Hospitals turn to sniffer dogs to combat illicit drugs in wards

Victoria’s secure psychiatric units are increasingly resorting to the controversial use of drug detection dogs to combat the danger illegal drugs are posing to patients and staff in hospital wards.

The use of sniffer dogs inside closed wards has divided mental health experts, as hospitals try to balance the potential trauma and invasion of privacy for vulnerable patients against the risk posed by illicit drugs.

Six major health services are now using sniffer dogs, with Monash Health the latest to resort to the measure, despite there being no rules or guidelines for their use within the Victorian health system.

Use of the dogs comes amid rising detection of drugs in closed psychiatric units and increasing aggression against staff and patients.

Mental health workers detailed claims to their union of drug use within their wards, including a recent haul of methamphetamines being dealt inside a secure forensic hospital and blatant methamphetamine use inside regional wards.

Seven sources at five mental health groups told this masthead of strong concerns about the use of sniffer dogs among vulnerable and sometimes terrified patients – including those admitted against their will – and fears that Victoria’s hospitals are not properly placed to cope with the high correlation between substance use and mental illness.

The issue prompted Victoria’s Chief Psychiatrist, Associate Professor Sophie Adams, to last month draft guidance for hospitals using the searches.

Adams said deploying sniffer dogs could seem at face value to be overly authoritarian. Her advice, seen by The Age, was to adopt a middle path, concluding that although hospitals should not use canine searches as a routine tool, there may be benefits in exceptional circumstances.

Adams’ guidance was intended to be published in an Office of the Chief Psychiatrist Quality and Safety Bulletin, but a source, who was not authorised to speak publicly, said it had been delayed over legal concerns.

In a May 12 email to outline the advice, Adams conceded there were strong feelings about the increased use of sniffer dogs, as well as the need for them.

“I acknowledge that this practice at face value seems overly authoritarian and I myself have never been a fan,” Adams wrote. “However, there are some competing values at play here that are worth outlining.

“On the one hand, sniffer dogs have a symbolic authority message not at first consideration aligned with our aims to be least restrictive and uphold dignity.

“On the other hand, wards with lots of substances on them can be dangerous to the consumer who takes the substance and other people in the environment, staff and other consumers due to user’s agitation or unpredictable or fear-based behaviours.”

Adams conceded in her email that drug detection dogs worked only as a deterrent, particularly in larger hospitals with more acute mental health patients and higher methamphetamine use.

“Also as sniffer dogs are always used with notice and opportunities for people to avoid the dogs, searches with sniffer dogs almost never find anything,” she wrote.

Melbourne Health first contracted private drug detection dog services in 2015. More recently Northern Health, Eastern Health, St Vincent’s Health, the Thomas Embling forensic hospital, and now Monash Health have contracted sniffer dog searches, while Western Health has abandoned the practice.

While some hospitals use the dogs for routine scheduled searches, others call them in at times when there are known or suspected high levels of illegal drugs present in their closed wards. The dogs used range from German shepherds to smaller breeds. Patients are given warning times ranging from hours to just a few minutes.

Recent issues detailed by mental health workers to their union include:

• Regional hospital staff who detected a patient using methamphetamine at 1am but had to abandon a search because they began feeling unwell due to exposure to the fumes.
• A major Melbourne hospital caught a patient with cocaine in a ward last week, while three other patients were recently detected with methamphetamine.
• Staff at another major Melbourne health network have requested an increase in its monthly drug detection dog searches because of a rise in illegal drug use.
• A patient returning to a forensic mental health service from unescorted leave was found carrying bags of powder and a supply of needles for sale to other patients.
• Instances of patients found to have brought methamphetamines into a regional mental health unit following approved leave.

Phillipa Thomas, chief executive of independent peak body Mental Health Victoria, said the increasing reliance on sniffer dogs was a signal the physical environment, staffing and skill in the state’s acute mental health units was failing to manage the safety risks and treatment needs of those who rely on them.

“I don’t know what is worse – the fact that detection canines are in use, or the fact that there is a need for them to be in use,” Thomas said.

“MHV are concerned that health services feel that this is a necessary measure to prevent harm, either because less intrusive or restrictive measures are ineffective to manage the scale of the problem, or because they don’t have sufficient resourcing or a suitable environment to effectively manage the problem in an alternative way.

“Alternatives, or levers to reduce the need for detection canines are desperately needed – increased staffing levels, fit-for-purpose environments, and increased availability of specialist addiction inputs tailored to providing interventions for people with substance use needs at this point of care.”

‘Decisions about safety measures must carefully balance risks with the rights, dignity and wellbeing of consumers.’

The Mental Health and Wellbeing Commission said it had not received any complaints regarding the use of drug detection dogs, but it was engaging with the government, the state’s chief psychiatrist and others to better understand this issue.

“People accessing mental health services should feel safe, respected and supported in their care environment. Decisions about safety measures must carefully balance risks with the rights, dignity and wellbeing of consumers, and must be guided by evidence and lived experience,” interim commissioner Maggie Toko said.

The clinical guidelines for how and when searches can be conducted in Victorian inpatient units have not been updated since 2014 and do not include any provision for the use of canines, which were not in use when the guidelines were established.

Contacted about the use of drug detection dogs in Victorian hospitals, and why her newly proposed guidance had not been published, Adams said her office was assessing the advice.

“Substances on mental health units can worsen distress, disrupt treatment, increase the risk of aggression or overdose, and make units less safe for consumers, staff and visitors – so it is necessary for health services to have tools to manage these risks,” Adams said.

“Health services may choose to use drug detection dogs to help manage the safety and recovery impacts of having drugs on mental health units, but they should be limited in their use.”

Paul Healey, Victorian branch secretary of the Health and Community Services Union, blamed a lack of alcohol and drug clinicians for rising impacts of drugs inside closed mental health units.

“The reality is the public mental health system is in dire need of ratios and staffing profiles for all disciplines within wards and community teams to give us more tools to better manage the situation,” he said.

A 2017 analysis of the initial NorthWestern Mental Health sniffer dog program, undertaken for the Australian College of Mental Health Nurses, found that drug use in the units was “prevalent and destructive” and, while the sniffer dogs were beneficial, patients were uninformed and consequences needed to be better customised to suit a patient’s circumstances.

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