The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has expressed deep concern following the passage of the Termination of Pregnancy (Restrictions on Terminations after 24 weeks and 6 days) Amendment Bill in South Australia’s Upper House today, warning the changes risk serious harm by excluding mental health from critical medical decision-making.

The RANZCP is calling on the South Australian Parliament to restore mental health as a consideration under the existing Act and urges Lower House members to reject the Bill as it stands tonight.

The RANZCP is particularly alarmed that the Bill removes consideration of mental health from decisions about termination of pregnancy after 24 weeks and 6 days, a change that is not supported by medical evidence or clinical reality.

"RANZCP President Dr Astha Tomar said the Bill is based on a fundamental misunderstanding of how serious mental illness presents and how it is treated, and warned that any legislative framework related to termination of pregnancy must reflect the full complexity of medical evidence.

“Mental health is not secondary to physical health. Psychological suffering can be as serious, disabling and life-threatening as any physical illness for pregnant women, and the law should reflect that,” Dr Tomar said.

“As RANZCOG has previously highlighted, procedures at this stage of pregnancy are extraordinarily rare, represent a tiny fraction of all abortions performed in SA, and are almost always complex and devastating clinical situations.

“Excluding mental health from consideration when it comes to late-term abortions is a dangerous precedent. It risks worsening serious psychiatric illness, including major depression, psychosis, trauma-related conditions, severe anxiety and suicidality, undermining the safety and wellbeing of both the mother and the infant.”

The RANZCP is also concerned about the suggestions that involuntary treatment under the Mental Health Act 2009 (SA) is a substitute for access to critical reproductive health care, describing that proposition as clinically and legally flawed.

Dr Tomar said the Mental Health Act exists for a completely different purpose, and that it is unlikely a woman requiring a late-stage termination of pregnancy would meet the thresholds of the Act, highlighting that it is not clinically or ethically appropriate and risks undermining patient autonomy.

“The Mental Health Act is designed to provide involuntary treatment when someone has a mental illness and has lost the capacity to make decisions for themselves. Most people seeking an abortion on mental health grounds do not meet that threshold. They are suffering, often profoundly, but they are still capable of making decisions about their own bodies and their own care,” Dr Tomar warned.

“The people most likely to be harmed by this change are among the most vulnerable, including those with pre-existing mental illness, young women, women experiencing family violence, Aboriginal and Torres Strait Islander women, and women from refugee and migrant backgrounds.

“As psychiatrists, we treat these patients and see firsthand the trauma, the deterioration of mental health outcomes and the long-term consequences of a system that fails to safeguard their wellbeing. This Bill will cause harm, and we have an obligation to say so clearly.”

“Decisions of this gravity must rest with the pregnant person and the clinicians who know their history, understand their circumstances, and are bound by a duty of care,” Dr Tomar said.

The RANZCP will make further comment when more information comes to hand following the Lower House vote tonight.

Update:  The Bill was defeated in SA Parliament's lower house, 36 votes to 9.

ENQUIRIES: For more information, or to arrange an interview, call Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org.

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au.

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.