Indeed, it is "bad medicine" + "bad brain doping (psychiatry)" to suddenly impose forced nicotine withdrawal on anyone unless there is some other majorly compelling reason.

..

But, if the last smoke you dispensed *Rhys* was the one that induced tongue cancer which resulted in the consequential loss of speech for the unintended victim, how would you feel?

..DOH!..

Or what about an individual who has been full on on the weed? They wouldn't be too happy about forced withdrawal either.

You could say, "But weed's illegal!"

To which some would reply, "Well weed never killed anyone, whereas people die from alcohol and cigarettes every day. ( &blows a raspberry for good measure! )"

...

Thus it begs the question as to whose law this is?

Is it a state law, or an internal head of department medical decision?

What indeed, is the view of the *Great BrainDoper?

Rhys Jones,
What about the right to a smoke free environment?

The smoke free policies are not based on depriving of individuals their “right to smoke”, but the rights of the majority to have a smoke free environment.

The utilitarian approach calls for the greatest good to the greatest number of people.

No one is forcing people to give up smoking. They are just being restricted from smoking whilst on the hospital grounds like everyone else. The mentally ill are not being singled out. When they eventually leave the hospital they are free to smoke again. Just like patients in the ICU and CCU.

The crux for some people seems to be more the broader issue of the restrictions placed on people when involuntarily admitted to a mental health facility. This is a bigger philosophical debate than what we are discussing here.

I have mentioned how we don’t allow the use of illicit drugs and alcohol whilst admitted to mental health facilities.

Does anyone feel that we should not be restricting drugs and alcohol from mental health facilities?

Maybe people need to have a look at why they draw the line where they do.

Dooey,
You suggested that a well ventilated, secure smoking area could be provided outside the bounds of the ward. But it would take a more than a little will, money and imagination. It would take a hell of a lot of will, money and imagination, as well as staff.

Maybe you can leave the health department some money and imagination in your will?

And how do you intend to provide the staff supervising these areas with a smoke free work place?

Having all these resources. How would you justify using it on well ventilated, secure smoking areas rather than more beds or other healthier services than smoking areas?

Is this really where people’s health priorities are?

Regarding my hypothetical

Whose smoke are you giving the girl?

Are you digging into your pocket?

As to what I would do: I wouldn’t provide a cigarette. Just as I would not provide alcohol to someone asking for alcohol.

I seem to recall that the Bentley facility had a lovely little outdoor area where people at that time (some 15+ years ago) could quite comfortably have a quiet durry without needing to infringe upon those who did not wish to participate in any form.

..

So, the point here between *Dooey* & *GadPhli* is mute.

..

Both parties, at least at that particular facility, could get what they wanted (after the initial admission period that is)at that point in time.

I gather though from what has been said by some of you here though that ban on smoking in guvment facilities has been extended to the outdoor area of the locked wards as well.

As to your hypothetical, you challenged readers to respond. I responded with what I would do. You have responded with what you would NOT do.

The focus of Rebekah’s opinion piece is the enforcement of a Smoke-Free policy NOT alcohol or any other substance that may be deemed ‘unhealthy’ or ‘illicit’. It’s about smoking bans and their impact on those patients not able to exercise freedom to go outside for a smoke. They are indeed, being ‘singled out’ because their circumstances are unique. What other patients can be held against their will?

To keep banging on about rights to a smoke-free environment for some and the right of others to smoke, and whose rights trump whose, only leads to being at loggerheads. Sometimes there can be no hard and fast rules because of special circumstances. Does a blind person have a right to take a dog into a cafe? Do I?

Perhaps a starting point could be to reopen the existing smokers courtyards, make them all-weather with the provision of an open shelter, install an exhaust system to draw off the smoke and use a self-closing door to prevent smoke drifting indoors. Just as nurses in the infectious diseases ward require safety equipment, then perhaps psych nurses who must supervise in a smoking area could be provided with masks or could supervise from behind glass.

Where there’s a will there’s a way.

Gadphli,
I mentioned earlier that the only restrictions we should be allowed to force upon involuntary mental patients are those that are clinically necessary. Unfortunately for those patients who enjoy drinking alcohol, this means they will not be able to do so during an inpatient admission as there is a powerful link between alcohol intoxication and violence, particularly in the context of a psychotic patient. Same goes for marijuana and speed. Therefore those prohibitions can be justified by the serious risk posed to the patient and others.
However, your assertion that the mentally ill are not being singled out is false. They are the "only" people who are not legally entitled to discharge themselves from the hospital. Even if you are in ICU you are entitled to refuse all treatment and be discharged. The practical consequences are that you may die, but this is every adults right. The only exception is those under the mental health act.
Whilst smoking indoors provides a significant risk from passive smoking to others, this has been banned for many years. The health risks from outdoor passive smoking are so small as to safely be ignored. There have been studies done which measure the amount of environmental smoke in outdoor areas and provided you are 2.7m away from the smoker, there are no detectable amounts in the air.
To ensure the outdoor smoking area is at least 3m away from all other areas should not be too hard to achieve.
The risk of violent assault from a distressed patient is a far greater OSH issue than the tiny amounts of second hand smoke you may be exposed to in an outdoor smoking area.

Posted by Rhys Jones, Friday, 5 August 2011 11:51:40 AM

" ... "

Yes, well said *Rhys* though I additionally wonder about circumstances that *Asylum Seekers* may find themselves in, and perhaps also those of *High Security Prisoners*

..

And of course, an individual in a psychotic state of consciousness who is paranoid and has a propensity towards violence can indeed be a danger to the public and themselves.

(But even problems such as this can be corrected with the "Best of Modern Medicine" shall I say.)

..

In fact,I believe that the prisons of this place are full of them.

..

Again, if this a law of the state, then you may not necessarily expect that it has the best interests of people in mind at all.

Just look at what they have done to children in the past, both the Original Australians, unwanted poms, kids down mines, stealing babies and the list goes on and on right up to what they are currently doing to the children of Asylum Seekers.

Now, I know that some of you like to think that "we are all wonderful" and "reasonable and rationale" and that we have nice little rules about talking nicely to each other etc etc HOWEVER, when you examine the history of this place, as well as some remnant mechanisms of the worst of the "evil" practices of the past, then it ought not surprise you *Rhys* that some people are made to suffer unnecessarily.