Revealed: How nation failed Rau
Jeremy Roberts and Michelle Wiese Bockmann
June 29, 2005
CORNELIA Rau spent five weeks in Baxter detention centre before being assessed by a psychiatrist, even though she had arrived in a distressed and confused state, the official inquiry into her case has found.
In the explosive extracts of the secret report obtained by The Australian, former federal police chief Mick Palmer finds Ms Rau was also refused admission to a mental institution because the hospital had a policy of admitting only one Baxter detainee at a time.
Mr Palmer describes the detention centre as "manifestly inadequate".
He finds Ms Rau, who was wrongly detained for four months as a suspected illegal immigrant, was the victim of poor mental health provision at the centre, poor communications between centre and healthcare professionals and lack of flexibility by staff.
Mr Palmer's report says the psychiatrist visited Baxter just once during the four months Ms Rau was wrongly incarcerated there, and just eight times last year, even though there is a "heightened incidence" of mental illess among detainees.
"The current situation at Baxter lacks clearly defined leadership and continuity of care," Mr Palmer concludes.
He recommends that the Immigration Department establish a city-based mental health unit to treat detainees held around Australia. But he also recommends that Baxter replace its mental health service sub-contractors with the state government providers that also appeared to botch her care.
German-born Ms Rau, who called herself Anna Brotmeyer, was wrongly detained for 10 months in immigration detention, including four months at Baxter.
Mr Palmer reveals it took almost three months, three direct requests and the eventual intervention of South Australia's mental health chief for sub-contracted medical staff at Baxter to organise with state mental health services to assess and commit Ms Rau.
Mr Palmer concludes "cumbersome" medical sub-contracting arrangements made by GSL, the private operator at Baxter, meant "there was an apparent lack of leadership, a lack of cohesion and a lack of a systematic approach to deal with continuity of care".
"It would be in the interests of good patient care to minimise the number and tiers of separate healthcare," he says.
Mr Palmer says that when two hunger-striking detainees from Baxter were admitted on New Year's Eve, admitting Ms Rau was then "likely to be resisted by Glenside (psychiatric hospital in Adelaide)".
Although a Baxter medical doctor diagnosed Ms Rau with "schizoid or schizotypal personality features" on January 7, "following discussions with a Glenside psychiatrist it was agreed that (Rau's) behaviour would not justify detention under the mental health act at that time", Mr Palmer says.
"It was obvious to the inquiry that in South Australia the two systems operate to the detriment of the potential patient -- the Baxter system of privately contracted clinicians and the SA government mental health system."
Six days after Mr Rau was admitted to Baxter in October last year under the name of Anna Brotmeyer, a psychologist diagnosed a personality disorder. But a recommended transfer to the all-female compound at Villawood detention centre in Sydney was not pursued.
In early November, Baxter's consultant psychiatrist, in his only consultation with Ms Rau, recommended she be assessed at Glenside.
But the state's Remote and Rural Mental Health Service triage team, which was to carry out the assessment, "seemed unsure of their relationship with Baxter" and failed to get back with clarification, Mr Palmer finds.
The team removed Ms Rau from their books for in-patient placement and did not notify Baxter staff. When the Baxter psychologist then sent a fax of patient notes to Glenside, the "information was insufficient to re-activate (Ms Rau's) place on the waiting list for assessment. They neglected to inform the Baxter staff."
Less than a week after Mr Palmer completed and began circulating his draft early this month, Immigration Minister Amanda Vanstone offered new temporary bridging visas to 50 long-term detainees.
Among them were nine receiving treatment for severe depression at Glenside and almost 20 at Baxter.
Source:
http://www.theaustralian.news.com.au/common/story_page/0,5744,15764026%5E601,00.html
