Evidence-based mental health law : the case for legislative change to allow earlier intervention in psychotic illness

Psychosis is a relatively common and severe mental disorder that results in impaired judgment and reasoning and is associated with an increased incidence of violence in the period before the initiation of treatment. Studies published since the Mental Health Act 1990 (New South Wales) was enacted have shown that the period before the emergence of acute symptoms (the prodrome) and first episode of illness carries a greatly increased risk of violence. It is also established that the longer-term prognosis is improved by early initiation of treatment. We believe the New South Wales Mental Health Act should be amended to reflect the scientific evidence of an increased risk of violence in the early stage of illness and the harm arising from delaying treatment. Emerging psychosis should be regarded as a medical emergency and the threshold for compulsory treatment for people in the early phase of psychotic illness should be lower.