental Health Court or the Director of Public Prosecutions, and whether the reference can be deferred due to the client being temporarily unfit for trial.

Also, once Chapter 7 Part 2 applies, the proceedings for the offence are suspended pursuant to section 243, until:

the Director of Public Prosecutions has made a decision on a reference under Chapter 7 Part 2, that the proceedings continue or be discontinued or

the Mental Health Court has made a decision on a reference under Chapter 7 Part 2 or

the Director has given notice to the Chief Executive for Justice that Chapter 7 Part 2 part no longer applies to the client.

During 2015‐16, the Director issued a Director’s Notice in relation to one forensic disability client who was served with a notice to appear in relation to a charge of alleged assault.

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Forensic Information Order Notifications Under the Mental Health Act 2000 the Mental Health Review Tribunal may make an order that certain persons can have information about a forensic disability client.

During 2015‐16 one forensic disability client was subject to a Forensic Information Order. As required by section 149 of the Act the Director made four notifications for this client as required by the Act.

Review of policies and procedures Section 91 of the Act states:

The Director must issue policies and procedures about the detention, care and support and protection of forensic disability clients.

The Director’s staff, in consultation with the FDS, has continued to review policies and procedures regarding the detention care and support and protection of forensic disability clients.

This is a critical contribution, not only in ensuring the ongoing compliance of the service, but in maintaining the congruency between its policy platform and contemporary research evidence base.

Submissions to Inquiries

April 2016 – Submission on the inquiry into the indefinite detention of people with cognitive and psychiatric impairment in Australia

The Director made a submission to an inquiry by the Community Affairs References Committee into the indefinite detention of people with cognitive and psychiatric impairment in Australia.

The submission outlined the forensic disability framework in Queensland, the role of the Director of Forensic Disability, including in the Mental Health Court, and the purpose of the FDS.

Review of the Mental Health Act 2000 (Qld) completion In 2015‐16 the review of the Mental Health Act 2000 was completed and the Mental Health Act 2016 passed in February 2016. Although the Mental Health Act 2016 has not yet taken effect, when it does it will result in amendments to the Forensic Disability Act 2011.

The amendments include changes to the types of forensic orders made by the Mental Health Court, which will include both inpatient and community types of Forensic Order (Mental Health Court ‐ Disability).

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Section 87(1) (d) Monitoring and auditing compliance with the Act

Monitoring compliance of the Forensic Disability Service Under section 87(1)(d) of the Act the Director is responsible for monitoring and auditing the compliance of the FDS with the Act. The Director is also responsible under section 87(1)(a) for ensuring the protection of the rights of forensic disability clients under the Act, and under section 87(1)(c) for facilitating the proper and efficient administration of the Act.

The Director and her team have been working in collaboration with the FDS to ensure the treatment and habilitiation needs of the clients are being met by the service; in particular, the delivery of a broad range of offender treatment programs, strong multidisciplinary assessment and risk assessment.

Compliance audit of the Forensic Disability Service In early 2016 the Director and her staff conducted a formal audit of the FDS’s compliance with the Act and the relevant clinical areas that fall within the Director’s statutory responsibility.

The audit found there were areas for compliance improvement, from both a legislative and clinical perspective. A number of recommendations were made in the audit report, including recommendations related to individual development plans, transition planning, behaviour management plans and clinical governance. These will be a priority for practice improvement in 2016‐17.

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Section 87(1)(e) Promoting community awareness and understanding of the administration of the Act

Mental Health Court

The Director may elect to be a party in any

Mental Health Court matter where there is

evidence that the individual may have an

intellectual or cognitive disability, pursuant to

section 403 of the Mental Health Act 2000.

The Director’s independence from the

DCCSDS means that the Director cannot insist

the advice of her staff is accepted by the

DCCSDS; however, the process is a useful

means of ensuring specific forensic disability

expertise is available to Regional Disability

Service clinicians and the Mental Health

Court.

The Director also uses this process to

recommend access to specialist forensic

disability funding, where client need exhausts

regional funding capacity. This pool of

funding, while small, has been used to access

critical clinical functions such as:

specialist risk assessment

specialist offender treatment where

regional capacity is limited

specialist legal services to attend to

complex client matters

specialist reports for court.

intellectual disability or cognitive impairment.

Of these 241 matters, 65 of the references

contained information that indicated the

person may have an intellectual disability or

cognitive impairment, resulting in the Director

making an application to appear.

The Mental Health Court requested 50 reports

from the DCCSDS during 2015‐16. This

comprised 20 original report requests, and 30

requests for updates on pre‐existing reports.

The Director and her staff peer reviewed and

quality assured all draft reports and provided

advice to the DCCSDS on how the court might

be best assisted. Ultimately, the decision to

action such advice sits with the DCCSDS.

Table 2 reflects the activity of the Director at

the Mental Health Court in detail.

Table 2: Activity of the Director at the

Mental Health Court

Activity Number

References reviewed 241

References elected 65

Reports and updates 50 viewed/filed

Further detail regarding the agreed Mental

Health Court Report writing process for the

DCCSDS Disability Services is provided in

Appendix 1.

Mental Health Court matters

In 2015‐16, staff reporting to the Director

reviewed 241 references to the Mental Health

Court, in order to identify whether the

references related to people with suspected

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Figure 2 below illustrates the types of offences pertaining to the 65 references the Director elected into. As some clients were alleged to have committed multiple offences, the total number of offences is 82.

Figure 2: Types of offences

2 11 11

36 12

2

5 10 2

Arson

Motor Vehicle Offences

Property Offences

Sex Offences Child

Violent Offences

Drug Offences

Sex Offences

Adult Stalking

Police Offences

Other

During 2015‐16, 21 matters relating to people

with intellectual disability or cognitive

impairment were finalised in court.

Of the 21 completed matters, 11 resulted in

the court making a Forensic Order (Mental

Health Court – Disability) with each of the

defendants having been determined by the

Court as being either of unsound mind at the

time of the offence or unfit to stand trial.

The outcomes for the remaining 10

completed matters were as follows:

Two of the matters resulted in a

Forensic Order (Mental Health Court)

rather than a Forensic Order (Mental

Health Court – Disability) due to a

co‐existing mental illness.

One matter did not result in a

Forensic Order as the Court

considered the risk to the community

and to the defendant did not warrant

a Forensic Order.

The remaining seven matters were

returned to the Criminal Courts for

the criminal proceedings to continue

in the usual course. This occurs when

the defendant is not found by the

Mental Health Court to have been of

unsound mind at the time of

committing the alleged offences, and

the Court also determines the

individual is presently fit for trial.

DCCSDS regional breakdown of the 65

references in 2015‐16 is detailed in Table 3

below. A map of Queensland regions is

provided in Appendix 2. As expected, the

number of references is higher in those

regions that have higher populations. Table 3: Regional breakdown of references

Region Number of matters

Brisbane 11

Central Queensland

6

Far North Queensland

7

North Coast 8

North Queensland

7

South East 13

South West 13

Excluding individuals who are required to be

detained to the FDS, there is a correlation

between the location of the regions for

individuals referred to the Mental Health Court

and the locality for the place of detention.

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Cultural identity Of the 65 matters the Director elected to be a

party to in 2015‐16, 11 (17 per cent) related to

Aboriginal and Torres Strait Islander clients.

This proportion is significantly higher than the

number of individuals identifying as

Indigenous in Queensland, which is reported

as being 4. 2 per cent4. Of the remaining

matters, 34 people identified as

non‐ Indigenous, 3 identified as other ethnicity

and 17 were of unknown cultural identity.

Mental Health Court references and the National Disability Insurance Scheme (NDIS) Queensland is moving toward an historical

shift in the manner in which Disability Services

will be provided with the rollout of the NDIS

commencing on 1 July 2016. Around 48,000

Queenslanders currently receive disability

support and this will increase to around

91,000 Queenslanders eligible to receive

support through the NDIS.

In April 2013 the Council of Australian

Governments agreed to ‘Principles to

determine the responsibilities of the NDIS and

other service systems, including a set of

applied principles that aim to provide clarity

about which supports can be provided or

funded under the NDIS, and which are more

appropriately the responsibility of other

service systems. In considering offenders with

4 Australian Bureau of Statistics (2013). Estimates of Aboriginal

and Torres Strait Islander Australians, 2011. Retrieved 12 December 2014 from http://www.abs.gov.au/ausstats/[email protected]/mf/3238.0.55.001

a disability who are not in custody, the

National Disability Insurance Agency (NDIA,

2015) has stated:

The NDIS will continue to fund the full range of

supports related to the impact of a person’s

disability in a person’s support package where

the person is not serving a custodial sentence

or other custodial order imposed by a court. As

such the NDIS would fund supports where the

person is on bail or a community based order

which places controls on the person to manage

risks to the individual or the community (except

in the case of secure mental health facilities).

The NDIS represents an opportunity to better

address the disability support needs of

offenders with intellectual disability or

cognitive impairment who are not detained

pursuant to a Forensic Order. However,

clarification is still required in relation to the

NDIS funding supports for individuals subject

to a Forensic Order.

Of direct relevance to the support of

offenders with a disability will be emergent

detail regarding the provision of

community‐based accommodation;

preparation of reports and appearances in the

Mental Health Court; and clinical functions

such as risk assessment and offender

treatment.

The Director and her staff are actively

involved in consultations regarding the design

and rollout of the NDIS, advocating for

comprehensive and carefully considered

service responses for this vulnerable group of

Queenslanders.

Capacity Building

Communitystakeholders

The Director’s staff delivered multiple training

and information sessions to stakeholders

inside and outside of the disability sector.

These sessions have focused on a range of

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contemporary issues pertaining to the detention,

care and support, and protection of the legal rights

of offenders and alleged offenders with an

intellectual disability. These sessions seek to

integrate research evidence on the best practice

support of offenders and alleged offenders with

intellectual disability, with the applied learnings

and practice of the Queensland context.

Training and information sessions presented by the

Director and the Director’s staff have included the

following topics:

Incidence and prevalence of

intellectual disability amongst

offender cohorts

Forensic risk assessment

Treatment approaches for offenders with

a disability

Models of support

Report writing and the Queensland

Mental Health Court.

Training has been provided to disability staff and

other professional from a range of contexts, such

as:

DCCSDS

Queensland Health

conferences in the context of

disability, law and psychology.

This training is now a regular feature of the

Centre of Excellence for Clinical Innovation and

Behaviour Support annual training calendar as

professional development for disability sector

clinical and service access staff.

Training to Queensland Corrective Services staff

In 2015‐16 the Director and her clinical staff

delivered training in delivering a sexual offender

treatment program to Corrective Services staff.

This training provided an opportunity for

Corrections staff to understand the issues

relating to habilitation and rehabilitation of

individuals with intellectual disabilities.

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Regional DCCSDS professional development

The Director of Forensic

Disability and the Principal

Clinical Advisors were involved

in:

developing and delivering a five day

training event in May 2016 in Far

North Queensland to a combination

of DCCSDS, Department of Health and

non‐government staff regarding

sexual offender treatment for people

with intellectual disability

providing a four‐day Functional

Assessment and Positive Behaviour

Interventions course to a

combination of FDS and regional staff

from July 2015.

Staff at the Forensic Disability Service

In addition to delivering training to community

stakeholders, the Director is also actively

involved in training staff working within the

FDS. During 2015‐16, the Director’s staff

provided training to FDS staff focused on

areas such as legislative compliance, the

operation of the Mental Health Court and the

Mental Health Review Tribunal, the role of the

Director, human rights protections, and

contemporary treatment approaches for

offenders with a disability.

The Director also engaged collaboratively with

the Administrator of the FDS to ensure new

staff are appropriately trained and inducted.

The Director ensured clinical and legal staff

would collaborate with the FDS to conduct

the staff induction program.

During 2015‐16 the Director sponsored two

clinical staff, one from the FDS and one

from the Director of Forensic Disability’s

Office, to commence the Specialist

Certificate in Criminology (Forensic

Disability) at University of Melbourne.

The Specialist Certificate in Criminology

(Forensic Disability) comprises two subjects:

introduction to forensic disability

advanced practice in forensic

disability.

This post‐graduate course provides an

up‐to‐date understanding of key concepts and

issues in forensic disability, including

theoretical and practical training in the

assessment (including risk assessment) and

management of forensic disability

populations, and the complex professional and

ethical issues encountered when working in

the forensic disability discipline. The two

subjects are completed across a full year, as

two intensive study periods (one in March and

the other in October).

The development of forensic disability

expertise is not only critical in ensuring

compliance with section 87(1)(e), but also in

ensuring the Director’s overarching obligation

to protect the human rights of forensic

disability clients, particularly the right of clients

to receive effective support. The Director looks

forward to reporting on the completion of the

Specialist Certificate in Criminology (Forensic

Disability) by the two members of staff in the

next annual report.

Director’s staff development

The development of staff supporting and

assisting the Director is an important way to

ensure the Director performs her functions to

the highest standard.

The Director supported the Principal Legal

Officer, who appears as Counsel in the Mental

Health Court, to complete the Bar Practice

Course.

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Future directions In 2016‐17 the Director of Forensic Disability

will actively seek to improve those systemic

structures and cross‐government agreements

that are required to ensure consistent,

evidence‐based supports are available to all

offenders with an intellectual disability. This is

a critical aspect of ensuring the protection of

their fundamental human rights, while

enhancing community safety. In accordance with the Act, in 2016‐17 the

Director will undertake a review of the benefit

for clients from care and support provided by

the FDS. This will apply to any clients who

have been detained to the FDS for a

continuous period of five years. This measure

will ensure that if a client can no longer

benefit from the services provided by the FDS

they will not be subjected to ongoing

detention at the FDS.

Appendices

Appendix 1: Process for preparing reports for the Mental Health Court

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Appendix 2: Map of Queensland regions

Documents

Director Forensic Disability annual report (002) · Director of Forensic Disability Annual Report 2015‐16 Table of contents MESSAGE FROM THE DIRECTOR OF FORENSIC DISABILITY