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22 Jul 2016

The AMA has raised serious concerns about the possibility that security authorities be given the power to access to mental health records as part of efforts to prevent so-called ‘lone wolf’ terror attacks.

In what he admitted would be a “huge step”, Prime Minister Malcolm Turnbull has asked Counter-Terrorism Coordinator Greg Moriarty to examine the possibility of police and intelligence service access to the mental health records of terrorist suspects as part of a review of the nation’s defences.

“It is important this be looked at carefully. Let me come to another point, you’ve got a number of important interests to balance here. Mental health alone, leaving aside issues of terrorism, is a gigantic challenge,” Mr Turnbull said. “But my most important obligation, my most important responsibility to Australia, is to keep the people of Australia safe, and so that is why we are constantly improving, upgrading our legislation – that is why we provide additional resources to our police and security services.”

But the AMA and other health groups have warned that such a breach of patient confidentiality was not only ethically problematic, but could also prove counter-productive by deterring people who need help from seeing a doctor.

“We would certainly not want any person to forego seeing their doctor, or modify the information they provide their doctor, because they fear their privacy will be breached,” an AMA spokeswoman told The Australian. “We also want to be extremely careful not to imply in any way that someone with a mental illness is inherently dangerous or automatically at risk of becoming radicalised. People with mental illness should not fear that their privacy will be breached or that they will be stigmatised in some way.”

The Prime Minister said a change in approach was necessary because of a recent spate of attacks, including in Orlando, Nice and Germany, suggested the terrorist threat was evolving to include individuals not previously considered to be a threat but who were socially, emotionally or mentally unstable and were susceptible to rapid radicalisation.

“What we are seeing at the moment is people being radicalised or adopting Islamist, murderous Islamist ideology very, very quickly. So that you have people that are not on the counter terrorism radar screen who then often, as a result of mental illness, will then attach themselves to this murderous ideology and then act very quickly,” Mr Turnbull said on radio 3AW. “They appear to be drawn to Islamist extremism very late and very fast, not necessarily because of a long-term religious or ideological belief, but as a means of filling a void and providing meaning or rationalisation. The Lindt Café attacker, who converted from Shia to Sunni in the days leading into the siege, might also fit this profile.”

But he admitted giving the security services access to mental health records would involve brushing aside “very significant privacy protections”.

There are also doubts about whether the huge breach of doctor-patient confidentiality involved would necessarily achieve much in detecting or heading off potential terror attacks.

Even if those contemplating undertaking a ‘lone wolf’ terror attack have a mental illness, they may not necessarily have sought treatment. Furthermore, they might be deterred from seeking care if they thought their health records could be accessed by the police or intelligence services, exacerbating their illness and potentially making them more of a threat to themselves and others.

Attorney-General Senator George Brandis said on ABC radio that doctors and health workers should report patients who show signs of being “susceptible” to radicalisation.

But Royal Australian and New Zealand College of Psychiatrists President, Dr Malcolm Hopwood, warned that asking doctors to dob in people simply on grounds of suspicion was dangerous.

Dr Hopwood said doctors already had an obligation to inform authorities if they believed a patient was at immediate risk, but Senator Brandis’s comments “suggests we might be nominating people to authorities who are not really yet showing any clear signs of risk to other people”.

“There’s a clear balance problem there with their right to privacy. If we breach privacy too readily, we run the risk of turning away people from mental health treatment because they won’t feel comfortable and confident they can talk about the things that concern them,” he said.

Mr Turnbull admitted that there would need to be a balance struck between patient confidentiality and being alerted to a possible terror attack.

Adrian Rollins  


Published: 22 Jul 2016