New rules to stop struggles between jail, health staff over suicidal inmates

ACT Health staff, not corrections officials, are now responsible for carrying out suicide and self-harm assessments in the Alexander Maconochie Centre.

It comes nearly 20 months after a secret briefing warned that tensions between the two services were making it "impossible" to deliver coordinated mental healthcare in the jail.

"Both ACT Health and ACT Corrective Services continue to strive to realise best-practice and standards for detainees through continuous quality improvement. This policy is part of that process," a Justice and Community Safety Directorate spokeswoman said.

The 2016 ACT Detainee Health and Wellbeing Survey revealed over half (54 per cent) of inmates had received one or more mental health diagnoses in their lifetime.

About 42 per cent had been diagnosed with depression, 29 per cent with an anxiety disorder and 27 per cent with a substance abuse disorder.

There are currently eight detainees classified as "at-risk" out of a total of 481 inmates, and the latest figures show around 17 per cent of inmates were receiving treatment from the mental health team.

But testimony about the strained relations between ACT Health and ACT Corrective Services staff was aired in the coroner's court after the suicide of an AMC inmate in 2013.

The inmate, who had a history of mental illness and suicidal thoughts, was marked as an at-risk prisoner and placed in the jail's 10-bed crisis support unit.

He was moved out of the unit three weeks later into a health ward after his condition improved, although he was still telling nurses and psychiatrists that he would likely kill himself in the future.

On the day of his death, a psychiatrist rated him to be a moderate to high risk of suicide in the longer term, but a lower risk in the short term.

However she was not told he had been moved to the health ward, that he was with another inmate, or of the potentially dangerous bathroom fixtures in the health ware ensuite.

The health ward was also isolated from other parts of the jail and its suitability for at-risk prisoners had not been assessed.

His death reportedly accelerated a review of the treatment of mentally ill inmates already under way.

In 2016, a confidential briefing obtained by Fairfax Media spoke of "explicit tensions" between ACT Health's forensic mental health service and ACT Corrective Services psychological and support services.

It said the forensic mental health team was being "undermined", "marginalised", and "micro-managed" by staff psychiatrists, with their input "ignored" during meetings to assess inmates wanting to self-harm.

It also said ACT Corrective Services psychological and support services appeared to be in charge of dealing with suicidal detainees, but were "not actively engaging clients in a clinically relevant way to reduce suicidality".

A review of mental health services at the jail was handed to government in June 2017.

Fairfax Media requested a copy under freedom of information laws in October, but the document that was released in January had any assessment, opinion or recommendations redacted.

However the Justice and Community Safety Directorate spokeswoman said the new code was in line with the recommendations of the review.

"The Review of Mental Health Services at the Alexander Maconochie Centre undertaken in 2017 recommended that the accountability for the assessment of suicide and self-harm return to ACT Health," she said.

"The ACT government accepted this recommendation and as a consequence of implementation both the operating policy and procedure have required updating to reflect the changes in service delivery.

"These documents reflect current practice and aim to provide high levels of support for detainees. ACT Health and ACT Corrective Services jointly developed the policy and operating procedure."

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