Comments on NSW Health Smoke-Free Policy

Mental Health Carers ARAFMI NSW Inc (ARAFMI) is grateful for the opportunity to comment on the, “NSW Health Smoke-Free Health Care Policy 2010”, about which we have sought comment from a selected group of carer members.

 It should first be noted that ARAFMI warmly supports measures to improve the physical health of mental health consumers, given the intimate links between physical and mental health at many levels.

 However, it is clear that the practical effect of mandatory closure of all on-site smoking areas on grounds controlled by NSW Health will be to force particularly involuntary mental health patients to stop smoking while receiving in-patient treatment.

 This involves the denial of a legal behaviour which publically funded bodies such as the Health Department do not have the right to coercively impose on vulnerable people requiring its services in times of personal crisis. None of the reasons advanced for this change are compelling.

 Further, this policy dramatically reverses recent developments in the progress of mental health consumer rights with regard to the provision of mental health treatment in Australia with the emphasis on respect for individuals’ choices and differences.

 Given the high rates of smoking among certain cohorts of people living with mental illness (in particular those suffering from schizophrenia) this will have a disproportionate impact upon the mentally ill. It will also certainly create increased levels of resentment and conflict between consumers and carers and treatment providers. It will also certainly cause consumers to abscond from treatment with a significant consequent increase in all of the attendant risks to which this exposes them and their carers.

 Given the difficulties already experienced by many carers in encouraging their loved ones to access and maintain necessary mental health treatment, this will create another obstacle to mental health treatment and another burden for carers which they simply do not need.

 Therefore ARAFMI does not support the withdrawal of the previous exemption of mental health patients from the smoke free policy and the mandatory closure of all on-site outdoor designated smoking areas.

 Instead ARAFMI would support the development with peer input of education targeted specifically at mental health consumers and provided to them when they are not in crisis but are able to make durable personal choices about their smoking behaviour as a far preferable means of addressing this issue.

(This is a summary of ARAFMI's submission)