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Misguided Psychological Evidence is conjecture & The Limits of Expert Evidence Food for thought & discussion re ACC contracted"Experts"

#21 User is offline   Determined 

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Posted 25 March 2013 - 09:41 AM

 hukildaspida, on 21 July 2009 - 02:57 PM, said:

Found this whilst reading NZlawyer magazine which is worth subscribing to & hope it helps you all in some way.
We appreciate this is in the Criminal Court jurisdiction, however there is no reason why it shouldn't be challenged elsewhere.

It is something that needs debate on in public.


http://www.nzlawyermagazine.co.nz/Archives...93/Default.aspx

Of note in Chief Justice Gleesons decision paragraphs Misguided psychological evidence of conjecture
44(I) and The Limits of expert evidence


Have the 'Expert' opinions Reports ever been challenged Legally in this way with ACC Assessors?


http://www.nzlawyermagazine.co.nz


That's a very good reference: http://www.nzlawyerm...93/Default.aspx
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#22 User is offline   hukildaspida 

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Posted 25 March 2013 - 04:07 PM

Thanks for your appreciation of our finds 'Determined', special thanks to those whom provided us the resource in the first place.

 Determined, on 25 March 2013 - 09:41 AM, said:

That's a very good reference: http://www.nzlawyerm...93/Default.aspx

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#23 User is offline   Compassion 

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Posted 25 March 2013 - 09:15 PM

 Alan Thomas, on 09 March 2013 - 11:02 AM, said:

By way of legislation the ACC as administrators of the act are be sold the terminators of fact when it comes to determining it's own liability.

In order to determine its own liability it is required to collect all relevant information.

I note that the ACC heavily promote what they call "best practice medicine" which in effect flies in the face of the "gold standard" of medicine.

Best practice medicine is a peer review style of approach whereby diagnosis is achieved by way of balance of probability set against statistical information. In this way a bell curve of information is created. However when you introduce the funding of the treatment and treatment provider you introduce a bias whereby the bell curve is progressively shifted. This approach proof beyond reasonable doubt that the so-called "best practice medicine" is quackery.

The scientific approach, "Gold standard", is for the medical expert to examine the patient and for the medical expert to rely upon their own expertise and when deemed appropriate superior specialist consultation to determine a proper diagnosis, treatment protocols and prognosis. The system relies upon ongoing study and peer review and is not driven by statistical probability.


I wander if this bias and people being told their injury is 'spent' actually further puts these statistics out of whack, I mean if they put percentages of those who's backs had healed by being 'spent' (ie diagnosed by one of their con men/women) then other drs look at the stats and go, well 90% are surposedly better by then....
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#24 User is offline   Determined 

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Posted 27 March 2013 - 07:24 AM

 Compassion, on 25 March 2013 - 09:15 PM, said:

I wander if this bias and people being told their injury is 'spent' actually further puts these statistics out of whack, I mean if they put percentages of those who's backs had healed by being 'spent' (ie diagnosed by one of their con men/women) then other drs look at the stats and go, well 90% are surposedly better by then....

Amongst the questions I asked under the OIA (which weren't answered) were:
1. How many new claims were there for back injuries (and also for head injuries) for each of the last 5 years; and
2. How many long term claims were there for back injuries (and also for head injuries) for each of the last 5 years.
(I did not ask how many of the new claims were active more than one year after the injury because of the stone-walling with ACC saying that those types of stats were too hard to provide)

Even answers to these 2 simple questions would have provided a percentage worthy of analysis. I suspect that the statistics would have shown that well under 10% of head or back injuries were active after 1 year. Otherwise ACC would have jumped at the opportunity to supply the data.

We're talking "impression management" here. The "mis-information" group at ACC is choosing what data to give (and mainly what to withhold) to create impressions that are misleading.

Whether lies of commission or omission - they are still lies.

http://truthliesdece....blogspot.co.nz
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#25 User is offline   hukildaspida 

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Posted 14 April 2013 - 02:44 PM

'Psychiatric Asbos' were an error says key advisor

Former champion says public safety fears led to adoption of measures that seriously curtailed patients' freedoms
Sanchez Manning

http://www.independe...or-8572138.html

Controversial powers to treat mental health patients in the community while seriously curtailing their freedoms have been criticised by one of their strongest supporters.

Popularly known as "psychiatric Asbos", Community Treatment Orders (CTOs) were introduced five years ago after a series of high-profile cases that involved mentally ill people attacking members of the public. The draconian measures have now been shown to make no clinical difference – and the psychiatrist who championed them is calling for their immediate suspension.

CTOs gave doctors legal authority to impose conditions on their patients after they are released from hospital such as where they must live, what drugs they must take and even how much alcohol they could consume.

If they broke any of these stipulations they could be immediately recalled and sectioned to a psychiatric unit.

It was hoped that the orders would strengthen psychiatrists' ability to ensure patients stuck to their treatment programmes after being discharged.

According to NHS figures, the number of people placed on CTOs has risen steadily since they were first brought in five years ago. The latest statistics show that in 2012 there were 4,764 people subject to orders – 473 more than in 2011, which amounts to an 11 per cent rise.

Now Tom Burns, the psychiatrist who originally advised the government on CTOs, has also come to the conclusion they are ineffective and unnecessary. Professor Burns, once a strong supporter of the new powers, said he has been forced to change his mind after a study he conducted proved the orders "don't work".

CTOs were introduced with the aim of reducing the number of readmissions of patients who were regularly in and out of hospital by compelling them to take their medication.

But after leading the UK's largest randomised trial of CTOs, Professor Burns has discovered that they made absolutely no difference to these so-called "revolving door" patients.

"The evidence is now strong that the use of CTOs does not confer early patient benefits despite substantial curtailment of individual freedoms," said Professor Burns, who is head of the social psychiatry department at Oxford University.

"Their current high usage should be urgently reviewed. I think there should be a moratorium on their use at least for a year or so while we think through how we can improve on the quality of evidence we've got. If we can't do that I think it really is unjustified to continue to use them."

In the study, researchers compared two separate groups of mentally ill patients to test if they experienced fewer hospital admissions. The first set of 166 patients were under CTOs, which can initially last for up to six months and can be renewed at the end of this period. Meanwhile, the other 167 participants tested had been placed on Section 17 leave, which is intended to be only a very short-term solution and can last a matter of days.

Their findings, published in The Lancet this month, revealed that 36 per cent of patients in both groups were readmitted to hospital within one year. There were no significant differences between the two groups in terms of the frequency and duration of admissions, the study found.

Both sets of patients were also remarkably similar in their social and medical outcomes.

Professor Burns added: "We were all a bit stunned by the result, but it was very clear data and we got a crystal clear result. So I've had to change my mind. I think sadly – because I've supported them for 20-odd years – the evidence is staring us in the face that CTOs don't work."

The legislation was conceived in the late 1990s in the wake of growing public anxiety about mentally ill patients committing unprovoked attacks because they were failing to take their medication.

This climate of fear had been fuelled by a series of high-profile attacks on unsuspecting victims by patients who had been released into the community. The most famous case was that of the paranoid schizophrenic Christopher Clunis who killed commuter Jonathan Zito on a train platform in London in 1992.

It was against this backdrop that CTOs were brought in as a central plank of the government's controversial 2007 Mental Health Act. But opponents to the legislation – including this newspaper – argued that the restrictions CTOs placed on patients' basic freedoms were unjustified.

A major objection was that research into their use in other countries had shown they had little effect when it came to keeping people on their medication and out of hospital. Matilda Macattram, director of Black Mental Health UK, said the latest findings came as no surprise. Concerns have previously been raised about CTOs being given to disproportionate numbers of black and ethnic minority patients.

"One of our key concerns when they were introduced was they would extend compulsion and erode the liberty of people who are currently subject to the most coercive treatment in the service. They are just a wholesale violation of the human rights of one of society's most vulnerable groups," she said.

Simon Lawton-Smith, head of policy at the charity the Mental Health Foundation, said the decision to bring in CTOs had been politically driven by the public's fear of attacks. He said the government pressed ahead with the plan in the face of huge opposition and research commissioned by the Department of Health which concluded the orders brought little benefit. He said: "Stranger danger was a serious element behind it."

The Care Quality Commission has also expressed worries about the overuse of CTOs. In February, it concluded the orders had contributed to an increase in the number of mental health patients being detained because patients were being kept on them for long periods. Patients subject to orders expressed concerns that it was difficult to get off them and regain control of their own lives.

But Mr Lawton-Smith cautioned that while Professor Burns's research has shown there are no overall benefits from the wide use of CTOs, the orders will still have helped some patients stay well in the community. "For one or two people, it may actually be doing the job it's meant to do, which is to keep them well, help them recover, help them have a social life, get into training and employment," he said.

A Department of Health spokesman said they welcomed the Burns report. He said: "We will consider the implications of this report carefully."

'My Community Treatment Order was the mental health equivalent of having a tag'

Paul Chapman had just got married when he was first placed on a Community Treatment Order (CTO) in 2009. He had a history of mental illness and had been admitted to hospital some 25 times since first being diagnosed with bipolar disorder and other forms of psychosis in 1991.

On this occasion, he had been sectioned to a psychiatric ward after he began hearing voices and his psychotic episodes re-ignited. After he absconded from the ward, his wife persuaded the hospital that he would be better cared for at home, so he was discharged on the CTO.

However, Paul, from Brigg in Lincolnshire, says what had first seemed like an attractive option turned into something less positive. The 46-year-old describes how being put on a CTO changed his relationship with his family and carer: rather than being based on empathy, it became a much more legalistic arrangement.

"Instead of them being concerned out of care and compassion for the problem I was having, there was reason for them to be responsible and have authority over me," he says.

"I think I had to be seen by my specialist care worker once a fortnight and there was a lockdown on medication – there was no messing with my medication. It was the mental health equivalent of having a tag. If I became unwell again or stopped taking my medication – like re-offending – I would have gone straight back into hospital."

After a few months, he inquired about being taken off the CTO but was turned down: "I felt stigmatised by it. Because of the nature of my condition, I felt other people might know and think, 'He must be bad, he's on a CTO'."

Paul was readmitted to a hospital last June after his psychosis returned.

Sanchez Manning
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#26 User is offline   hukildaspida 

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Posted 06 January 2014 - 11:49 AM

http://www.theguardi...ns-pilot-scheme


Mental health nurses to be posted in police stations

£25m pilot scheme to ensure people get the treatment they need and cut reoffending will initially run in 10 areas

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* The Guardian, Saturday 4 January 2014
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Mental health nurses to be posted in police stations
£25m pilot scheme to ensure people get the treatment they need and cut reoffending will initially run in 10 areas

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* The Guardian, Saturday 4 January 2014
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Norman Lamb, Home Office minister
Norman Lamb, care and support minister, said: 'Too often people with mental health illnesses who come into contact with the criminal justice system are only diagnosed when they reach prison.' Photograph: Anthony Devlin/PA Archive/Press Association Ima

Mental health nurses are to be posted in police stations and courts in a £25m pilot scheme designed to ensure people receive the treatment they need and cut reoffending rates.

The government scheme, which will initially run in 10 areas and be rolled out across the rest of the country by 2017 if successful, was welcomed by mental health campaigners, confident that it would prove its worth.

The majority of people who end up in prison have a mental health condition, a substance misuse problem or a learning disability and one in four has a severe mental health illness, such as chronic depression or psychosis.

"Too often people with mental health illnesses who come into contact with the criminal justice system are only diagnosed when they reach prison," said care and support minister Norman Lamb. "We want to help them get the right support and treatment as early as possible. Diverting the individual away from offending and helping to reduce the risk of more victims suffering due to further offences benefits everyone."

The money will be made available over the next year to bridge the gap between the police, courts and mental health services in Avon and Wiltshire, Coventry, Dorset, Leicester, London, Merseyside, South Essex, Sunderland and Middlesbrough, Sussex and Wakefield. The Department of Health said it would ensure people receive the treatment they need "at the earliest possible stage". It has been estimated that police officers spend 15% to 25% of their time dealing with people with mental health problems. Policing minister Damian Green said: "Officers should be focused on fighting crimes and people with mental health conditions should get the care they need as early as possible. These pilots will not only ensure that happens but in the longer term will help drive down reoffending by individuals who, with the right kind of treatment, can recover fully."

The scheme comes nearly five years after the landmark Bradley report said too many offenders with mental health difficulties and learning disabilities were ending up in prison without access to appropriate treatment. One of its recommendations was that all police stations and courts "should have access to liaison and diversion services".

Andy Bull, deputy chief executive of the Centre for Mental Health, said: "The fact that this is a new investment in a new form of service – or one that is patchy at present – is hugely encouraging. This will genuinely help a lot of people." But he said it was crucial that services were available when mental health issues had been identified.

Paul Jenkins, chief executive of Rethink Mental Illness, said there had been some frustration at the amount of time it had taken to implement such a scheme since the Bradley report, but welcomed the "really significant initiative", which he said would easily demonstrate its worth. "There's immense potential to divert people away from expensive prison sentences," he said. "But in the short term we might just see it be less hassle for the police in terms of processing people, which will also save money."
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#27 User is offline   unit1of2 

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Posted 06 January 2014 - 09:59 PM

I think it's just creating another level of costly intervention which leads to the same end. If suspected of mental health or similar then it's up to the police to track who the person is and follow the already process available to them... The Police are already trained in certain aspects of peoples behaviour, behavioural patterns etc. Again isn't it the Police who do the track and trace thereafter and guide the process and person in cuffs to the correct padded cell or cell with bars, or hospital bed. As it's their paid job to protect some folk even from themselves, as well as from others.

Or have I misread the above..? Forgive me if this is the case.


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#28 User is offline   Compassion 

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Posted 07 January 2014 - 11:09 AM

 unit1of2, on 06 January 2014 - 09:59 PM, said:

I think it's just creating another level of costly intervention which leads to the same end. If suspected of mental health or similar then it's up to the police to track who the person is and follow the already process available to them... The Police are already trained in certain aspects of peoples behaviour, behavioural patterns etc. Again isn't it the Police who do the track and trace thereafter and guide the process and person in cuffs to the correct padded cell or cell with bars, or hospital bed. As it's their paid job to protect some folk even from themselves, as well as from others.

Or have I misread the above..? Forgive me if this is the case.


I would of thought treating people in their own home more effective, afterall they are not going to offend at the police station? Perhaps having these nurses and mental health workers make visits and physically hand over the medication and just see where they are at during this visit. If they are not well,psychosis or lapse with alcohol etc then they can refer them to their psychiartrists, psychologists and counselling. Wouldn't this be more proactive, isn't this lack of consistent medication causing these crimes?
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#29 User is offline   unit1of2 

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Posted 07 January 2014 - 09:45 PM

 Compassion, on 07 January 2014 - 11:09 AM, said:

I would of thought treating people in their own home more effective, afterall they are not going to offend at the police station? Perhaps having these nurses and mental health workers make visits and physically hand over the medication and just see where they are at during this visit. If they are not well,psychosis or lapse with alcohol etc then they can refer them to their psychiartrists, psychologists and counselling. Wouldn't this be more proactive, isn't this lack of consistent medication causing these crimes?



In the posted topic they are referring to having Nurses placed in 'Police Stations'... due to the Police bringing in offenders. Some of these offenders are 'Mental health', simple drug and alchohol abusers. The Police 'ARE' actually trained to deal with these situations already. So I don't really understand what the real issue or deal is with this. It is already protecol to have a Doctor called in to assess. NOT a nurse...

Hahaha why don't they go the whole hog and set up a complete specialist Hospital ward at the Police station... My gawd... hahaha Oh hang on they maybe stupid enough to actually do it!! Only to find it wouldn't be a viable financial option after all.... cheaper to use a salaried Police officer to take them to the hospital to get 'actual specialist care'...by fully Qualified Mental Health Specialists....

If a person is flipped out on drugs or alchohol there would be NO-WAY really to determine if they are actually mental health patients until they have spent time in a cell on their own to detox, then they can be reassessed. A medical Doctor would have already have been called in to assess them on the initial phase and If 'psychotic or abnormal behaviour is suspected and they have a name for the person they do a Mental Health Register check for them, also a check on the Registered Drug User register is done. Adequate process follows..
If an unknown person is presented they are still checked by a DOCTOR and monitered with the usual procedures...

Again I scratch my head......
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#30 User is offline   hukildaspida 

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Posted 18 July 2014 - 05:53 PM

Jails struggle with mentally ill
High booking, release rates exacerbating the problem

By ADAM GELLER
AP National Writer

http://www.durangohe...h-mentally-ill-

Article Last Updated: Sunday, July 13, 2014 10:24pm

CHICAGO – The numbers, posted daily on the Cook County sheriff’s website, would be alarming at an urgent care clinic, let alone a jail: On a Wednesday, 36 percent of all new arrivals report having a mental illness. On a Friday, it’s 54 percent.

But inside the razor wire framing the 96-acre compound, the faces and voices of the newly arrested confirm its accidental role as Chicago’s treatment center of last resort for people with serious mental illnesses. It’s a job thrust on many of the nation’s 3,300 local jails, and like them, it is awash in a tide of bookings and releases that make it particularly unsuited for the task.

Peering through the chain link fence of an intake area holding pen, a 33-year-old man wrapped in a Navy varsity jacket leans toward clinical social worker Elli Petacque Montgomery, his bulging eyes a clue that something’s not right.

“They say I got bipolar, that’s all,” he says.

“OK, are you taking your meds?” she asks.

“When I can get them.”

Two pens over, a white-haired man with a cane huddles on a bench, booked in on a narcotics charge. He tells Montgomery he is haunted by visions of people he killed in the Vietnam War, and heroin eases the post-traumatic stress.

“I’m down here every day,” says Montgomery, deputy director of the sheriff’s office of mental-health policy. “Every morning, I hear this.”

The Cook County Jail, with more than 10,600 inmates, is one of the country’s largest single-site jails. But it is not unique. From big cities to rural counties, jails have seen a rise in the number of inmates with serious mental illnesses, most of them arrested for nonviolent crimes.

Unlike prisons – where inmates serve extended sentences – jails hold those trying to make bail while awaiting trial or serving shorter terms. U.S. jails hold about 731,000 people, less than half the 1.57 million in state and federal prisons. But last year, jails booked 11.7 million people – more than 19 times the number of new inmates arriving at prisons.

The revolving door greatly complicates the task of screening for mental illness, managing medications, providing care and ensuring inmate safety.

“Jails are churning people,” says Henry J. Steadman, a former New York state mental-health official and longtime consultant to government agencies across the country on how courts and correctional facilities deal with people with mental illnesses. “You can do things in prison, in terms of treatment and getting to know people, that is very difficult to do in a jail because of that constant movement.”

Experts have pointed to rising numbers of inmates with mental illnesses since the 1970s, not long after states began closing psychiatric hospitals without following through on promises to create and sustain comprehensive community-treatment programs.

But as the number of those with serious mental illnesses has climbed or surpassed 20 percent in some jails, many have struggled to keep up, sometimes putting inmates in jeopardy.

The Associated Press has reported at least nine of the 11 suicides in New York City jails over the past five years came after operators failed to follow safeguards designed to prevent self-harm by inmates. In one case, a mentally ill man hanged himself from a pipe on his third attempt after orders to put him on 24-hour watch were apparently ignored.

The AP’s investigation into the deaths of two mentally ill inmates at the city’s Rikers Island jail complex – one who essentially baked to death in a 101-degree cell in February and the other who sexually mutilated himself last fall – have prompted oversight hearings and promises of reform.

“The incredibly high intake rate makes it very difficult (for jailers) to do their job well because they operate in environments that are so chaotic,” says Amy Fettig, senior staff counsel at the American Civil Liberties Union’s National Prison Project, which has sued a number of jails to demand they provide federally mandated care and improve conditions for inmates with mental illnesses.

“Frankly, local jails have become the new social safety net for individuals with mental illnesses,” she says. “The only net that catches them is the criminal justice system.”
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#31 User is offline   hukildaspida 

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Posted 16 July 2015 - 12:56 PM

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 hukildaspida, on 21 July 2009 - 02:57 PM, said:

Found this whilst reading NZlawyer magazine which is worth subscribing to & hope it helps you all in some way.
We appreciate this is in the Criminal Court jurisdiction, however there is no reason why it shouldn't be challenged elsewhere.

It is something that needs debate on in public.


http://www.nzlawyermagazine.co.nz/Archives...93/Default.aspx

Of note in Chief Justice Gleesons decision paragraphs Misguided psychological evidence of conjecture
44(I) and The Limits of expert evidence


Have the 'Expert' opinions Reports ever been challenged Legally in this way with ACC Assessors?


http://www.nzlawyermagazine.co.nz

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