Are our policies and laws leading to treatment delays for people with schizophrenia?

Under Australian mental health laws, people with schizophrenia can only be involuntarily committed to a mental health facility if they are assessed and it is determined that their illness is making them dangerous to themselves or others. To determine whether they are to undergo involuntary treatment, mental health workers must assess people against an ‘Obligatory Dangerousness Criterion’. This criterion is an advance on methods used prior to the mid-1970s, when many countries authorised involuntary commitment to a mental health facility on medical certification alone, without court approval or any proof of an emergency situation. An Obligatory Dangerousness Criterion is now widely used in Australia, the USA, and some areas of Canada and Europe as the means by which patients are assessed for the appropriateness of involuntary (compulsory) treatment. There is no doubt the policy underpinning its use was well intentioned; an Obligatory Dangerousness Criterion was originally developed in an attempt to bett er balance the rights of the mentally ill with the need to protect the public. However, over time some experts have begun to raise questions about the utility of this criterion, suggesting that it sometimes means patients don’t get access to necessary treatment as quickly as they should