'The lack of a border scheduling (detention) arrangement actually makes cross border transport illegal and continues to be a major impediment to the safe management of these patients. There appears to be recent action by the Department of Human Services in South Australia to correct this problem.' (Exhibit C12, paragraph 6.2.1) South Australian law requires that detention may only be ordered by a Medical Practitioner, which is often impractical on the Anangu Pitjantjatjara Lands. Dr Torzillo commented: 'In our view the only way this could be overcome is that following discussion with a responsible Medical Officer for Nganampa Health Council, the Psychiatrist on-call for the Rural and Remote Psychiatry service (in Adelaide) is actually able to write a schedule (detention order) for the patient so as to initiate their transfer.' (Exhibit C12) I have mentioned these issues because they are relevant not only to the deaths of Kunmanara Ryan and Kunmanara Cooper, but possibly also to the other examples of self-harming behaviour which have been displayed on the Anangu Pitjantjatjara Lands in the last 18 months or so. Conclusions Clearly, there is room for improvement in the standard of mental health services on the Anangu Pitjantjatjara Lands, even though improvements have already been made. It is not possible for me to conclude, on the basis of the evidence before me, that the absence of psychiatric services on the Anangu Pitjantjatjara Lands had a direct causal relationship with any of the deaths before me. In particular: Kunmanara Ryan received periodic consultant psychiatric treatment from Dr Cord-Udy during 2003, and on the last occasion he gave no indication that he was suicidal or otherwise intent upon harming himself. On that basis, it cannot be argued that Kunmanara Ryan received a level of treatment which was less than that which might be expected in the metropolitan area of Adelaide (assuming that is the criterion), and it has not been established that a lack of psychiatric services played a part in Kunmanara Ryan’s death. Similarly, although there were difficulties during Kunmanara Cooper’s imprisonment both in Port Augusta and at James Nash House in Adelaide, he was
'The lack of a border scheduling (detention) arrangement actually makes cross border transport illegal and continues to be a major impediment to the safe management of these patients. There appears to be recent action by the Department of Human Services in South Australia to correct this problem.' (Exhibit C12, paragraph 6.2.1) South Australian law requires that detention may only be ordered by a Medical Practitioner, which is often impractical on the Anangu Pitjantjatjara Lands. Dr Torzillo commented: 'In our view the only way this could be overcome is that following discussion with a responsible Medical Officer for Nganampa Health Council, the Psychiatrist on-call for the Rural and Remote Psychiatry service (in Adelaide) is actually able to write a schedule (detention order) for the patient so as to initiate their transfer.' (Exhibit C12) I have mentioned these issues because they are relevant not only to the deaths of Kunmanara Ryan and Kunmanara Cooper, but possibly also to the other examples of self-harming behaviour which have been displayed on the Anangu Pitjantjatjara Lands in the last 18 months or so. Conclusions Clearly, there is room for improvement in the standard of mental health services on the Anangu Pitjantjatjara Lands, even though improvements have already been made. It is not possible for me to conclude, on the basis of the evidence before me, that the absence of psychiatric services on the Anangu Pitjantjatjara Lands had a direct causal relationship with any of the deaths before me. In particular: Kunmanara Ryan received periodic consultant psychiatric treatment from Dr Cord-Udy during 2003, and on the last occasion he gave no indication that he was suicidal or otherwise intent upon harming himself. On that basis, it cannot be argued that Kunmanara Ryan received a level of treatment which was less than that which might be expected in the metropolitan area of Adelaide (assuming that is the criterion), and it has not been established that a lack of psychiatric services played a part in Kunmanara Ryan’s death. Similarly, although there were difficulties during Kunmanara Cooper’s imprisonment both in Port Augusta and at James Nash House in Adelaide, he was
COOPER%20Kunmanara.docx