A review of CCTV use across inpatient units has returned alarming results. Now the case for change is overwhelming, writes patient advocate Karyn Black.

Last year I became aware that closed circuit television was being used in adult mental health inpatient units in New Zealand. The reasons for this video surveillance ranged from property damage and patient behaviour to poor visibility of the hospital environment. This discovery prompted me undertake a national audit, using the Official Information Act to find out how widespread the use of cameras was in adult inpatient units. The results were alarming.

It turns out that over 60% of our adult inpatient units are utilising this technology to some extent. More troubling is that at least five have CCTV operating in what would be defined as treatment areas. This poses a number of concerns, especially given that the Mental Health (Compulsory Assessment and Treatment) Act 1992 expressly prohibits the use of audio or video recording of treatment without patient consent.

There are a total of 20 adult mental health inpatient units operating across New Zealand. In 2015, 14,500 people had an admission to one of these units, and on any given day 654 people are subject to an inpatient treatment order. An inpatient treatment order means a person is detained in hospital for a period of time and must comply with treatment.

When undertaking the CCTV audit the majority of District Health Boards justified the use of video surveillance saying it improved safety for patients, staff and visitors. When reviewing the literature relating to CCTV use, however, there seems to be little evidence to suggest CCTV reduced violent incidents within mental health inpatient units. Put bluntly: this technology is not a helpful tool for improving safety.

Part of the problem is the continuing stigma and stereotyping faced by mental health patients. Recently we have heard stories of our inpatient units becoming increasingly dangerous workplaces. A 2014 article in Kai Tiaki – a magazine produced by the New Zealand Nurses Organisation – stated there were 4,821 reported assaults on staff nationwide between 2010 and 2012, and last year the Bay of Plenty Times reported on staff safety concerns at Tauranga Hospital’s mental health inpatient unit.

Unfortunately, the narratives of these stories tend to play into the public’s perception of the violent and dangerous mental health patient – narratives that are not only damaging and incorrect, but that neglect a crucial perspective. The reports often focus solely on staff experiences of violence, ignoring the violence experienced by people actually using mental health services. Conversely, there seems to be limited acknowledgement of the violent nature of mental health services themselves, and a refusal to recognise some of the institutionalised violence of the system, such as forced detention, locked wards, physical restraint, seclusion and enforced medication. Any consideration of safety needs to take into account the experiences of people using these services.

The process of compulsory assessment and treatment is determined by The Mental Health (Compulsory Assessment and Treatment) Act 1992. Commonly referred to as the Mental Health Act, it has been described as a compromise between competing demands: the demand of the medical profession to assess and treat people deemed to be mentally disordered, and the demand for greater respect of patient dignity.

Part 6 of the Act sets out the rights of patients subject to compulsory treatment, including the specific question of video or audio recordings:

(1) Every patient is entitled to be informed where it is intended to make or use a videotape or other visual or audio recording of any interview with, or any other part of the treatment of the patient.

(2) Nothing referred to in subsection (1) shall be done without the prior consent of the patient or (where the patient is not capable of giving consent) the prior consent of the patient’s personal representative.

These two clauses highlight the need for patients to be informed of recordings being made when receiving treatment, and that consent must be given for this to occur. Whether CCTV in inpatient units is legal is therefore dependent on the definition of “treatment” and whether consent is given.

The Mental Health Act doesn’t define “treatment”, but a definition has been incorporated into law by the courts. According to this definition, treatment includes nursing interventions, occupational therapy programs, psychological therapy sessions, support from cultural staff, and medication support – all of which occurs inside inpatient units and in areas where CCTV is currently operating.

Inpatient units must inform patients of the presence of CCTV and gain consent before taking visual recordings. Currently this is not happening, and if patients are not informed such surveillance is under way, they obviously cannot provide consent. Looking at policy documents obtained from DHBs with CCTV in treatment areas, there is not a single instance where a consent process is mentioned in regards to its use.

Given it came into law in 1992, the act predates the widespread use of CCTV. That in no way excuses its presence inside units and in treatment areas, however. Nor can it be an issue simply of amending the legislation. In a survey distributed among service users in the Auckland region, an overwhelming 78% disagreed with the use of CCTV inside units. Given this, the likelihood of gaining patient consent to be filmed is very low indeed.

If we are serious about improving the safety of inpatient units, we must consider these issues and bring the voice of the service user to the forefront of any further discussions. In the same survey, another question asked: “What would improve safety in a mental health inpatient unit?” Responses indicate that what was most important was not CCTV or security staff, but increased access to peer support, day programs and activities, outside garden areas, quiet spaces and sensory modulation. This view of safety is more about enhancing the therapeutic environment positively and improving wellbeing, rather than restriction and control.

As a result of this nationwide review of CCTV use, it couldn’t be clearer to me that there needs to be change. The use of such equipment in treatment areas is plainly illegal; even if it weren’t, all the research suggests it is neither helpful nor effective as a tool for addressing safety. There must be better alternatives to the issue of well-being – ideas that take into account the violence inherent in the institution of psychiatry, ideas which acknowledge that a culture of custodial care and surveillance can only beget negative responses. A good starting point is to uphold patient rights: to make a positive step and remove cameras from all treatment areas.

Karyn Black is a mental health advocate with Kāhui Tū Kaha in the Auckland region. She is also a member of CAPO, a direct action community group addressing psychiatric oppression in Aotearoa.

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With his death going viral, Nigel the Mana Island gannet joins a proud tradition of New Zealand celebrity animals. Calum Henderson pays tribute to the creatures we’ve loved and lost.

This article was first published in February 2018.

A dead gannet is the latest New Zealand animal to attain celebrity status. Nigel, of Mana Island, made headlines around the world last week after the heartbreaking details of his death went viral. Nigel died alone after unsuccessfully courting a concrete decoy gannet on the island for the last four years.

The pitiable seabird is yet another chapter in New Zealand’s proud history of celebrity animals. Over the years a lack of interesting human celebrities has meant we have had to turn to different species to fill the void. A cat, a sheep, several dogs, an otter – all have achieved a level of fame most of us will never know.

The emergence of a new celebrity animal can lift the spirit of the whole nation. Usually they are pure, wholesome figures – blank canvases onto which we can project our innermost hopes and fears. Unlike their human counterparts, our animal celebrities rarely let us down.

It’s time we paid tribute to the celebrity animals who have inspired us through the years in the best way we know how: by assigning them arbitrary rankings.

15. Happy Feet (Penguin)

An Antarctic Emperor Penguin who somehow ended up on the Kapiti Coast, Happy Feet quickly rose to celebrity status in 2011. His arrival the same month that beloved sheep Shrek died seemed to be the universe’s way of telling New Zealand everything would be alright, that there would always be a celebrity animal to guide us. After racking up tens of thousands of dollars in medical bills at Wellington Zoo, Happy Feet was eventually put on a ship to the Campbell Islands, but the penguin’s newly-fitted transmitter lost its signal just days after his release.

14. Kaikoura Cows

Nothing illustrates New Zealand’s hunger for celebrity animals better than the cows who got stuck following the Kaikoura earthquake in 2016. While many human lives were thrown into disarray by the quake, the only ones anybody watching from afar seemed to care about were the three marooned cows after footage of their plight went viral. They were eventually rescued and returned to anonymity.

13. Sirocco (Kākāpō)

A member of the exclusive group of New Zealand celebrities famous for having a sexual encounter involving a visiting international star. Plump kākāpō Sirocco achieved viral notoriety in 2009 after performing an avian sex act on the head of zoologist Mark Carwardine during filming of the Stephen Fry documentary Last Chance to See. In another example of a sexual indiscretion failing to hinder the career of a male celebrity, Sirocco was appointed an official spokesbird for conservation by Prime Minister John Key in 2010.

12. Paddles (Cat)

In the entire history of the nzherald.co.nz Breaking News banner, few have been more shocking than the one last year announcing the death of Paddles in a traffic accident. In a matter of months the ginger and white polydactyl cat adopted by prime minister Jacinda Ardern and partner Clarke Gayford had achieved a level of celebrity never before seen by a parliamentary pet. Destined to be one of the great celebrity animals, she was taken too soon.

11. The Hore Seal

Some of the most famous names in New Zealand history are those of murder victims. In 2005 a fur seal rose to fame in such fashion after being shot and killed by three men aboard a fishing vessel off the Otago Peninsula. Among the three was All Black Andrew Hore. The 83-test hooker, then 26 years old, pleaded guilty and was fined $2,500 for his part in the slaying of the protected marine mammal.

10. Spot (Dog)

Like Beaurepaires spokesman Vince Martin, Spot was an Australian who became an honorary New Zealander by virtue of his outstanding run of TV commercials. The talented Jack Russell served as a brand ambassador for Telecom throughout the 1990s, during which time the arrival of a new Spot ad was a cause for celebration across the country. Spot died of old age in 2000.

9. Charisma (Horse)

New Zealand’s most accomplished animal athlete, Charisma rose to fame after winning a gold medal with rider Mark Todd in Individual Eventing at the 1984 Summer Olympic Games. The pair added a second gold medal in the same event at the 1988 games in Seoul, cementing Charisma’s reputation as one of our greatest sporting role models. He died on Todd’s Cambridge farm in 2003. He was 30.

8. Kashin (Elephant)

A long-serving corporate mascot for ASB Bank, Kashin was one of New Zealand’s most beloved celebrity animals for decades. Originally conceived as an advertising symbol for the bank in 1964, the real-life Kashin was gifted to Auckland Zoo by ASB in 1972. A crowd favourite at the zoo until her death in 2009, the memory of Kashin is now preserved in the form of thousands of plastic money boxes belonging to children nationwide.

7. Nigel (Gannet)

A tortured, romantic soul who achieved fame only after death. We haven’t really seen a celebrity animal like Nigel before, his story resonating as it does on such a deep level. Only in time may we come to realise his true legacy.

6. Dexter (Dog)

The Tux Wonder Dogs mascot from 1993 until his death in 2000, Dexter was New Zealand’s golden lab. The sight of him relaxing next to his owner, host Mark Leishman, brought great comfort and joy to the nation on a weekly basis. He was a good boy and looked very handsome in a neckerchief.

5. Shrek (Sheep)

New Zealand has never gone more hard out over a celebrity animal than when an unshorn merino was found on Bendigo Station in Central Otago in 2004. Dubbed Shrek the Sheep, the woolly creature was an overnight sensation, visiting parliament and being shorn live on Holmes. By 2006 Shrek was still famous enough to be put on a helicopter and flown out to an iceberg floating off the coast of Dunedin, where he was shorn again. Shrek was euthanised in 2011 at the age of 16.

4. Jin (Otter)

Many animals have escaped from New Zealand zoos over the years but few have survived as long in the wild as Jin. The Asiatic short-clawed otter’s 2006 escape from Auckland Zoo was one of this country’s most exciting fugitive episodes, with sightings on the North Shore stoking the fires of speculation for weeks. After 26 days on the lam, she was finally captured by zookeepers on Rangitoto, and eventually relocated to Wellington Zoo, where she died in 2010.

3. Opo (Dolphin)

New Zealand’s modern obsession with celebrity animals can probably be traced back to one friendly bottlenose dolphin. Opo rose to fame in the summer of 1955 after gaining a reputation for playing with children in the waters at Opononi. People flocked from far and wide to swim with Opo, but like so many celebrities her life was cut tragically short, being found dead under suspicious circumstances March 1956. Opo is memorialised by a statue in Opononi and was the subject of songs, children’s books and multiple documentaries.

2. Rastus (Cat)

Considering most cats will flee at the sound of a vacuum cleaner, the fact that one willingly rode a motorbike is nothing short of incredible. Rastus, with the help of owner Max Corkill, was one of New Zealand’s most philanthropic animal celebrities, raising money for the SPCA and other charities on his many rides. The pair were tragically killed in a collision with a drunk driver in 1998.

1. The Canterbury Panther

New Zealand’s most reclusive celebrity animal has been the subject of intense speculation since its first possible sighting in 1996. A large black cat, believed to be a panther or puma, has been spotted in Canterbury on several occasions over the last two decades. The most compelling evidence of its existence remains this 2011 video, in which a man can be heard uttering the words “that’s not a fuckin’ cat … that’s fuckin’ huge!”