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Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, April 28, 2024

I Suspect The Social Media Giants Are Slowly Loosing The Social License To Operate.

 This appeared a few days ago:

Surge of violence tests policy tolerance of social media

The Coalition in particular has to ask tricky questions of when enough is enough on social media platforms.

Laura Tingle Columnist

It has become a standard, if unfortunate, part of Australian politics in recent years for politicians to pick up and run with some incident to crystallise public sentiment on an issue and let the media debate rage on it.

Think African gangs, needles in strawberries, Woolworths not selling enough Australia Day merchandise.

You might notice that these have tended to be the preserve of the Coalition side of politics more than the Labor side.

That Labor doesn’t do it so much may be testament to their better angels, or to the fact they have just never been good at the particular style of politics.

But we now face a perfect firestorm of issues that challenge our community cohesion and present us with Australian society in all its ugliness.

It is a particularly complex set of issues that cannot be untangled from each other.

That makes this particular modus operandi dangerous for both those who might be tempted to practice it, and for the rest of us.

We all know social media has become an unwieldy force in politics around the globe. But our political leaders are now being forced to confront, in very specific terms, the really difficult questions thrown up about when enough is enough with social media.

A debate that has largely been framed in terms of freedom of speech has become conflated with a whole range of issues that now challenge us: from social cohesion, to terrorism, to domestic violence.

The killings, predominantly of women, at Bondi Junction and the stabbing attack on a bishop in the western Sydney suburb of Wakeley have come at a time of horrendously relentless killings of women, and amid heightened tensions provoked by the Gaza conflict.

Social media is a thread that has run through all these stories: from the misinformation and disinformation spread about the Bondi attacker while the attacks were still underway; to the livestreaming of the bishop’s church service and subsequent misinformation that led to a violent riot; to questions about the growing aggression of misogynistic online content directed towards young men; to online abuse and threats of violence levelled at anyone on either side of the Gaza conflict.

This week, the e-safety commissioner, Julie Inman Grant, took on X and Elon Musk in the Federal Court seeking to force X to take down 65 postings of graphic footage of the knife attack on the bishop in western Sydney.

She is seeking to do that under the powers the parliament granted her – under the Morrison government – in the Online Safety Act in 2021.

There are now two mighty struggles going on about how we communicate and debate each other in future.

While there had been a lot of political noise made in the wake of the Bondi attacks 48 hours earlier about dealing with the disinformation and the misinformation that had circulated at the time, the social media platforms are currently subject only to voluntary codes of conduct about removing inflammatory commentary and misinformation.

Legislation dealing with these issues is currently being considered, as are changes to the Online Safety Act – which was already under review before these attacks all happened.

The ground has now shifted under the political debates about the specifics of both those legislative developments.

But in the meantime, there are now two mighty struggles going on about how we communicate and debate each other in future.

One concerns the fight in the courts with Musk and his assertion that, in trying to force his company to take down the posts, the Australian government is not only hindering free speech, it is over-reaching into an attempt to dictate what can be seen online outside Australia’s borders.

The second struggle concerns the general position of our politicians about if, and how, we reset the terms of social media’s social contract. 

Dutton’s dilemma

The political leader in the more difficult position on this is the opposition leader, Peter Dutton, who not only faces divisions on this in his party – and in the conservative base – but also the problem of reconciling those divisions with his own strong views about social media when it comes to issues like law and order and child abuse.

It is instructive to look at comments Dutton made on April 8, before the Sydney attacks, about social media and its role in facilitating things like young people posting crimes like house-breaking or car theft online.

The social media companies, he said, have to “make sure that they take content down so that these young offenders don’t get the publicity that they’re seeking”.

The Coalition’s private members bill would set up the power to do this, he said.

“Because at the moment, a lot of people are living in fear and they’re worried about whether they’re going to be broken into again. It’s devastating, it’s confronting to have somebody coming into your bedroom or coming into your living area, particularly when you’ve got young children.”

In the wake of the Bondi and Wakeley attacks, Dutton told the ABC’s Insiders on Sunday that there was “no question at all [that tougher action needed to be taken against social media companies] and I think there’s a bipartisan position in relation to this”.

“We know that the companies – and we’ve seen some of the comments from Elon Musk overnight – they see themselves above the law. The Australian law here should apply equally in the real world as it does online ... you would be sued for defamation and you would be taken before the courts under various acts for publishing some of that which freely flows on the internet.

“They’re allowing paedophiles to distribute through their networks, images and videos of children being sexually abused, they’re impeding the investigations of the police.”

This issue of removing explicit content is the same one Inman Grant is trying to deal with over the bishop’s stabbing.

For some, including Senate crossbenchers Pauline Hanson and Ralph Babet, and the Institute of Public Affairs, this amounts to an attack on free speech.

Dutton also faces questions about his approach from some in his own ranks.

But he can’t really go too far on the question of removing violent content given his position on things like kids posting themselves breaking the law or child exploitation.

The fact that the Australian Federal Police and ASIO emerged this week to explicitly link the violent content with terror threats also highlights the difficulties for Dutton, given his tough line on national security.

Our national security officials told us the Wakeley footage could be used just as footage of the Christchurch terror attacks had been used by Isis as part of their recruitment of young men.

And we subsequently saw the arrest of five teenagers linked to the Wakeley attacker, some of whom we were told had just graphic content on their phones.

The even more difficult question becomes how parliaments and governments deal with misinformation and disinformation since it involves not just removing graphic images but people’s opinions and, therefore, becomes a much clearer debate about censorship and free speech.

When the government put up some draft laws to deal with this last year, the Coalition howled it down.

You would have to think the optics and the policy imperatives have changed.

Who wins and loses in the Federal Court is just one aspect of the battle ahead.

Here is the link:

https://www.afr.com/politics/federal/surge-of-violence-tests-policy-tolerance-of-social-media-20240422-p5fll7

Social media can be a force for both good and evil. For good it can educate and inform as well as assist people stay in contact and feel valued and supported.

For evil it is now clear social media can assist in radicalization as well as assist in the organization of malign forces and entities.

Frankly I think the time has now come for a great deal more responsibility to be attached to social media and for accountability to be demanded for dangerous and divisive social media activity.

On another tack there is also a problem with data-encryption and how it is used. It is clearly good when used to protect commercial transactions and the like – but maybe not so good when facilitating secret malign plotting and scheming!

I am presently not sure just how well those responsible for keeping ordinary citizens safe understand some of the malign forces circulating in our community and how they can lead to the attacks and stabbings seen recently.

There seems to be a well of psychopathy and distress that the community is yet to fully understand and come to grips with. There seems to be rather too many alienated and disenchanted souls out there we need to work harder as a community to reach and support.

Right now I am not all that sure social media is adding much to community health and cohesion – commercially driven as it is!

How do readers assess all this at present?

David.

AusHealthIT Poll Number 744 – Results – 28 April, 2024.

Here are the results of the poll.

Do We Still Need Specialised Clinics To Manage People Suffering From The Effects Of Prolonged COVID-19 Disease?

Yes                                                                              19 (54%)

No                                                                               16 (46%)

I Have No Idea                                                             0 (0%)

Total No. Of Votes: 35

An almost perfectly split vote with just a tiny vote in favour of specialised clinics

Any insights on the poll are welcome, as a comment, as usual!

A good number of votes.  

0 of 35 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.

Friday, April 26, 2024

Anxiety With The Potential Capabilities Of AI Is Certainly Rising!

This appeared last week:

Where do we draw the line on using AI in TV and film?

Recent controversies, including Civil War posters and altered photos in a Netflix documentary, have led to concern over the growing use of artificial intelligence on screen

Adrian Horton

Sat 20 Apr 2024 17.12 AEST  Last modified on Sat 20 Apr 2024 17.13 AEST

Though last year’s writers’ and actors’ strikes in Hollywood were about myriad factors, fair compensation and residual payments among them, one concern rose far above the others: the encroachment of generative AI – the type that can produce text, images and video – on people’s livelihoods. The use of generative AI in the content we watch, from film to television to large swaths of internet garbage, was a foregone conclusion; Pandora’s box has been opened. But the rallying cry, at the time, was that any protection secured against companies using AI to cut corners was a win, even if only for a three-year contract, as the development, deployment and adoption of this technology will be so swift.

That was no bluster. In the mere months since the writers’ and actors’ guilds made historic deals with the Alliance of Motion Picture and Television Producers (AMPTP), the average social media user has almost certainly encountered AI-generated material, whether they realized it or not. Efforts to curb pornographic AI deepfakes of celebrities have reached the notoriously recalcitrant and obtuse US Congress. The internet is now so rife with misinformation and conspiracies, and the existence of generative AI has so shredded what remained of shared reality, that a Kate Middleton AI deepfake video seemed, to many, a not unreasonable conclusion. (For the record, it was real.) Hollywood executives have already tested OpenAI’s forthcoming text-to-video program Sora, which caused the producer Tyler Perry to halt an $800m expansion of his studios in Atlanta because “jobs are going to be lost”.

In short, a lot of people are scared or at best wary, and for good reason. Which is all the more reason to pay attention to the little battles over AI, and not through a doomsday lens. For amid all the big stories on Taylor Swift deepfakes and potential job apocalypse, generative AI has crept into film and television in smaller ways – some potentially creative, some potentially ominous. In even just the past few weeks, numerous instances of AI legally used in and around creative projects are testing the waters for what audiences will notice or take, probing what is ethically passable.

There was a small social media flare-up over AI-generated band posters in the new season of True Detective, following some viewer concern over similarly small AI-generated interstitials in the indie horror film Late Night With Devil. (“The idea is that it’s so sad up there that some kid with AI made the posters for a loser Metal festival for boomers,” the True Detective showrunner, Issa López, said on X. “It was discussed. Ad nauseam.”) Both instances have that uncanny lacquer look of AI, as in the AI-generated credits of the 2023 Marvel show Secret Invasion. Same, too, with promotional posters for A24’s new film Civil War, depicting American landmarks destroyed by a fictional domestic conflict, such as a bombed-out Sphere in Las Vegas or the Marina Towers in Chicago, with trademark AI inaccuracies (cars with three doors, etc).

There’s been blowback from cinephiles over the use of AI enhancement (different from generative AI) to sharpen – or, depending on your view, oversaturate and ruin – existing films such as James Cameron’s True Lies for new DVD and Blu-ray releases. An obviously and openly marked AI trailer for a fake James Bond movie starring Henry Cavill and Margot Robbie – neither of whom are part of the franchise – has, as of this writing, over 2.6m views on YouTube.

And arguably most concerning, the website Futurism reported on what appear to be AI-generated or enhanced “photos” of Jennifer Pan, a woman convicted of murder-for-hire of her parents in 2010, in the new Netflix true crime documentary What Jennifer Did. The photos, which appear around the film’s 28-minute mark, are used to illustrate Pan’s high school friend Nam Nguyen’s description of her “bubbly, happy, confident, and very genuine” personality. Pan is laughing, throwing up the peace sign, smiling widely – with a noticeably too long front tooth, oddly spaced fingers, misshapen objects and, again, that weird, too-bright sheen. Film-maker Jeremy Grimaldi neither confirmed nor denied in an interview with the Toronto Star: “Any film-maker will use different tools, like Photoshop, in films,” he said. “The photos of Jennifer are real photos of her. The foreground is exactly her. The background has been anonymized to protect the source.” Netflix did not respond to a request for comment.

Grimaldi does not explain which tools were used to “anonymize” the background, or why certain features of Pan look distorted (her teeth, her fingers). But even if generative AI was not used, it’s still a troubling disclosure, in that it suggests a muddling of truth: that these are old photos of Pan, that there is a visual archive that does not exist as such. If it is generative AI, that would tip into straight-up archival lie. Such use would go directly against a suite of best-practice guidelines just put forth by a group of documentary producers called the Archival Producers Alliance, which rules in favor of using AI to lightly touch up or restore an image but advises against new creation, altering a primary source, or anything that would “change their meaning in ways that could mislead the audience.”

It’s this final point – misleading the audience – that I think is the growing consensus on what application of AI is or is not acceptable in TV and film. The “photos” in What Jennifer Did – absent a clear response, it’s unclear with what tools they were altered – recall the controversy over bits of Anthony Bourdain’s AI-generated voice in the 2021 documentary Roadrunner, which overshadowed a nuanced exploration of a complicated figure over an issue of disclosure, or lack thereof. The actual use of AI in that film was uncanny, but revivified evidence rather than created it; the issue was in how we found out about it, after the fact.

And so here we are again, litigating certain small details whose creation feels of utmost importance to consider, because it is. An openly AI-generated trailer for a fake James Bond movie is strange and, in my opinion, a waste of time, but at least clear on its intent. Creation of AI posters in shows where an artist could be hired feels like a corner cut, an inch given away, depressingly expected. AI used to generate a fake historical record would clearly be ethically dubious at best, truly manipulative at worst. Individually, these are all small instances of the line we’re all trying to identify, in real time. Collectively, it makes finding it seem more urgent than ever.

Here is the link:

https://www.theguardian.com/culture/2024/apr/20/artificial-intelligence-ai-movies-tv-film

This article makes a very good point that the capacity for deception and illusion has progressively amped up and we are now at a stage where the logical progression of what is being do is the cause for more than a little concern.

Just how all this will be managed in the future is very hard to predict but I fear it is not going to be easy or straightforward!

What do you think?

David.

Thursday, April 25, 2024

I Hope You Have A Respectful And Restful ANZAC Day!

Best wishes to all out veterans and all those marching!

It is an important day to remember all those who served and the many who paid a major sacrifice for what we now enjoy in the way of freedom and security.

I am very proud of all in my family who served or suffered at the hands of conflict. I was very lucky to miss out on any direct experience of conflict or loss but have seen the damage that resulted and remained from such conflicts!

Lest we forget!

David.


Wednesday, April 24, 2024

I Usually Stay Clear Of Politics But I Need To Add My Voice To Those Who Think Julian Assange Needs To Stay In An UK Or US Jail Until He Agrees To Shut Up Permanently.

 

I feel to man is clearly a deluded self-publicist with very few redeeming features and that is being polite!

Others clearly agree:

Assange’s sordid tale of treachery


Julian Assange is a criminal, a fabulist and an undisciplined, arrogant work-shy fraud who lacks an education while remaining a mannerless vulgarian. The WikiLeaks founder is no journalist.

By Alan Howe

April 20, 2024

Julian Assange is a criminal, a fabulist and an undisciplined, arrogant work-shy fraud who lacks an education while remaining a mannerless vulgarian.

In Assange’s fantasy world he is a warrior for justice; the truth is his WikiLeaks was a Trojan horse for hate. Assange did not set out to reveal what he believed to be the immoral, corrupt manner in which our allies in the West seek security in a dangerous world. He wanted to strafe the foundations of the complex, sensitive diplomatic communications that help keep us a step ahead of our enemies.

His betrayals raise him into treason’s hall of fame alongside Norway’s Nazi collaborator Vidkun Quisling, the Gunpowder Plot’s Guy Fawkes, and Marshal Philippe Petain who led Vichy France.

Et tu, Assange? No doubt. He is the Judas Iscariot of the digital age.

Assange describes himself as a journalist, editor and publisher. He is neither a journalist nor an editor – trained as either he would have handled his infamous leaks more responsibly – but he is certainly a publisher in the manner that so is anyone who posts a photograph of their kids on social media.

Recklessly dumping classified correspondence on a website is regarded as journalism by nobody.

Publisher too was Chelsea Manning who, while training in intelligence for the US Army, stole hundreds of thousands of secret files from her employer, hiding these in a CD dressed up as a copy of Lady Gaga’s The Fame album. Fame of sorts would come Manning’s way. She passed these files on to the recently established WikiLeaks.

It was being published from England by Townsville-born, Melbourne-raised Assange. He claims to have attended 37 schools but learnt very little at any of them, but he did study maths and computing at the University of Melbourne, leaving before any credentials loomed.

Assange first appeared on my radar in July 1995, when I edited a Melbourne newspaper and he was interviewed about drug “recipes” that could be found on the internet. He said anyone with a basic knowledge of pharmacology could make amphetamines, ecstasy, crack and “lots of versions of LSD”.

At the time he was part of a group of hackers and ran their operations from his mother’s house. Going by the name Splendide Mendax (roughly, glorious liar) Assange and his friends tricked their way into some significant websites in the days before computer security was so highly rated: it is estimated that today about 10 per cent of any company’s information technology budget is spent keeping out the likes of Assange.

In December the following year, court documents secured by The Australian show, Assange appeared at a pre-sentencing hearing in the Victorian County Court, where his crimes included hacking 11,000 computers owned by Canadian telecommunications company Northern Telecom. His Melbourne lawyer, Paul Galbally, told judge Leslie Ross: “One of the motives for these offences was that by leading on to these major computer sites, it gave you the power and enabled you to move from one site to the other.”

Ross believed Assange had wanted only to empower himself and had not sought personal gain, so he was spared a jail term but ordered to pay reparations of $2100.

The lucky hacker’s sense of victimhood was already well developed – it would flourish lavishly – and Assange told Ross “a great misjustice has been done and I would like to record the fact that you have been misled by the prosecution”.

He was, and remains, a first-class whinger. As former prime minister John Howard said more than a decade ago: “He’s just an attention seeker of the worst kind.”

When trying to attract the attention of London’s women, The Guardian reported, Assange went on a dating site using the pseudonym Harry Harrison and writing that he was 188cm tall and, according to the site’s online test, “87% slut”. “He began: ‘WARNING: Want a regular, down to earth guy? Keep moving … I am DANGER, ACHTUNG!’ ”

The 2010 WikiLeaks documents made Assange’s name and reputation. The tidal wave of documents was released to left-leaning newspapers, most of which had once been esteemed but by then were living off the momentum of the past. These included The Guardian, The New York Times, The Age and The Sydney Morning Herald.

All defence forces in all conflicts commit regrettable acts that end in the death of innocents.

Ten million civilians were killed in World War I, not too many intentionally but more than the number of combatants. It is estimated that perhaps 85 million people died during World War II, maybe 25 million of whom were combatants.

On the night of March 3, 1945, towards the end of that conflict the RAF mistakenly bombed the Dutch village of Bezuidenhout killing 532 locals. It’s war. It happens, as we saw with the recent accidental killing of aid workers in Gaza.

WikiLeaks’ most acclaimed exclusive was video of the killing of a group of Iraqis dubbed Collateral Murder. US soldiers in Baghdad had come under fire and sent up an Apache helicopter that spotted a group of locals, some appearing to hold military equipment.

The audio and vision of that episode reveal on-edge, no doubt inexperienced, young American soldiers watching these men. They fire upon them killing them all, including two Reuters journalists. It is a dreadful event. But it is also war. Inadvertent tragedy is regrettable but common. Were these killings avoidable? Perhaps.

The nature of communications between even allied nations is necessarily secret and robust. Who can forget WikiLeaks revealing that America’s man in Australia thought Australia’s then prime minister Kevin Rudd had made “significant blunders”, or that Rudd told a group of visiting US congressmen “the national security establishment in Australia was very pessimistic about the long-term prognosis for Afghanistan”.

But these sometimes petty, sometimes vindictive conversations allow the free flow of opinions between and about countries. The cogs of diplomacy would jam if leaders and diplomats thought nothing they uttered was private. It is why they were labelled secret and why Manning and Assange are guilty of towering crimes.

Paul Monk, a specialist in international relations, an author and former senior Australian intelligence analyst, has been monitoring the Assange case for years.

“There have always been people – most famously Daniel Ellsberg (who stole and released the Pentagon Papers revealing American strategies during the Vietnam war) – who have leaked things for what they believe to be principled reasons,” he says. “One can debate back and forth whether they made a correct judgment.” Monk insists Assange is not in that category.

“Assange has openly said that he wants to make it impossible for the diplomatic and security system to work,” Monk says, adding that Assange has character flaws rather than “some great insight into the ways our diplomatic services and intelligence agencies function”. Unlike Ellsberg, Assange had never worked inside and understood the system “he openly said he wanted to wreck”. He never understood what purposes it served. “He’s plainly intelligent, but somehow he became a self-obsessed narcissistic rebel.”

Ellsberg assumed he would be jailed for life for his crimes, the price he was prepared to pay for what he saw as a moral duty.

“Assange thinks it’s outrageous that they want to arrest him,” Monk says.

Manning passed the first files to WikiLeaks in February 2010. She was arrested in May and charged with theft, computer fraud and abuse, disobeying orders and, more seriously, aiding the enemy, for which an offender can be executed. Prosecutors did not seek the death penalty and on conviction Manning received a 35-year jail term that Barack Obama commuted after seven years.

Assange faces 18 charges in the US over the stolen WikiLeaks documents and could be sentenced to a combined, but improbable, 175 years. His pressing legal issue in 2010 was a series of possible charges of rape and sexual molestation arising from a visit to Sweden. Interpol posted a Red Notice seeking his arrest. He was detained briefly in London, bailed and continued working at WikiLeaks while dealing with the Swedish claims. Assange always denied them, but in August 2012 he sought asylum at the Ecuadorian embassy in London and was granted Ecuadorian citizenship.

Ecuador’s hypocritical left-wing president, Rafael Correa, hated his country’s free press but admired Assange. An embassy office was remodelled for him with a bathroom and kitchenette, and the embassy kitchen provided him with food – supporters sent him endless hampers from Harrods – and allowed him to buy a cat. But the house guest quickly turned into a house pest.

Assange reportedly was unclean, ungrateful and unmanageable. The Ecuadorians were patient with their unexpected lodger, whose stay cost them $10m, mostly on security. By 2019 they had enough, cancelled his citizenship and invited London police to enter and arrest him.

To describe his rooms as a pigsty is an insult to pigs. Ecuador’s ambassador, Jaime Marchan, took London’s Daily Mail through them, saying Assange “had to be reminded of normal standards of behaviour all the time. He would always leave the cooker on.” The veteran diplomat added: “The asylum system is to protect innocent people. (He) abused it. He is a predator.”

Marchan said the Australian had a disgusting way of protesting against what he thought unfair treatment: “When Assange wanted to be unpleasant he put excrement on the walls and underwear with excrement in the lavatory. We had to remind him to flush the toilet and clean the dishes.”

Assange – who was given the run of almost the entire embassy building in up-market Belgravia – played loud music and refused to clean up after his cat.

Marchan added with irritation: “We have proved Ecuador respects human rights but he didn’t comply with his obligations. He is very selfish. I told him, ‘One day you’ll realise how much Ecuador did to protect you.’ ”

These days Assange is held in Belmarsh prison, just outside Woolwich in southeast London. He has already written to King Charles to complain about his conditions. Other famous inmates have included disgraced former British cabinet member Jonathan Aitken, who described the jail’s “stillness of the morning … amazingly peaceful – Belmarsh was as quiet as a becalmed battleship”. One of author Jeffrey Archer’s most serious complaints when held there was not being able to purchase bottled Highland Spring water.

Acclaimed Scottish author Andrew O’Hagan was approached by a publisher to write Assange’s life story – to be known as WikiLeaks versus the World: My Story by Julian Assange – and for a time was embedded in the activist’s life as both men tested each other to see if it would work.

O’Hagan is Glaswegian tough, but he had never encountered anyone like his subject. By then Assange had fallen out with almost everybody, including the editors of the newspapers he had chosen to publish WikiLeaks. O’Hagan observed: “He had a strange, on-the-spectrum inability to see when he was becoming boring or demanding. He talked as if the world needed him to talk and never to stop. Oddly for a dissident, he had no questions.”

In between Assange boasting that Cuban dictator Fidel Castro had said he loved WikiLeaks, O’Hagan noticed that he “tended to eat pretty much with his hands. People in magazine articles say he doesn’t eat, but he had three helpings of lasagne that night and he ate both the baked potato and the jam pudding with his hands.”

Later, the author rented a house nearby. “I made lunch every day and he’d eat it, often with his hands, and then lick the plate. In all that time he didn’t once take his dirty plate to the sink. That doesn’t make him like Josef Mengele, but, you know, life is life.”

Here is the link

https://www.theaustralian.com.au/inquirer/wikileaks-founder-julian-assanges-sordid-life-of-luxury/news-story/ad3a56041477347baf54a05b969bd55b

Sorry for wasting your time on this jerk – but as the above shows – he really is an unpleasant piece of work.

His first and last mention on this blog, but people need to come out and point out what an unsatisfactory and useless human he is!

David.

Tuesday, April 23, 2024

We Reap What We Sow With Mental Health Services Provision!

This appeared last week

Psychiatrists warn mental health system is ‘under siege and stress’

Exclusive By Natasha Bita

Education Editor

8:27PM April 19, 2024

Psychotic and suicidal patients are being turned away from short-staffed public hospitals, as the nation’s health ministers work to plug gaping gaps between medical treatment and NDIS support for the mentally ill.

Frontline health and emergency workers have warned of a “dangerously broken” mental health system as hospitals overflow with mentally ill patients who are too poor to pay for ­private psychiatric help.

Professor Allan Fels, a former National Mental Health Commissioner who served on the Victorian Royal Commission into mental health, on Friday said he knew people who had killed themselves after hospitals refused to treat them.

"I know people who’ve been turned away from hospital taking their lives straight away,’’ he told The Weekend Australian.

“Most mental health services are not well organised and badly resourced, especially for the treatment of the homeless who are mentally ill.’’

Professor Fels said he felt the Bondi Junction massacre – when mentally ill man Joel Cauchi used a knife to murder six people and injure 12 others before a policewoman shot him dead last weekend – could have been prevented.

“My feeling was that if we had a better mental health system, including accommodation for people with severe mental illness, this tragic event might not have occurred,’’ he said.

“Tragically, (mental illness) is not a very high public priority and even within the health system, it’s much less of a priority than common illnesses such as cancer.

“But the Bondi experience could be a turning point.’’

The nation’s health ministers on Friday agreed to work on ways to support people with mental illness who do not qualify for support under the National Disability Support Scheme. he father of Joel Cauchi, the man who killed six people in Bondi Junction's Westfield, has spoken out about why… he believes his son targeted women in the horrific attack. “He wanted a girlfriend, and he’s got no social skills, and he was frustrated out of his brain,” Andrew More

Federal Health Minister Mark Butler, who met state and territory health ministers in Brisbane on Friday, said they were still analysing the “unmet need for mental health services for people with particularly severe and chronic mental health’’.

He said governments would “try and work out where those gaps are for people with severe needs who might not be currently in the NDIS”.

Tragic and distressing details of mental health patients’ suffering are detailed in submissions to a NSW parliamentary inquiry into mental health.

Paramedics revealed that mental health cases make up 15 per cent of their workload, and they attend 670 suicide attempts, 1559 cases of suicidal ideation, and 489 cases of self-injury every month.

Ambulances are repeatedly taking the same patients back to hospital, sometimes multiple times a day.

“A system should not be so broken that patients are made worse off by the people they are seeking help from,’’ the Australian Paramedics Association of NSW has told the inquiry.

“Paramedics are at the coal face of this crisis. We see our patients become more and more unwell over time, unable to access the right care at the right time.’’

The chair of the NSW Upper House inquiry into outpatient and community mental health care, Greens health spokeswoman and former GP Amanda Cohn, said a payroll tax levy to raise funds for mental health – already imposed on employers in Victoria and Queensland - should be “on the table’’ in NSW.

“That’s what we’re doing with mental health,’’ Dr Cohn said. “We’re leaving people just languishing on endless waitlists in the community until they’re in a state of absolute crisis, bringing them into hospital for the absolute bare minimum of (treatment) and then putting them back in the community without support.

“We wouldn’t do it with any other kind of health condition.’’

Psychiatrists have described NSW’s mental health system as “under siege, under stress and in survival mode”, with chronic shortages of psychologists and mental health workers.

“Emergency departments have become the main entry point into the mental health system for many people,’’ the Royal Australian and New Zealand College of Psychiatrists has told the inquiry.

“The medical workforce is under unprecedented strain, with public services at risk of shrinking or closing due to lack of medical workforce.’’

The Australian Medical Association said homeless people were being rejected from Community Mental Health teams, which require patients to have a fixed address. It criticised a “fragmented and siloed’’ system.

Rural Doctors’ Association of NSW president Charles Evill said most mental health services are at or near capacity.

“In regard to attempted suicides, there seems minimal support, if any, after an accident and emergency assessment,’’ Dr Evill said. “This is a potentially fatal problem considering poor access to GPs and long waiting times and poor access to psychologists.’’

If you or someone you know is at risk of suicide, call Lifeline (13 11 14) or the Suicide Call Back Service (1300 659 467), or see a doctor.

Here is the link:

https://www.theaustralian.com.au/nation/politics/psychiatrists-warn-mental-health-system-is-under-siege-and-stress/news-story/6f9e3d0665e3664f71e2658f3a4b1d7b

Having, for my sins, run a large metropolitan hospital emergency department for a number of years I know from experience that these places are just not where you care for the disturbed and mentally ill. You need calm, privacy and skilled dedicated staff, which is too big an ask in a busy ED!.

More, you need access to these experts at short notice – something that they often fail to understand - and leave amateurs to try an cope with disturbed patients - who need an expert hand sooner rather than later – if they are going to be successfully cared for!

My experience is now somewhat dated but I have seen no evidence things have changed and I have to say it is the rare psychiatrist who is seized of the need to respond promptly when called – to the disadvantage of those poor souls who find themselves in EDs.

We in EDs know threatened or attempted suicide / self-harm are medical emergences and need a swift and skilled response – which we are often ill-equipped to provide!

Let me know if things have improved! As for how resources in this area can be boosted that is well above my pay-grade!

David.

Sunday, April 21, 2024

I Suspect We Have A While To Go Before We Can Declare Total Victory Over COVID-19 And Its Sequelae.

This appeared last week as a bit of a reminder.

Long Covid expert backs dedicated care clinics over seeing GPs

Exclusive

By Milanda Rout

Deputy editor of The Weekend Australian's Travel + Luxury

8:37PM April 19, 2024

The nation’s leading expert in Long Covid care has urged the federal government to back dedicated treatment clinics and abandon plans to shift the burden of patient care to GPs.

The government is leaving those suffering the debilitating effects of Long Covid – thought to be as many as 10,000 cases a month – to GPs and online support, in defiance of a federal ­parliamentary committee’s recommendation that supports funding more Long Covid rehabilitation clinics.

Professor Steven Faux, the co-founder of the Long Covid clinic at St Vincent’s Hospital in Sydney, said the government’s approach was flawed and Long Covid care should be conducted in rehab clinics like his, which takes a holistic approach to treatment.

Professor Faux, the hospital’s director of pain medicine who previously spent 22 years as the director of rehabilitation, has a six- to nine-month waiting list for new patients, he says in an interview for The Weekend Australian Magazine.

“The GPs are doing their best but there’s not enough GPs, and it’s very complicated because you’ve got to rule out everything else first,” Professor Faux says.

In January of this year, 100,000 positive cases were registered in the country. That means, 10,000 people got Long Covid,” Professor Faux said. “And every month there’ll be ­another 10,000.

“There’s lower vigilance with respect to Covid vaccinations and so we expect that people will get it a little bit more. There’s been no decrease in demand at the clinic.”

An RMIT study published last October found the nation had “insufficient Long Covid clinics to meet the demand”.

The Senate committee’s Sick and Tired: Casting A Long Shadow report into Long Covid ­recommended “funding be provided in partnership with state health departments for selected public hospitals to develop multidisciplinary Long Covid clinics linked to nationally consistent referral guidelines for screening patients with challenging Long Covid complications.”

Health Minister Mark Butler has not supported the recommendation, instead stating that those living with the condition would benefit from the ­government’s commitment to “expand general practices”.

Professor Faux’s clinical team at St Vincent’s includes nurses, physiotherapists, a sleep specialist, a neurological rehabilitation expert, and a psychologist. A rehabilitation program is tailored to each patient’s needs.

“If patients are identified early and they … start treatment early, the evidence from overseas is that they recover faster,” Professor Faux said.

Here is the link:

https://www.theaustralian.com.au/nation/long-covid-expert-backs-dedicated-care-clinics-over-seeing-gps/news-story/d4310ee45ef954e4309ce1e9987e008e

This rather feels to me that we are seeing an outburst of wishful thinking on the part of the Departmental Bureaucrats that COVID is over and we can all go beck to the way we were – even though there is good evidence specialist services will be needed for a while yet and that there is evidence that the disease has a ‘long tail’ for some small percentage of patients – who of course need care!

It is just all too easy to ignore these patients and their travails if most seem to have recovered but is is pretty unfair to pull away the chocks before all have been cared for as they needed!

I suspect there are more of these patients than the Government would lile to admit!

David.

AusHealthIT Poll Number 743 – Results – 21 April, 2024.

Here are the results of the poll.

Are You Concerned That Our Mental Health Services Are Not Reliably Identifying Potentially Dangerous Sufferers And Getting Them Effective Care?

Yes                                                                               6 (21%)

No                                                                                5 (17%)

It Is A Very Difficult Task And It Is Virtually

Impossible To Be 100% Right Consistently          18 (62%)

I Have No Idea                                                             0 (0%)

Total No. Of Votes: 29

People seem to think that identifying, catching and effectively treating all dangerous mental illness is, and probably will remain, just too hard – despite out best efforts!

Any insights on the poll are welcome, as a comment, as usual!

A fair number of votes. But also a very clear outcome! 

0 of 29 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.