Mental Health Regulations 1998

i Mental Health Regulations 1998 S.R. No. 120/1998 TABLE OF PROVISIONS Regulation Page PART 1—PRELIMINARY 1 1. Objective 1 2. Authorising provisions 1 3. Commencement 1 4. Definition 2 PART 2—ADMISSION OF INVOLUNTARY PATIENTS 3 5. Involuntary admission to approved mental health service 3 6. Special warrant 5 PART 3—STATEMENTS OF PATIENT'S RIGHTS 6 7. Statements to be provided on admission to approved mental health service 6 8. Statements to be provided with respect to treatment 6 PART 4—ELECTROCONVULSIVE THERAPY 8 9. Application for licence to perform electroconvulsive therapy 8 10. Form of licence to perform electroconvulsive therapy 8 11. Form of application for renewal of licence 8 12. Form of application for amendment of licence 8 13. Form of monthly return by licence holder 8 PART 5—REGISTER OF MAJOR NON-PSYCHIATRIC TREATMENT 9 14. Form of register of major non-psychiatric treatment 9 PART 6—PATIENT'S MONEY 10 15. Limits on patient's trust accounts 10 -- 1 of 108 -- Regulation Page ii PART 7—COMMUNITY SUPPORT SERVICES 11 16. Form of application for registration of community support service 11 PART 8—COMMUNITY VISITORS 12 17. Record of visits by community visitors 12 18. Manner of electing Community (Psychiatric Services) Visitors Board 12 PART 9—MISCELLANEOUS 13 19. Release of patient information 13 20. Recommendation fee 13 __________________ SCHEDULES 14 SCHEDULE 1—Form of involuntary admission request 14 SCHEDULE 2—Form of involuntary admission recommendation 16 SCHEDULE 3—Particulars of use of restraint or sedation 19 Form 1—Particulars of use of restraint 19 Form 2—Particulars of use of sedation 21 SCHEDULE 4—Form of authority to transport involuntary patient 23 SCHEDULE 5—Special warrant 25 SCHEDULE 6—Statement of rights—involuntary patient 26 SCHEDULE 7—Statement of rights—hospital order patient 32 SCHEDULE 8—Statement of rights—community treatment order or restricted community order 39 SCHEDULE 9—Statement of rights—security patient 46 SCHEDULE 10—Statement of rights—continuing treatment involuntary patient 53 SCHEDULE 11—Statement of rights—forensic patient 60 SCHEDULE 12—Statement of rights—appeals to mental health review board 68 SCHEDULE 13—Statement of rights—applications and appeals to forensic leave panel 75 SCHEDULE 14—Statement of rights—electroconvulsive therapy 81 SCHEDULE 15—Statement of rights—psychosurgery 86 -- 2 of 108 -- Regulation Page iii SCHEDULE 16—Statement of rights major non-psychiatric treatment or major medical procedure 92 SCHEDULE 17—Application for licence to permit the performance of electroconvulsive therapy 97 SCHEDULE 18—Licence authorising performance of electroconvulsive therapy 98 SCHEDULE 19—Application for renewal of an electroconvulsive therapy licence 99 SCHEDULE 20—Application for amendment of an electroconvulsive therapy licence 100 SCHEDULE 21—Form of monthly return by holders of licence to perform electroconvulsive therapy 101 SCHEDULE 22—Form of register of major non-psychiatric treatment 102 SCHEDULE 23—Application for registration of an association or organisation providing community support services 103 SCHEDULE 24—Record of visits by community visitors return for the month of 105 ═══════════════ -- 3 of 108 -- 1 STATUTORY RULES 1998 S.R. No. 120/1998 Mental Health Act 1986 Mental Health Regulations 1998 The Governor in Council makes the following Regulations: Dated: 22 September 1998 Responsible Minister: ROB KNOWLES Minister for Health SHARNE BRYAN Clerk of the Executive Council PART 1—PRELIMINARY 1. Objective The objective of these Regulations is to prescribe forms, fees and other matters necessary or convenient to be prescribed for the purpose of giving effect to the Mental Health Act 1986. 2. Authorising provisions These Regulations are made under sections 9, 11, 18, 43, 53, 53B, 75, 76, 77, 78, 80, 85, 91, 100, 114, 116, 120A, 127 and 142 of the Mental Health Act 1986. 3. Commencement These Regulations come into operation on 29 September 1998. -- 4 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 2 4. Definition In these Regulations— "the Act" means the Mental Health Act 1986. _______________ r. 4 -- 5 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 3 PART 2—ADMISSION OF INVOLUNTARY PATIENTS 5. Involuntary admission to approved mental health service (1) For the purposes of section 9(1)(a) of the Act, a request to admit and detain a person as an involuntary patient must be in the form of Schedule 1. (2) For the purposes of section 9(1)(b) of the Act, a recommendation by a registered medical practitioner must be in the form of Schedule 2. (3) For the purposes of section 9(7), 9(7A), 43(1A) and 53(1A) of the Act, the form of particulars of restraint or sedation must be— (a) in the form of Form 1 or Form 2 of Schedule 3 (as the case requires); and (b) completed by— (i) the person who administered the restraint, immediately the restraint ceases to be used; (ii) the person who administers the sedation, immediately after that administration; (iii) the person who authorised the administration, before the sedation is administered. (4) For the purposes of section 9(7A)(c) of the Act, an authority to transport a person to an approved mental health service must be in the form of Schedule 4. (5) For the purposes of the definition of "mental health practitioner" in section 9(8) of the Act, the prescribed classes of health service providers are the following persons employed by an r. 5 -- 6 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 4 approved mental health service and engaged in the provision of acute psychiatric assessment and treatment functions in the community— (a) registered nurses; (b) registered psychologists within the meaning of the Psychologists Registration Act 1987; (c) social workers; (d) occupational therapists. (6) For the purposes of the definition of "prescribed registered medical practitioner" in section 9(8) of the Act, a registered medical practitioner is of a prescribed class if the registered medical practitioner is— (a) in general practice; or (b) the registered medical practitioner who recommended that the person be admitted to and detained in the approved mental health service; or (c) the head of the emergency department of a hospital; or (d) employed as such in or by a psychiatric service within the meaning of section 106 of the Act; or (e) a psychiatrist; or (f) forensic physician. (7) For the purposes of the definition of "prescribed person" in section 9(8) of the Act, the prescribed classes are— (a) registered medical practitioners; (b) registered nurses; (c) registered psychologists within the meaning of the Psychologists Registration Act 1987; r. 5 -- 7 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 5 (d) social workers; (e) occupational therapists— employed, appointed or engaged to provide care and treatment to persons with a mental disorder in an approved mental health service, a State child and adolescent psychiatry service, any premises licensed under section 75 of the Act, a hospital admitting or caring for persons with a mental disorder, a mental health service of a community health centre, a psychiatric outpatient clinic, or a community mental health service. 6. Special warrant For the purposes of section 11(3) of the Act, a special warrant must be in the form of Schedule 5. _______________ r. 6 -- 8 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 6 PART 3—STATEMENTS OF PATIENT'S RIGHTS 7. Statements to be provided on admission to approved mental health service For the purposes of section 18(1) of the Act, the prescribed printed statement to be given to every patient upon admission to an approved mental health service, must— (a) in relation to an involuntary patient, be in the form in Schedule 6; (b) in relation to a hospital order patient, be in the form in Schedule 7; (c) in relation to a person who is subject to a community treatment order or a restricted community treatment order, be in the form in Schedule 8; (d) in relation to a security patient, be in the form of Schedule 9; (e) in relation to a continuing treatment involuntary patient, be in the form of Schedule 10; (f) in relation to a forensic patient, be in the form in Schedule 11; (g) in relation to appeals by patients to the Mental Health Review Board, be in the form in Schedule 12; (h) in relation to applications and appeals by forensic patients to the Forensic Leave Panel, be in the form in Schedule 13. 8. Statements to be provided with respect to treatment For the purposes of section 53B(2) of the Act, the prescribed printed statement to be given to a person prior to that person giving his or her r. 7 -- 9 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 7 consent to the performance on him or her of treatment, must— (a) in relation to a person upon whom it is proposed to perform electroconvulsive therapy, be in the form in Schedule 14; (b) in relation to a person upon whom it is proposed to perform psychosurgery, be in the form in Schedule 15; (c) in relation to a person upon whom it is proposed to perform a major non-psychiatric treatment or a major medical procedure, be in the form in Schedule 16. _______________ r. 8 -- 10 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 8 PART 4—ELECTROCONVULSIVE THERAPY 9. Application for licence to perform electroconvulsive therapy (1) For the purposes of section 75(3)(a) and (b) of the Act, an application for a licence to perform electroconvulsive therapy, must be in the form of Schedule 17. (2) For the purposes of section 75(3)(c) of the Act, the prescribed fee is $750.00. 10. Form of licence to perform electroconvulsive therapy For the purpose of section 76(1)(b) of the Act, a licence to perform electroconvulsive therapy must be in the form of Schedule 18. 11. Form of application for renewal of licence (1) For the purposes of section 77(2)(a) and (b) of the Act, an application for the renewal of a licence to perform electroconvulsive therapy must be in the form of Schedule 19. (2) For the purposes of section 77(2)(c) of the Act, the prescribed fee is $750.00. 12. Form of application for amendment of licence For the purposes of section 78(2) of the Act, an application for amendment of a licence must be in the form of Schedule 20. 13. Form of monthly return by licence holder For the purposes of section 80 of the Act, a monthly return must be in the form of Schedule 21. _______________ r. 9 -- 11 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 9 PART 5—REGISTER OF MAJOR NON-PSYCHIATRIC TREATMENT 14. Form of register of major non-psychiatric treatment For the purposes of section 85 of the Act, a register of major non-psychiatric treatment performed must be in the form of Schedule 22. _______________ r. 14 -- 12 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 10 PART 6—PATIENT'S MONEY 15. Limits on patient's trust accounts For the purposes of section 91(2) of the Act, the prescribed amount of money held in a Patients Trust Account which may not be exceeded is $5000.00. _______________ r. 15 -- 13 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 11 PART 7—COMMUNITY SUPPORT SERVICES 16. Form of application for registration of community support service For the purposes section 100(1) of the Act, an application for the registration of an association or organisation which provides community support services must be in the form of Schedule 23. _______________ r. 16 -- 14 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 12 PART 8—COMMUNITY VISITORS 17. Record of visits by community visitors For the purposes of section 114 of the Act, a record of visits by community visitors must be in the form of Schedule 24. 18. Manner of electing Community (Psychiatric Services) Visitors Board For the purposes of section 116(2)(b) of the Act— (a) the election of community visitors to the Community (Psychiatric Services) Visitors Board must be held annually; (b) the procedure for the election is to be determined by the Public Advocate. _______________ r. 17 -- 15 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 13 PART 9—MISCELLANEOUS 19. Release of patient information For the purposes of section 120A(3)(ca) of the Act, the following classes of staff of a psychiatric service are prescribed— (a) registered nurses; (b) registered psychologists within the meaning of the Psychologists Registration Act 1987; (c) social workers; (d) occupational therapists— employed, appointed or engaged by the relevant psychiatric service. 20. Recommendation fee For the purposes of section 127 of the Act, the prescribed recommendation fee that may be paid to a registered medical practitioner is $91.00. __________________ r. 19 -- 16 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 14 SCHEDULES SCHEDULE 1 Regulation 5(1) FORM OF INVOLUNTARY ADMISSION REQUEST Mental Health Act 1986 (Section 9) Mental Health Regulations 1998 PART A REQUEST FOR ADMISSION OF A PERSON AS AN INVOLUNTARY PATIENT TO AN APPROVED MENTAL HEALTH SERVICE TO THE ADMITTING REGISTERED MEDICAL PRACTITIONER Please admit ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person to be admitted of................................................................................................................... (ADDRESS OF PERSON TO BE ADMITTED) as an involuntary patient to an appropriate approved mental health service. PART B DETAILS OF PERSON MAKING THE REQUEST ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person making the request of................................................................................................................... address of person making the request signed.......................................................................date.............................. Sch. 1 -- 17 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 15 PART C TAKING PERSON TO APPROVED MENTAL HEALTH SERVICE (TO BE COMPLETED IF NECESSARY) * I hereby authorise ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of a **member of the police force, an ambulance officer or a person authorised by the person making the request employed by.................................................designation................................ to take the abovenamed person to an appropriate approved mental health service. ................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person making the request signed.......................................................................date............ * This authorisation to take a person to an approved mental health service is only to be used when a Request and Recommendation have been completed. In the case of an Authority to Transport without Recommendation, schedule 4 must be used. **Circle as necessary _______________ Sch. 1 -- 18 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 16 SCHEDULE 2 Regulation 5(2) FORM OF INVOLUNTARY ADMISSION RECOMMENDATION Mental Health Act 1986 (Section 9) Mental Health Regulations 1998 RECOMMENDATION FOR ADMISSION OF A PERSON AS AN INVOLUNTARY PATIENT TO AN APPROVED MENTAL HEALTH SERVICE TO THE ADMITTING REGISTERED MEDICAL PRACTITIONER Please admit ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person to be admitted of................................................................................................................... address of person to be admitted I am a registered medical practitioner and state as follows— I have personally examined the abovenamed person on (date)........................ at.............*am/pm. It is my opinion that: (a) the person appears to be mentally ill (a person is mentally ill if he or she has a mental illness, being a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and (b) the person's mental illness requires immediate treatment and that treatment can be obtained by admission to and detention in an approved mental health service; and (c) because of the person's mental illness, the person should be admitted and detained for treatment as an involuntary patient for his or her health or safety (whether to prevent a deterioration in the person's physical or mental condition or otherwise) or for the protection of members of the public; and (d) the person has refused or is unable to consent to the necessary treatment for the mental illness; and Sch. 2 -- 19 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 17 (e) the person cannot receive adequate treatment for the mental illness in a manner less restrictive of that person's freedom of decision and action. I do not consider the person to be mentally ill by reason only of any one or more of the exclusion criteria listed in section 8(2) of the Mental Health Act 1986. I base my opinion on the following facts— FACT/S PERSONALLY OBSERVED BY ME ON EXAMINATION ........................................................................................................................... ................................................................................................................. FACTS COMMUNICATED TO ME BY ANOTHER PERSON ........................................................................................................................... ................................................................................................................. TO BE COMPLETED WHERE NO FACTS ARE PERSONALLY OBSERVED As no facts were personally observed by me, the following facts were communicated directly to me *in person/in writing/by telephone/by electronic communication by Dr.................................................................................................................. GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of other registered medical practitioner of................................................................................................................... doctor's address doctors telephone number........................................................................who examined the abovenamed person on (date)............................ (being a period not more than 28 days prior to today's date) FACTS COMMUNICATED BY OTHER EXAMINING REGISTERED MEDICAL PRACTITIONER: ........................................................................................................................... ................................................................................................................. I consider that the abovenamed person should be admitted to an approved mental health service. ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of recommending registered medical practitioner signed........................................................................................................... SIGNATURE of recommending registered medical practitioner Qualifications:............................................................................................... Sch. 2 -- 20 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 18 Address......................................................................................................... Telephone number.............................................date.......................................... *circle as necessary _______________ Sch. 2 -- 21 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 19 SCHEDULE 3 Regulation 5(3) PARTICULARS OF USE OF RESTRAINT OR SEDATION FORM 1 PARTICULARS OF USE OF RESTRAINT Mental Health Act 1986 (Section 9) Mental Health Regulations 1998 THIS FORM MUST BE COMPLETED IF RESTRAINT IS USED FOR THE PURPOSES OF SAFELY TRANSPORTING A PERSON TO AN APPROVED MENTAL HEALTH SERVICE (please cross !) " ATTACHED TO THIS FORM IS A COMPLETED RECOMMENDATION IN THE PRESCRIBED FORM. OR " ATTACHED TO THIS FORM IS A COMPLETED AUTHORITY TO TRANSPORT WITHOUT A RECOMMENDATION IN THE PRESCRIBED FORM. OR " RESTRAINT HAS BEEN APPLIED TO TRANSPORT A PERSON WITHOUT LEAVE OR PERMISSION. NO RECOMMENDATION OR AUTHORITY TO TRANSPORT IS ATTACHED. ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person to be transported of.................................................................................................................. address of person to be transported I................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of prescribed person Sch. 3 -- 22 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 20 am employed by............................................................................................ *police/ambulance/psychiatric service/other (please specify) and am a prescribed person for the purposes of section 9 of the Mental Health Act 1986. (please cross !) " I have observed a completed recommendation in the prescribed form. OR " I have observed a completed authority to transport without recommendation in the prescribed form. OR " Restraint has been applied to transport the abovenamed person absent without leave or permission. No recommendation or authority to transport is attached. I applied the following restraint on the abovenamed person: restraint........................time applied...................time removed...................... restraint........................time applied...................time removed...................... restraint........................time applied...................time removed...................... Such restraint/s was/were necessary for the following reasons (please provide reasons for each occasion restraint was used): ........................................................................................................................... ........................................................................................................................... ............................................................................................................ signed.....................................................designation..................................... date......................... *circle as necessary _______________ Sch. 3 -- 23 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 21 FORM 2 Mental Health Act 1986 (Section 9) Mental Health Regulations 1998 PARTICULARS OF USE OF SEDATION THIS FORM MUST BE COMPLETED IF SEDATION IS TO BE USED FOR THE PURPOSES OF SAFELY TRANSPORTING A PERSON TO AN APPROVED MENTAL HEALTH SERVICE (please cross !) " ATTACHED TO THIS FORM IS A COMPLETED RECOMMENDATION IN THE PRESCRIBED FORM. OR " SEDATION IS TO BE USED TO TRANSPORT A PERSON ABSENT WITHOUT LEAVE OR PERMISSION. NO RECOMMENDATION IS ATTACHED. ..................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person to be transported of.................................................................................................................. address of person to be transported I.................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of prescribed registered medical practitioner of................................................................................................................... address of prescribed registered medical practitioner am a prescribed registered medical practitioner for the purposes of section 9 of the Mental Health Act 1986. (please cross !) " I have observed a completed recommendation in the prescribed form. OR " Sedation is to be used to transport the abovenamed person who is absent without leave or permission. No recommendation is attached. The person is unable to consent to or has refused sedation and I am of the opinion that it is necessary to sedate the person so as to enable the person to be taken safely to an appropriate approved mental health service. Sch. 3 -- 24 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 22 I base my opinion on the following facts: ........................................................................................................................... ........................................................................................................................... ............................................................................................................ PARTICULARS OF SEDATION drug............................................................................................................... dose.....................route:(IM, IV, Oral)..................frequency.......................... (please cross !) " I administered the above sedation myself at the following time/s........................... am/pm OR " I direct............................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of authorised person a *registered medical practitioner/registered nurse to administer the above sedation in the prescribed form. Signed...........................................................date.......................................... TO BE COMPLETED AS NECESSARY BY AUTHORISED PERSON I,................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of authorised person of................................................................................................................... address of authorised person am the person authorised above by Dr.................................................................................................................. a prescribed registered medical practitioner to administer the following sedation PARTICULARS OF SEDATION ADMINISTERED drug............................................................................................................... dose.................route:(IM, IV, Oral)...........time/s administered...................... signed...............................................qualifications........................................ date:....................................... *circle as necessary _______________ Sch. 3 -- 25 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 23 SCHEDULE 4 Regulation 5(4) FORM OF AUTHORITY TO TRANSPORT INVOLUNTARY PATIENT Mental Health Act 1986 (Section 9) Mental Health Regulations 1998 AUTHORITY TO TRANSPORT WITHOUT RECOMMENDATION TO THE ADMITTING REGISTERED MEDICAL PRACTITIONER Please admit ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person to be admitted of................................................................................................................... address of person to be admitted I am a mental health practitioner for the purposes of section 9 of the Mental Health Act 1986 and I state as follows— (1) I have observed a completed request in the prescribed form relating to the abovenamed person. (2) A recommendation has not been made in the prescribed form because a registered medical practitioner was not available within a reasonable period to consider making a recommendation despite all reasonable steps having been taken to secure the attendance of one. (3) It is my opinion that: (a) the person appears to be mentally ill (a person is mentally ill if he or she has a mental illness, being a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and (b) the person's mental illness requires immediate treatment and that treatment can be obtained by admission to and detention in an approved mental health service; and (c) because of the person's mental illness, the person should be admitted and detained for treatment as an involuntary patient for his or her health or safety (whether to prevent a deterioration in the Sch. 4 -- 26 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 24 person's physical or mental condition or otherwise) or for the protection of members of the public; and (d) the person has refused or is unable to consent to the necessary treatment for the mental illness; and (e) the person cannot receive adequate treatment for the mental illness in a manner less restrictive of that person's freedom of decision and action. (4) I do not consider the person to be mentally ill by reason only of any one or more of the exclusion criteria listed in section 8(2) of the Mental Health Act 1986. (5) I base my opinion on the following facts personally observed by me on examination— .............................................................................................................. .............................................................................................................. (6) I consider that the abovenamed person should be— • transported in accordance with the request in the form in Schedule 1 made by ...........................................................................................; AND GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person making request • admitted to an approved mental health service for examination by a registered medical practitioner for the purpose of making a recommendation. ...................................................................................................... GIVEN NAME(S)/FAMILY NAME of mental health practitioner Signed:.............................................................Date...................................... signature of mental health practitioner employed by...................................................designation.......................... approved mental health service NOTE: The person who made the request to admit cannot sign this form as a mental health practitioner. _______________ Sch. 4 -- 27 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 25 SCHEDULE 5 Regulation 6 SPECIAL WARRANT Mental Health Act 1986 (Section 11) Mental Health Regulations 1998 IN THE MAGISTRATES' COURT AT UPON the sworn information of of CONCERNING (Name of person) of who appears to be mentally ill and incapable of caring for herself or himself. I AUTHORISE AND DIRECT a member of Victoria Police accompanied by a registered medical practitioner to enter any premises and, if necessary, to use such force as may be reasonably necessary to enable the registered medical practitioner to examine the person appearing to be mentally ill. DATED this day of (year) Signed Magistrate _______________ Sch. 5 -- 28 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 26 SCHEDULE 6 Regulation 7(a) STATEMENT OF RIGHTS—INVOLUNTARY PATIENT Mental Health Act 1986 Mental Health Regulations 1998 INVOLUNTARY PATIENT ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • appeal to the Mental Health Review Board against being an involuntary patient in a mental health service or on a community treatment order; • obtain a second opinion from a psychiatrist of your choice about your treatment; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing your treatment with your psychiatrist or doctor; • contact people by letter or phone; • complain about your treatment; • withdraw and spend money that is held in a trust account for you. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure is to help answer questions you might have about being in a mental health service. Most importantly, it tells you what your legal rights are as an Involuntary Patient under the Mental Health Act 1986. A member of staff will talk to you about your rights and answer your questions. If at any time you have questions about your rights, ask someone to explain. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. Sch. 6 -- 29 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 27 Why Am I Here? You have been admitted to a mental health service so you can receive treatment for a mental illness. A doctor has recommended it because, in the doctor's opinion: • you appear to be mentally ill (mental illness is defined in the Mental Health Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and • your mental illness requires immediate treatment and this can be obtained in a mental health service; and • because of your mental illness, you need to be admitted and kept here for treatment as an involuntary patient for your health or safety (whether to prevent a deterioration in your physical or mental condition or otherwise) or for the protection of members of the public; and • you have either refused or are unable to consent to the necessary treatment; and • there is no less restrictive way for you to receive adequate treatment for your mental illness. Within 24 hours of being admitted, a psychiatrist from the mental health service will examine you to decide if all these reasons apply to you. If they do, you must remain an involuntary patient. If the psychiatrist does not believe all of these reasons apply to you, you will be free to leave. However, if both you and the psychiatrist think you would benefit from further treatment at the mental health service, you can ask to be allowed to stay. In some circumstances, you can be made an involuntary patient on a community treatment order and you will not have to go to a mental health service. If this happens, your psychiatrist will explain the reasons, tell you your rights and give you the brochure Community Treatment Order and Restricted Community Treatment Order. What Will Happen To Me While I'm Here? Treatment It is your right to receive the best possible care and treatment while you are in this mental health service. Your case manager and the members of the treating team will provide you with treatment designed to meet your specific needs. They will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. You have the right to be involved in planning your treatment and the treating team will consider your preferences and concerns. However, if your psychiatrist believes a particular psychiatric treatment is necessary, that Sch. 6 -- 30 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 28 treatment can be given to you, even if you refuse. If this happens, your psychiatrist will explain why the treatment is necessary. You may have a friend or an advocate with you when you are discussing your treatment with your doctor. Generally, your family or primary carer (a relative or friend who is primarily responsible for providing support or care to you) can only be given information about your treatment and care if you agree. However, if a guardian, family member or your primary carer needs information to care for you, a member of the medical staff can give them the information, even if you don't agree. Second Opinion It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this or you can choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. Medical Treatment If a doctor suggests that you need medical or surgical treatment for a physical condition and the treatment is a major non-psychiatric treatment or a major medical procedure, you will be given the brochure Major Non-Psychiatric Treatment and Major Medical Procedure which explains your rights. Leave of Absence When you are well enough, you may be allowed to leave the mental health service for a short time (for example, a few hours, overnight or a weekend) to visit family or friends or for some other purpose. If you would like to have leave, you should talk to your case manager, doctor or psychiatrist. Your psychiatrist will make the final decision about your request for leave. Seclusion and Restraint Seclusion Seclusion is when a person is locked in a room alone for a period of time. This only happens if it is necessary to protect the person or others from an immediate or imminent risk to their health or safety or to prevent the person from absconding. It is only used when other ways of ensuring safety have failed. Mechanical Restraint Mechanical restraint is the use of a device, such as a harness or straps, to restrict a person's freedom to move about. Restraint may be used to enable a person to be medically treated, to prevent the person from causing injury to Sch. 6 -- 31 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 29 themself or others or to prevent the person from continuing to destroy property. Seclusion and restraint may be approved by your psychiatrist or, in an emergency, authorised by the senior nurse on duty. They can only be used for as long as the above reasons apply. If you are put in seclusion or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash. A registered nurse must review your physical and mental condition at least every 15 minutes. If you are being restrained you must be monitored continuously. A doctor must examine you at least every 4 hours unless your psychiatrist thinks less frequent examinations are appropriate. Transfer If your psychiatrist believes that you would benefit from moving to a different mental health service or a transfer is necessary for your treatment, you may be transferred. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. Community Treatment Order If your psychiatrist believes that you are well enough to live in the community while you receive the treatment you need, you may be placed on a community treatment order. You will still be an involuntary patient, even though you will be living in the community. To find out more about community treatment orders you can ask a staff member or your case manager to explain them and give you the brochure Community Treatment Order and Restricted Community Treatment Order. When Can I Leave? If at any time you want to be discharged from the mental health service, you should talk to your psychiatrist or doctor, or you can appeal to the Mental Health Review Board. If your psychiatrist believes that any of the reasons listed under Why Am I Here? no longer apply to you, you must be discharged as an involuntary patient and you will be free to leave. However, if both you and your psychiatrist think that you are benefiting from the treatment you are getting at the mental health service, you can ask to stay. Your Rights to Appeal and Review You have the right to appeal to the Mental Health Review Board against being an involuntary patient at any time. If you want to appeal, ask a member of staff for an Appeal Form, fill it in and ask the staff member to send it to the Board. If you need help to fill in the form, ask a friend, relative, lawyer, Sch. 6 -- 32 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 30 member of staff or community visitor to assist you. If no appeal form is available, you can write a letter to the Board which sets out your name, the name of the mental health service and what you want to appeal about. The Board must hear your appeal without delay. To find out more about the Board, ask for the brochure Mental Health Review Board or call the Board on [insert telephone number]. Whether or not you appeal to the Board, it will review you within 8 weeks of your admission as an involuntary patient. If you remain as an involuntary patient, you will be reviewed at least every 12 months. If you are discharged by the Board, you will no longer be an involuntary patient and you will be free to leave the mental health service. You can then discuss continuing treatment with your case manager or psychiatrist. Can I Complain? While you are in this mental health service, it is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about anything that happens while you are here, you have a right to complain. A good place to start is with your case manager, the senior nurse in your ward, the complaints liaison officer, your treating doctor or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] Sch. 6 -- 33 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 31 • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 6 -- 34 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 32 SCHEDULE 7 Regulation 7(b) STATEMENT OF RIGHTS—HOSPITAL ORDER PATIENT Mental Health Act 1986 Mental Health Regulations 1998 HOSPITAL ORDER PATIENT ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • appeal to the Mental Health Review Board against being a hospital order patient in a mental health service or on a restricted community treatment order; • obtain a second opinion from a psychiatrist of your choice about your treatment; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing your treatment with your psychiatrist or doctor; • contact people by letter or phone; • complain about your treatment; • withdraw and spend money that is held in a trust account for you. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure is to help answer questions you might have about being in a mental health service. Most importantly, it tells you what your rights are under the Mental Health Act 1986 as a Hospital Order Patient under the Sentencing Act 1991. A member of staff will talk to you about your rights and answer your questions. If at any time you have questions about your rights, ask someone Sch. 7 -- 35 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 33 to explain. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. Why Am I Here? You have been admitted to a mental health service so you can receive treatment for a mental illness. A psychiatrist has examined you and found that: • you appear to be mentally ill and require treatment for your illness (mental illness is defined in the Mental Health Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and • the treatment you need can be obtained in a mental health service; and • because of your mental illness, you need to be admitted and kept here for treatment as an involuntary patient for your health or safety (whether to prevent a deterioration in your physical or mental condition or otherwise) or for the protection of members of the public. There are 4 ways in which you may have been admitted as a hospital order patient. A member of staff will tell you which of the following applies to you and tick the correct box. " 1. As a prisoner or youth detainee, you have been transferred here by order of the Commissioner, Correctional Services, the Secretary, Department of Human Services or the Chief Commissioner of Police. " 2. You have been found guilty of an offence and the court ordered that you be assessed in a mental health service for up to 72 hours before being returned to court. " 3. You have been found guilty of an offence and the court ordered that you be diagnosed, assessed and treated in a mental health service for up to 3 months before being returned to court. " 4. You have been found guilty of an offence and the court ordered that you be admitted to and detained in a mental health service as an involuntary patient instead of receiving a sentence. What Will Happen To Me While I'm Here? Treatment It is your right to receive the best possible care and treatment while you are in this mental health service. Your case manager and the members of the treating team will provide you with treatment designed to meet your specific needs. They will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. Sch. 7 -- 36 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 34 You have the right to be involved in planning your treatment and the treating team will consider your preferences and concerns. However, if your psychiatrist believes a particular psychiatric treatment is necessary, that treatment can be given to you, even if you refuse. If this happens, your psychiatrist will explain why the treatment is necessary. You may have a friend or an advocate with you when you are discussing your treatment with your doctor. Generally, your family or primary carer (a relative or friend who is primarily responsible for providing support or care to you) can only be given information about your treatment and care if you agree. However, if a guardian, family member or your primary carer needs information to care for you, a member of the medical staff can give them the information, even if you don't agree. Second Opinion It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this or you can choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. Medical Treatment If a doctor suggests that you need medical or surgical treatment for a physical condition and the treatment is a major non-psychiatric treatment or a major medical procedure, you will be given the brochure Major Non-Psychiatric Treatment and Major Medical Procedure which explains your rights. Leave of Absence When you are well enough, you may be allowed to leave the mental health service for a short time (for example, a few hours, overnight or a weekend) to visit family or friends or for some other purpose. If you would like to have leave, you should talk to your case manager, doctor or psychiatrist. Your psychiatrist will make the final decision about your request for leave. Seclusion and Restraint Seclusion Seclusion is when a person is locked in a room alone for a period of time. This only happens if it is necessary to protect the person or others from an immediate or imminent risk to their health or safety or to prevent the person from absconding. It is only used when other ways of ensuring safety have failed. Mechanical Restraint Mechanical restraint is the use of a device, such as a harness or straps, to restrict a person's freedom to move about. Restraint may be used to enable a Sch. 7 -- 37 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 35 person to be medically treated, to prevent the person from causing injury to themself or others or to prevent the person from continuing to destroy property. Seclusion and restraint may be approved by your psychiatrist or, in an emergency, authorised by the senior nurse on duty. They can only be used for as long as the above reasons apply. If you are put in seclusion or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash. A registered nurse must review your physical and mental condition at least every 15 minutes. If you are being restrained you must be monitored continuously. A doctor must examine you at least every 4 hours unless your psychiatrist thinks less frequent examinations are appropriate. Transfer If your psychiatrist believes that you would benefit from moving to a different mental health service or a transfer is necessary for your treatment, you may be transferred. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. Restricted Community Treatment Orders If you were admitted as described in point 4 under Why Am I Here? and your psychiatrist and the chief psychiatrist believe that you are well enough to live in the community while you receive the treatment you need, you may be placed on a restricted community treatment order. You will still be an involuntary patient, even though you will be living in the community. To find out more about restricted community treatment orders you can ask a member of staff or your case manager to explain them and give you the brochure Community Treatment Order and Restricted Community Treatment Order. When Can I Leave? If at any time you want to be discharged from the mental health service, you should talk to your psychiatrist or doctor, or you can appeal to the Mental Health Review Board. How you can leave depends on how you became a hospital order patient. A member of staff will tell you which of the following applies to you and tick the correct box. " If you were transferred here as a prisoner or youth detainee as described in point 1 under Why Am I Here?, you can only be held in this mental health service while you remain a prisoner or youth detainee. If the term of your sentence ends, or you are released from Sch. 7 -- 38 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 36 custody by a court, or you are granted bail, you can no longer be treated as an involuntary patient. You can then discuss continuing treatment with your psychiatrist or case manager. You can also ask the Mental Health Review Board or the chief psychiatrist or your psychiatrist to review you at any time, and if they believe that any of the reasons listed under Why Am I Here? no longer apply to you, you must be discharged as an involuntary patient and returned to your original place of detention. " If you were admitted to the mental health service by a court order as described in points 2 or 3 under Why Am I Here? and the Mental Health Review Board or the chief psychiatrist or the court, on application by your psychiatrist, believes that any of the reasons listed under Why Am I Here? no longer apply to you, you must be discharged as an involuntary patient and returned to the court for sentencing or other order. At the end of the time specified in the order, you will be returned to the court for sentencing or other order. " If you were admitted to the mental health service by a court order as described in point 4 under Why Am I Here? and the Mental Health Review Board or the chief psychiatrist believes that any of the reasons listed under Why Am I Here? no longer apply to you, you must be discharged as an involuntary patient and you will be free to leave. You can then discuss continuing treatment with your case manager or psychiatrist. Your Rights to Appeal and Review You have the right to appeal to the Mental Health Review Board against being an involuntary patient at any time. If you want to appeal, ask a member of staff for an Appeal Form, fill it in and send it to the Board. If you need help to fill in the form, ask a friend, relative, solicitor, member of staff or community visitor to assist you. If no appeal form is available, you can write a letter to the Board which sets out your name, the name of the mental health service and what you want to appeal about. The Board must hear your appeal without delay. To find out more about the Board, ask for the brochure Mental Health Review Board or call the Board on [insert telephone number]. Whether or not you appeal to the Board, it will review you within 8 weeks of your admission as a hospital order patient. If you remain as a hospital order patient, you will be reviewed at least every 12 months. Can I Complain? While you are in this mental health service, it is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about anything that happens while you are here, you have a right to complain. Sch. 7 -- 39 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 37 A good place to start is with your case manager, the senior nurse in your ward, the complaints liaison officer, your treating doctor or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: Sch. 7 -- 40 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 38 [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 7 -- 41 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 39 SCHEDULE 8 Regulation 7(c) STATEMENT OF RIGHTS—COMMUNITY TREATMENT ORDER OR RESTRICTED COMMUNITY ORDER Mental Health Act 1986 Mental Health Regulations 1998 COMMUNITY TREATMENT ORDER AND RESTRICTED COMMUNITY TREATMENT ORDER ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • appeal to the Mental Health Review Board against being on a community treatment order or restricted community treatment order; • obtain a second opinion from a psychiatrist of your choice about your treatment; • obtain legal advice and have a lawyer represent you; • have a friend or relative represent you; • have someone of your choice with you when you are discussing your treatment with your psychiatrist or doctor; • complain about your treatment. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure is to help answer questions you might have about being on a community treatment order (CTO) or a restricted community treatment order (RCTO). Most importantly, it tells you your rights under the Mental Health Act 1986 in relation to these orders. Sch. 8 -- 42 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 40 A member of staff will talk to you about the order and explain your rights. You will be given a copy of the order. If at any time you have questions about the order or your rights, ask someone to explain. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. What Is A Community Treatment Order/Restricted Community Treatment Order? CTOs and RCTOs are orders which enable some involuntary patients to live in the community while they receive necessary treatment for their mental illness. Why Am I On An Order? You are on an order because your psychiatrist believes you need treatment for a mental illness, but at this time the treatment can be provided while you live in the community. You are still an involuntary patient, even though you are living in the community. Community Treatment Order Involuntary Patient You are on a CTO because your psychiatrist believes that: • you appear to be mentally ill (mental illness is defined in the Mental Health Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and • your mental illness requires immediate treatment and this can be obtained on a CTO; and • because of your mental illness, you need to be on a CTO for your health or safety (whether to prevent a deterioration in your physical or mental condition or otherwise) or for the protection of members of the public; and • you have either refused or are unable to consent to the necessary treatment; and • there is no less restrictive way for you to receive adequate treatment for your mental illness. In some circumstances, you can be made an involuntary patient on a CTO and you will not have to go to a mental health service. If this has happened your psychiatrist will explain the reasons, tell you your rights and give you the brochure Involuntary Patient. Restricted Community Treatment Order Sch. 8 -- 43 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 41 Hospital Order Involuntary Patient You are on a RCTO because the chief psychiatrist believes that: • you appear to be mentally ill and require treatment for your illness (mental illness is defined in the Mental Health Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and • the treatment you need can be obtained on a RCTO; and • because of your mental illness, you need to be on a RCTO for your health or safety (whether to prevent a deterioration in your physical or mental condition or otherwise) or for the protection of members of the public. The Mental Health Review Board must approve a RCTO before it can take effect. What Will Happen To Me While I Am On The Order? Planning for the Order Your psychiatrist will talk to you about the order. You have the right to be involved in planning the order. The plan will include an assessment about your needs for continuing treatment and support in the community and the best way these can be met. Your preferences will be taken into consideration for example, you may have a particular doctor that you wish to supervise the order. Conditions of the Order A community treatment order will name the psychiatrist who is to monitor your treatment and the doctor who is to supervise it, where you will receive the treatment and how long the order will last. The CTO may also state where you must live if this is considered necessary for the treatment of your illness. If you are unhappy with any of the conditions, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. A restricted community treatment order will state which psychiatrist is going to supervise your treatment, where and how often you will receive it, and how long the order will last. The chief psychiatrist may also include any other conditions that are necessary. The conditions of your CTO or RCTO may be varied from time to time for example, as your mental illness improves, you may need to see the doctor less often. Your psychiatrist will discuss this with you. The order can be made for a period of up to 12 months, but can be extended if the psychiatrist who made the order believes the reasons listed under Why Sch. 8 -- 44 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 42 Am I On An Order still apply to you. There is no limit to the number of times an order can be extended. Treatment It is your right to receive the best possible treatment while you are on an order. Your case manager and the members of the treating team will provide you with treatment designed to meet your specific needs. They will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. You have the right to be involved in planning your treatment and the treating team will consider your preferences and concerns. However, if your psychiatrist believes a particular psychiatric treatment is necessary, that treatment can be given to you, even if you refuse. If this happens, your psychiatrist will explain why the treatment is necessary. You may have a friend or an advocate with you when you are discussing your treatment with your doctor. Generally, your family or primary carer (a relative or friend who is primarily responsible for providing support or care to you) can only be given information about your treatment and care if you agree. However, if a guardian, family member or your primary carer needs information to care for you, a member of the medical staff can give them the information, even if you don't agree. Second Opinion It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this or you can choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. Medical Treatment If a doctor suggests that you need medical or surgical treatment for a physical condition and the treatment is a major non-psychiatric treatment or a major medical procedure, you will be given the brochure Major Non-Psychiatric Treatment and Major Medical Procedure which explains your rights. When Does The Order Finish? Discharge If at any time you want to be discharged from the order, you should talk to your doctor or psychiatrist, or you can appeal to the Mental Health Review Board. If any one of the reasons listed under Why Am I On An Order? no longer apply to you and you no longer need treatment as an involuntary patient, the psychiatrist who made the order or the Mental Health Review Board must discharge you from the order and you will be free to choose whether you Sch. 8 -- 45 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 43 want to continue your treatment. You can then discuss continuing treatment with your case manager or psychiatrist. Your Rights to Appeal and Review You have the right to appeal to the Mental Health Review Board against the order at any time. If you want to appeal, ask a member of staff for an Appeal Form, fill it in and send it to the Board. If no appeal form is available, you can write a letter to the Board which sets out your name, the name of the mental health service and what you want to appeal about. The Board must hear your appeal without delay. To find out more about the Board, ask for the brochure Mental Health Review Board or call the Board on [insert telephone number]. Whether or not you appeal to the Board, it will review you within 8 weeks of you being made an involuntary patient. If you remain as an involuntary patient, you will be reviewed at least every 12 months or whenever your CTO or RCTO is extended. If you are discharged by the Board, you will no longer be on the order and you will be free to choose whether you want to continue your treatment. You can then discuss continuing treatment with your case manager or psychiatrist. Revoking the Order If you do not comply with the conditions of the order, or if the psychiatrist who made the order or the Mental Health Review Board believe that your illness would be better treated in a mental health service, they may revoke the order and you must return to the mental health service. If this happens, reasonable efforts will be made to tell you that the order has been revoked. Can I Complain? While you are on an order, it is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about anything that happens while you are on the order, you have a right to complain. A good place to start is with your case manager, the complaints liaison officer, the manager of the community mental health service, your treating doctor or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. Sch. 8 -- 46 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 44 • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] Sch. 8 -- 47 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 45 • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 8 -- 48 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 46 SCHEDULE 9 Regulation 7(d) STATEMENT OF RIGHTS—SECURITY PATIENT Mental Health Act 1986 Mental Health Regulations 1998 SECURITY PATIENT ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • appeal to the Mental Health Review Board against being a security patient; • obtain a second opinion from a psychiatrist of your choice about your treatment; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing your treatment with your psychiatrist or doctor; • contact people by letter or phone, unless your psychiatrist has applied a security condition to you; • complain about your treatment; • withdraw and spend money that is held in a trust account for you. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure is to help answer questions you might have about being in a mental health service. Most importantly, it tells you what your legal rights are as a Security Patient under the Mental Health Act 1986. A member of staff will talk to you about your rights and answer your questions. If at any time you have questions about your rights, you should Sch. 9 -- 49 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 47 ask someone to explain. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. Why Am I Here? You have been admitted to a mental health service so you can receive treatment for a mental illness. A psychiatrist has examined you and found that: • you appear to be mentally ill and require treatment for your illness (mental illness is defined in the Mental Health Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and • the treatment you need can be obtained in a mental health service; and • because of your mental illness, you need to be admitted and kept here for treatment for your health or safety (whether to prevent a deterioration in your physical or mental condition or otherwise) or for the protection of members of the public. There are 2 ways you may have been admitted as a security patient. A member of staff will tell you which of the following applies to you and tick the correct box. " 1. You have been transferred to a mental health service from prison, police cells, a youth training centre, a remand centre or a youth residential centre by either the Secretary, Department of Justice or the Secretary, Department of Human Services, or the Chief Commissioner of Police. " 2. You have been found guilty of an offence and the court has sentenced you to be admitted to and detained in a mental health service on a hospital security order for the time specified in the order. What Will Happen To Me While I'm Here? Treatment It is your right to receive the best possible treatment while you are in this mental health service. Your case manager and the members of the treating team will provide you with treatment designed to meet your specific needs. They will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. You have the right to be involved in planning your treatment and the treating team will consider your preferences and concerns. However, if your psychiatrist believes a particular psychiatric treatment is necessary, that treatment can be given to you, even if you refuse. If this happens, your psychiatrist will explain why the treatment is necessary. You may have a Sch. 9 -- 50 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 48 friend or an advocate with you when you are discussing your treatment with your doctor. Generally, your family or primary carer (a relative or friend who is primarily responsible for providing support or care to you) can only be given information about your treatment and care if you agree. However, if a guardian, family member or your primary carer needs information to care for you, a member of the medical staff can give them the information, even if you don't agree. Second Opinion It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this or you can choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. Medical Treatment If a doctor suggests that you need medical or surgical treatment for a physical condition and the treatment is a major non-psychiatric treatment or a major medical procedure, you will be given the brochure Major Non-Psychiatric Treatment and Major Medical Procedure which explains your rights. Leave of Absence When you are well enough, the chief psychiatrist may allow you leave of absence from the mental health service, with such security conditions as are considered necessary. There are two kinds of leave: special leave of absence and leave of absence. Special leave of absence cannot exceed 24 hours and is for specific purposes. You can apply to the chief psychiatrist stating the special circumstances for which special leave is required. If the chief psychiatrist is satisfied there are special circumstances and the safety of members of the public will not be seriously endangered, the special leave must be granted. Leave of absence is approved by the chief psychiatrist and may be allowed for any appropriate purpose and period of time, provided the safety of members of the public will not be seriously endangered. If you would like to have leave, you should talk to your case manager, doctor or psychiatrist about how to make an application. If you are refused leave by the chief psychiatrist, you can appeal to the Mental Health Review Board. Seclusion and Restraint Seclusion Sch. 9 -- 51 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 49 Seclusion is when a person is locked in a room alone for a period of time. This only happens if it is necessary to protect the person or others from an immediate or imminent risk to their health or safety or to prevent the person from absconding. It is only used when other ways of ensuring safety have failed. Mechanical Restraint Mechanical restraint is the use of a device, such as a harness or straps, to restrict a person's freedom to move about. Restraint may be used to enable a person to be medically treated, to prevent the person from causing injury to themself or others or to prevent the person from continuing to destroy property. Seclusion and restraint may be approved by your psychiatrist or, in an emergency, authorised by the senior nurse on duty. They can only be used for as long as the above reasons apply. If you are put in seclusion or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash. A registered nurse must review your physical and mental condition at least every 15 minutes. If you are being restrained you must be monitored continuously. A doctor must examine you at least every 4 hours unless your psychiatrist thinks less frequent examinations are appropriate. Transfer If the chief psychiatrist believes that you would benefit from moving to a different mental health service or a transfer is necessary for your treatment, you may be transferred. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. Security Conditions While you are in the mental health service, you are in the custody of your psychiatrist who may apply such security conditions to you as are considered necessary for example, limit your phone calls or open your mail. When Can I Leave? If at any time you want to be discharged from the mental health service, you should talk to your psychiatrist or doctor, or you can appeal to the Mental Health Review Board. You can be held in this mental health service as a security patient only as long as you are legally able to be held at your original place of detention. If the term of your sentence ends, or you are released from custody by a court or you are granted bail, you can no longer be treated as a security patient. Sch. 9 -- 52 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 50 You can then discuss continuing treatment with your psychiatrist or case manager. If the chief psychiatrist believes that any of the reasons listed under Why Am I Here? no longer apply to you, you may be discharged as a security patient and returned to your original place of detention. If you are here as a hospital security order patient, you will be discharged and sent to prison to serve the rest of your sentence. Your Rights to Appeal and Review You have the right to appeal to the Mental Health Review Board against being a security patient at any time. If you want to appeal, ask a member of staff for an Appeal Form, fill it in and send it to the Board. If you need help to fill in the form, ask a friend, relative, solicitor, member of staff or community visitor to assist you. If no appeal form is available, you can write a letter to the Board which sets out your name, the name of the mental health service and what you want to appeal about. The Board must hear your appeal without delay. To find out more about the Board, ask for the brochure Mental Health Review Board or call the Board on [insert telephone number]. Whether or not you appeal to the Board, it will review you within 8 weeks of your admission as a security patient. If you remain as a security patient, you will be reviewed at least every 12 months. If you are discharged by the Board, you will be returned to your original place of detention. If you are here as a hospital security order patient, you will be discharged and sent to prison to serve the rest of your sentence. Can I Complain? While you are in this mental health service, it is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about anything that happens while you are here, you have a right to complain. A good place to start is with your case manager, the senior nurse in your ward, the complaints liaison officer, your treating doctor or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. Sch. 9 -- 53 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 51 • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: Sch. 9 -- 54 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 52 [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 9 -- 55 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 53 SCHEDULE 10 Regulation 7(e) STATEMENT OF RIGHTS—CONTINUING TREATMENT INVOLUNTARY PATIENT Mental Health Act 1986 Mental Health Regulations 1998 CONTINUING INVOLUNTARY TREATMENT (SECTION 12A–12D) ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • appeal to the Mental Health Review Board against being a continuing treatment involuntary patient; • obtain a second opinion from a psychiatrist of your choice about your treatment; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing your treatment with your psychiatrist or doctor; • contact people by letter or phone; • complain about your treatment; • withdraw and spend money that is held in a trust account for you. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure is to help answer questions you might have about being in a mental health service. Most importantly, it tells you what your legal rights are as a Continuing Treatment Involuntary Patient under the Mental Health Act 1986. Sch. 10 -- 56 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 54 A member of staff will talk to you about your rights and answer your questions. If at any time you have questions about your rights, ask someone to explain. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. Why Am I Here? You have been admitted to a mental health service so you can receive treatment for a mental disorder. You were first admitted and detained in the mental health service as an Involuntary Patient and your admission was confirmed by a psychiatrist. Your psychiatrist or the chief psychiatrist has now examined you and believes that: • you appear to have a mental disorder; and • you would cause serious physical harm to yourself if not detained and treated in a mental health service; and • treatment can be obtained for your mental disorder in the mental health service. To decide these things, they will talk with you, consider your recent behaviour and may seek information from members of the treating team, a relative, your primary carer or guardian (if you have one). Application For Continuing Treatment Application By Your Psychiatrist If your psychiatrist believes that all of the reasons listed under Why Am I Here? apply to you, your psychiatrist may apply to the chief psychiatrist for your detention to be continued for a period of up to 3 months. After receiving the application, the chief psychiatrist will notify the Secretary to the Department of Human Services about the application. Application By The Chief Psychiatrist If the chief psychiatrist believes that all of the reasons listed under Why Am I Here? apply to you and your psychiatrist has not made an application, the chief psychiatrist may apply to the Secretary to the Department of Human Services for your detention to be continued for a period of up to 3 months. What Happens After An Application is Made? The Secretary will arrange for a committee of 3 psychiatrists to decide whether to agree to the application. The chief psychiatrist will be a member of the committee and there will be 2 other independent psychiatrists. Each member of the committee will examine you to decide whether you should continue to be detained or not. The committee must make its decision Sch. 10 -- 57 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 55 within 7 days of the application being made; if it does not you will be discharged. If the committee believes that all of the reasons listed under Why Am I Here? apply to you, you must remain as a Continuing Treatment Involuntary Patient. The committee will consent to your continuing detention and treatment for a period of up to 3 months. At the end of the time, your psychiatrist or the chief psychiatrist may make an application to have your detention extended for another period of up to 3 months. There is no limit to the number of times an order can be extended. If the committee does not believe that all of the reasons apply to you, your psychiatrist must discharge you and you will be free to leave. You can then discuss continuing treatment with your case manager or psychiatrist. Your Rights to Appeal and Review If the committee decides that you should remain in the mental health service, the Mental Health Review Board will hold a hearing within 14 days after the committee's decision to decide whether you should continue to be detained or not. The Board will notify the Public Advocate about the hearing. The Public Advocate may be able to offer you advice and assistance and can be contacted on [insert telephone number]. If you are discharged by the Board, you will no longer be a continuing treatment involuntary patient and you will be free to leave. You can then discuss continuing treatment with your case manager or psychiatrist. If the Board does not discharge you, you must remain a continuing treatment involuntary patient. You have the right to appeal to the Mental Health Review Board against being a continuing treatment involuntary patient at any time. If you want to appeal, ask a member of staff for an Appeal Form, fill it in and send it to the Board. If you need help to fill in the form, ask a friend, relative, lawyer, member of staff or community visitor to assist. If no appeal form is available, you can write a letter to the Board which sets out your name, the name of the mental health service and what you want to appeal about. The Board must hear your appeal without delay. To find out more about the Board, ask for the brochure Mental Health Review Board or call the Board on [insert telephone number]. What Will Happen To Me While I'm Here? Treatment It is your right to receive the best possible care and treatment while you are in this mental health service. Your case manager and the members of the treating team will provide you with treatment designed to meet your specific needs. They will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. Sch. 10 -- 58 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 56 You have the right to be involved in planning your treatment and the treating team will consider your preferences and concerns. However, if your psychiatrist believes a particular psychiatric treatment is necessary, that treatment can be given to you, even if you refuse. If this happens, your psychiatrist will explain why the treatment is necessary. You may have a friend or an advocate with you when you are discussing your treatment with your doctor. Generally, your family or primary carer (a relative or friend who is primarily responsible for providing support or care to you) can only be given information about your treatment and care if you agree. However, if a guardian, family member or your primary carer needs information to care for you, a member of the medical staff can give them the information, even if you don't agree. Second Opinion It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this or you can choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. Medical Treatment If a doctor suggests that you need medical or surgical treatment for a physical condition and the treatment is a major non-psychiatric treatment or a major medical procedure, you will be given the brochure Major Non-Psychiatric Treatment and Major Medical Procedure which explains your right. Leave of Absence When you are well enough, you may be allowed to leave the mental health service for a short time (for example, a few hours, overnight or a weekend) to visit family or friends or for some other purpose. If you would like to have leave, you should talk to your case manager, doctor or psychiatrist. Your psychiatrist will make the final decision about your request for leave. Seclusion and Restraint Seclusion Seclusion is when a person is locked in a room alone for a period of time. This only happens if it is necessary to protect the person or others from an immediate or imminent risk to their health or safety or to prevent the person from absconding. It is only used when other ways of ensuring safety have failed. Mechanical Restraint Mechanical restraint is the use of a device, such as a harness or straps, to restrict a person's freedom to move about. Restraint may be used to enable a person to be medically treated, or to prevent the person from causing injury Sch. 10 -- 59 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 57 to themself or others or to prevent the person from continuing to destroy property. Seclusion and restraint may be approved by your psychiatrist or, in an emergency, authorised by the senior nurse on duty. They can only be used for as long as the above reasons apply. If you are put in seclusion or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash. A registered nurse must review your physical and mental condition at least every 15 minutes. If you are being restrained you must be monitored continuously. A doctor must examine you at least every 4 hours unless your psychiatrist thinks less frequent examinations are appropriate. Transfer If your psychiatrist believes that you would benefit from moving to a different mental health service or a transfer is necessary for your treatment, you may be transferred. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. When Can I Leave? If at any time you want to be discharged from the mental health service, you should talk to your psychiatrist or doctor, or you can appeal to the Mental Health Review Board. If the chief psychiatrist believes that any of the reasons listed under Why Am I Here? no longer apply to you, you must be discharged as a continuing treatment involuntary patient and you will be free to leave. You can then discuss continuing treatment with your case manager or psychiatrist. Can I Complain? While you are in this mental health service, it is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about anything that happens while you are here, you have a right to complain. A good place to start is with your case manager, the senior nurse in your ward, the complaints liaison officer, your treating doctor or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. Sch. 10 -- 60 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 58 • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: Sch. 10 -- 61 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 59 [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 10 -- 62 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 60 SCHEDULE 11 Regulation 7(f) STATEMENT OF RIGHTS—FORENSIC PATIENT Mental Health Act 1986 Mental Health Regulations 1998 FORENSIC PATIENT ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • obtain a second opinion from a psychiatrist of your choice about your treatment; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing your treatment with your psychiatrist or doctor; • contact people by letter or phone, unless these rights have been limited by a security condition imposed by your psychiatrist; • complain about your treatment; • withdraw and spend money that is held in a trust account for you. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure is to help answer questions you might have about being in a mental health service. Most importantly, it tells you what your legal rights are as a Forensic Patient under the Mental Health Act 1986. A member of staff will talk to you about your rights and answer your questions. If at any time you have questions about your rights, you should ask someone to explain. You may choose to ask a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. Sch. 11 -- 63 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 61 Why Am I Here? You have been admitted to the mental health service so you can receive treatment or care for a mental disorder. There are three ways you may have been admitted as a forensic patient to this mental health service. A member of staff will tell you which of the following applies to you and tick the correct box: " a remand order. A court has remanded you in custody, for the time specified in the order, to await further court proceedings. " a transfer order. You have been transferred from a prison to receive treatment for a mental disorder. " a custodial supervision order. A court has placed you on a custodial supervision order. The order is not for a fixed period of time, but will end when the court decides. What Will Happen To Me While I'm Here? Treatment It is your right to receive the best possible care and treatment while you are in this mental health service. Your case manager and the members of the treating team will provide you with treatment designed to meet your specific needs. They will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. You have the right to be involved in planning your treatment and the treating team will consider your preferences and concerns. However, if your psychiatrist believes a particular psychiatric treatment is necessary, that treatment can be given to you, even if you refuse. If this happens, your psychiatrist will explain why the treatment is necessary. You may have a friend or an advocate with you when you are discussing your treatment with your doctor. If you are on a custodial supervision order, a report about your treatment and progress must be sent to the court which made your supervision order at least every 12 months. Confidentiality Generally, your family or primary carer (a relative or friend who is primarily responsible for providing support or care to you) can only be given information about your treatment and care if you agree. However, if a guardian, family member or your primary carer needs information to care for you, a member of the medical staff can give them the information, even if you don't agree. Second Opinion Sch. 11 -- 64 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 62 It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this or you can choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. Medical Treatment If a doctor suggests that you need medical or surgical treatment for a physical condition and the treatment is a major non-psychiatric treatment or a major medical procedure, you will be given the brochure Major Non-Psychiatric Treatment and Major Medical Procedure which explains your rights. Leave of Absence Leave of absence allows forensic patients to leave the mental health service for a variety of purposes, including medical appointments, court appearances and rehabilitation programs. Leave is always subject to security conditions and time limits. If you would like to have leave, you should talk to your case manager, doctor or psychiatrist about how to make an application. The following kinds of leave are available: • Special Leave Special leave of absence is for specific purposes and cannot exceed 24 hours. You, or someone on your behalf, can apply to the authorised psychiatrist stating the special circumstances for which special leave is required. If your psychiatrist is satisfied that there are special circumstances and the safety of members of the public will not be seriously endangered, special leave must be granted. If you are refused special leave, you can appeal to the Forensic Leave Panel. • On-Ground Leave and Limited Off-Ground Leave On-ground leave and limited off-ground leave are available to forensic patients who are on custodial supervision orders: On-ground leave allows you to leave the mental health service, but you will be limited to a defined area around the mental health service known as the surrounds. Limited off-ground leave allows you to go beyond the surrounds of the mental health service. Generally, limited off-ground leave is only permitted during the day between the hours of 7.30 am and 7.30 pm. It can be granted outside these hours, but only for a maximum of 3 consecutive days in any 7 day period. To apply for on-ground leave or limited off-ground leave, you must make an application to the Forensic Leave Panel. The Panel must be satisfied that your safety or the safety of members of the public will not be seriously endangered by granting you leave. Leave may be granted for a period of up Sch. 11 -- 65 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 63 to 6 months. At the end of this time, you can apply to the Panel to have the leave renewed. • Extended Leave Extended leave allows patients on custodial supervision orders to be absent from the mental health service to live in the community. To apply for extended leave, you must make an application to the court that made your custodial supervision order. The court must be satisfied that your safety or the safety of members of the public will not be seriously endangered by granting you leave. Extended leave may be granted for a period of up to 12 months. At the end of this time, you can apply to the court to have the leave renewed. Suspension of Leave If, at any time, the Chief Psychiatrist believes your safety or the safety of members of the public will be seriously endangered, your leave may be suspended. If your leave is suspended, the Chief Psychiatrist will notify you in writing and you must return to the mental health service. If you do not return, you can be apprehended at any time by police or other prescribed people. Forensic Leave Panel The main function of the Forensic Leave Panel is to consider applications for on-ground leave and limited off-ground leave by forensic patients who are on custodial supervision orders. To find out more about the Panel, ask for the brochure Forensic Leave Panel or call the Panel on [insert telephone number]. Seclusion and Restraint Seclusion Seclusion is when a person is locked in a room alone for a period of time. This only happens if it is necessary to protect the person or others from an immediate or imminent risk to their health or safety or to prevent the person from absconding. It is only used when other ways of ensuring safety have failed. Restraint Mechanical restraint is the use of a device, such as a harness or straps, to restrict a person's freedom to move about. Restraint may be used to enable a person to be medically treated, to prevent the person from causing injury to themself or others or to prevent the person from continually destroying property. Seclusion and restraint may be approved by your psychiatrist or, in an emergency, authorised by the senior registered nurse on duty. They can only be used for as long as the above reasons apply. Sch. 11 -- 66 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 64 If you are put in seclusion or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash. A registered nurse must review your physical and mental condition at least every 15 minutes. If you are being restrained you must be monitored continuously. A doctor must examine you at least every 4 hours unless the authorised psychiatrist thinks less frequent examinations are appropriate. Transfer If the Chief Psychiatrist believes you would benefit by moving to a different mental health service or a transfer is necessary for your treatment, you may be transferred. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Forensic Leave Panel. Security Conditions While you are in the mental health service, the authorised psychiatrist may apply necessary security conditions to you - for example, limit your phone calls or open your mail. Security conditions are applied to ensure your health or safety or for the protection of members of the public. How Can I Leave? Generally, the decision about when and how you leave the mental health service will be made by the court which ordered your detention. Extended leave of absence is one option and has been discussed earlier. Other ways you can leave will depend on the type of order, as set out below. Remand Order If you are on remand, you will be returned to the court at the end of the time specified in the court order. Transfer Order If you were transferred from prison to the mental health service while on a custodial supervision order, you will remain at the mental health service until the court makes another order. Custodial Supervision Order If you are on a custodial supervision order, you can apply to the court which made the order to have it varied. The court can: • confirm the order; or • change the place of custody; or Sch. 11 Sch. 11 -- 67 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 65 • change the order to a non-custodial supervision order. If the court releases you on a non-custodial supervision order, you will be able to live in the community, subject to conditions decided by the court. The court cannot make a non-custodial supervision order unless: • it is satisfied your safety or the safety of members of the public will not be seriously endangered; and • you have completed at least 12 months of extended leave. The court will take into account whether you have complied with the conditions of the extended leave. If the court refuses your application, you cannot apply again for at least 3 years, unless the court sets a shorter period. You have the right to appeal against the court's decision to the Court of Appeal. Your psychiatrist, the Secretary to the Department of Human Services or the Director of Public Prosecutions can also apply to have your order varied. There is no time limit on when they can make further applications. Major Review When the court made your supervision order, it set a time called the nominal term. At least 3 months before the end of the nominal term the court must conduct a major review of your progress. The major review will only occur if you are still subject to a supervision order at the end of the nominal term. If the court has released you from supervision before the end of the nominal term, there is no need for a major review. If you are still subject to a custodial supervision order at the end of the nominal term, the purpose of the major review will be to decide whether you can be released on a non-custodial supervision order. The court must vary your order to a non-custodial supervision order if: • it is satisfied your safety or the safety of members of the public will not be seriously endangered; and • you have successfully completed at least 12 months of extended leave. If the court does not release you on a non-custodial supervision order, you have the right to appeal to the Court of Appeal. Can I Complain? While you are in this mental health service, it is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about anything that happens while you are here, you have the right to complain. A good place to start is with your case manager, the senior nurse in your ward, the complaints liaison officer, your treating doctor or the Director of Psychiatry of the mental health service. Sch. 11 -- 68 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 66 If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below: • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor, and may be able to assist with legal representation at court or Forensic Leave Panel hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to assist with legal representation at court or Forensic Leave Panel hearings. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • Forensic Leave Panel is an independent Panel. Its main function is to hear applications for leave of absence by forensic patients and forensic residents. You can contact the Panel at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care -- 69 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 67 consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 11 -- 70 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 68 SCHEDULE 12 Regulation 7(g) STATEMENT OF RIGHTS—APPEALS TO MENTAL HEALTH REVIEW BOARD Mental Health Act 1986 Mental Health Regulations 1998 MENTAL HEALTH REVIEW BOARD HOW IT CAN HELP YOU What Are My Rights? You have the right to: • appeal to the Mental Health Review Board against being kept in a mental health service or on a community treatment order or restricted community treatment order; • obtain a second opinion from a psychiatrist of your choice about your treatment; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • complain about your treatment. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure has been given to you to tell you about the Mental Health Review Board. You have the right to appeal against being kept in a mental health service or about any of the other matters listed under What Does The Mental Health Review Board Do? and What Else Does The Board Do? at any time. A member of staff will talk to you about the Mental Health Review Board and explain your rights. If at any time you have questions about the Board or your rights, ask someone to explain. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. Sch. 12 -- 71 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 69 You can also get information from the Mental Health Review Board by calling [insert telephone number]. What Does The Mental Health Review Board Do? The Mental Health Review Board is an independent board. Its main functions are: • to hear appeals from involuntary and security patients and people on community treatment orders and restricted community treatment orders who want to be discharged; • to review all involuntary and security patients within 8 weeks of admission and all continuing treatment involuntary patients within 2 weeks of their detention, to decide if they should continue to be detained; • to review all involuntary and security patients at least every 12 months to decide if they should continue to be detained. How Does The Board Decide Appeals and Reviews? The Board must decide whether the reasons you are being kept in a mental health service or on a community treatment order or restricted community treatment order, still apply to you. The reasons are listed below for each patient group. A member of staff will tell you which group applies to you and tick the correct box. If any one of the relevant reasons does not apply, you will be discharged. If the Board decides all of the relevant reasons apply to you, you must remain as an involuntary or security patient. " Involuntary Patient If you are an involuntary patient in a mental health service or on a community treatment order (CTO), the Board must decide whether: • you appear to be mentally ill (mental illness is defined in the Mental Health Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and • your mental illness requires immediate treatment and this can be obtained in the mental health service or on a CTO; and • because of your mental illness, you need to be kept in the mental health service or on a CTO for treatment, for your health or safety (whether to prevent a deterioration in your physical or mental condition or otherwise) or for the protection of members of the public; and • you have either refused or are unable to consent to the necessary treatment; and Sch. 12 -- 72 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 70 • there is no less restrictive way for you to receive adequate treatment for your mental illness. " Hospital Order or Security Patient If you are a hospital order patient in a mental health service or on a restricted community treatment order (RCTO) or a security patient, the Board must decide whether: • you appear to be mentally ill and require treatment for your illness (mental illness is defined in the Mental Health Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory); and • the treatment you need can be obtained in the mental health service or on a RCTO; and • because of your mental illness, you need to be kept in the mental health service or on a RCTO for treatment, for your health or safety (whether to prevent a deterioration in your physical or mental condition or otherwise) or for the protection of members of the public. " Continuing Treatment Involuntary Patient If you are a continuing treatment involuntary patient, the Board must decide whether: • you appear to have a mental disorder; and • you would cause serious physical harm to yourself if not detained and treated in a mental health service; and • treatment can be obtained for your mental disorder in a mental health service. What Else Does The Board Do? The Board also: • hears appeals from patients who do not want to be transferred to a different mental health service; • hears appeals from security patients who have been refused leave by the chief psychiatrist; • reviews all RCTOs made by the chief psychiatrist (the RCTO does not take effect unless it has been approved by the Board); and • reviews the extension of all CTOs and RCTOs. How Can I Appeal To The Board? If you want to appeal to the Board, ask a member of staff for an Appeal Form, fill it in and ask the staff member to send it to the Board. If no appeal Sch. 12 -- 73 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 71 form is available, you can write a letter to the Board which sets out your name, the name of the mental health service and what you want to appeal about. The appeal should be mailed or faxed to: Executive Officer Mental Health Review Board [insert appropriate address and telephone and facsimile numbers] The appeal may also be initiated by sending it to one of the following: the chief psychiatrist, an authorised psychiatrist, a community visitor, the Ombudsman or the Health Services Commissioner. If you need help to fill in the form or with anything else, you should ask a friend or relative, your case manager, a member of staff, your doctor, a lawyer or community visitor to help you. How Should I Prepare For The Hearing Of An Appeal or A Review? The Board will send you a notice advising the date, time and place at which your review or appeal will be heard. You are encouraged to attend the hearing. You can have anyone attend to offer support or speak for you, for example, an advocate, a lawyer, a friend or relative. If you are unable to attend the hearing, you should tell the Board as soon as possible. If you have special needs, such as an interpreter, you should discuss these with a member of staff or contact the Board. The Board will arrange an interpreter if necessary. Continuing Treatment Involuntary Patient If you are a continuing treatment involuntary patient, the Board must notify the Public Advocate about the hearing. The Public Advocate may be able to offer you advice and assistance. Will I Have Access To Documents For the Hearing? You or your representative will be given the opportunity to read any documents to be given to the Board for your hearing, including your clinical file, at least 24 hours before the hearing. However, if your psychiatrist believes you should not see a document or part of any document because it will cause serious harm to your health or the health or safety of another person, or if information in a document was given in confidence or is personal information about another person, your psychiatrist can apply to the Board to stop you seeing the document or part of the document. If this happens, the Board will make the final decision. If the Board decides you should not see a document or part of any document, it may allow your representative to see it instead. What Happens At The Hearing? Sch. 12 -- 74 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 72 Hearings are held either at hospitals or community mental health services. Your hearing will usually be heard by 3 Board members—a lawyer, a psychiatrist and a community member. If the hearing is the annual review of your involuntary detention in the mental health service or the review of the extension of your community treatment order, it may be conducted by one person—a lawyer, a psychiatrist or a community member of the Board. The hearing will be informal and private, unless the Board decides that it is in your best interests or the public interest for the hearing to be open. Your doctor and other members of the treating team will give information to the Board. You and your representative will be able to ask questions and explain your side of the case for example, why you believe you should not be kept in the mental health service. If you are too ill to attend the hearing, a member of the Board may visit you in your ward. At the end of the hearing, the Board will advise you of its decision and the reasons for it. You will be given a written copy of the order, however, if you want written reasons, you must request these in writing from the Board within 28 days and the Board must provide you with a statement of reasons within 14 days of your request. The Board's Decision What Happens If The Board Discharges Me? If you are discharged by the Board, you will no longer be an involuntary or security patient. What happens will depend on how you came to the mental health service. A member of staff will tell you which of the following applies to you and tick the correct box. If you were: " an involuntary patient, you will be free to leave the mental health service; " an involuntary patient on a CTO, you will no longer be on the order and will be free to choose whether you want to continue your treatment; " a hospital order involuntary patient from a court, you will be free to leave the mental health service; " a hospital order involuntary patient on a RCTO, you will no longer be on the order and will be free to choose whether you want to continue your treatment; " a continuing treatment involuntary patient, you will be free to leave the mental health service; " a hospital order involuntary patient from a prison or detention centre, you will be returned to your original place of detention; Sch. 12 -- 75 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 73 " a hospital order (diagnosis, assessment and treatment) patient, you will be returned to court for sentencing or another order; " a security patient, you will be returned to your original place of detention; " a hospital security order patient, you will be sent to prison to serve the rest of your sentence. If you are discharged, you can discuss continuing treatment with your case manager or psychiatrist. If you have been an in-patient and both you and your psychiatrist think you would benefit from further treatment at the mental health service, you can ask to be allowed to stay. What If The Board Doesn't Discharge Me? If the Board doesn't discharge you, you remain an involuntary or security patient. You can appeal again to the Board at any time. Whether or not you appeal, the Board will automatically review you at least every 12 months. Your psychiatrist will also regularly review you to see if you should be discharged. Can I Appeal Against The Board's Decision? If you disagree with the Board's decision you can appeal to the Victorian Civil and Administrative Tribunal (VCAT). VCAT is an independent tribunal with the power to confirm or overturn the decision of the Board. Appeals must be made in writing within 28 days to: Victorian Civil and Administrative Tribunal [insert appropriate address and telephone and facsimile numbers] Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] Sch. 12 -- 76 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 74 • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 12 -- 77 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 75 SCHEDULE 13 Regulation 7(h) STATEMENT OF RIGHTS—APPLICATIONS AND APPEALS TO FORENSIC LEAVE PANEL Mental Health Act 1986 Mental Health Regulations 1998 FORENSIC LEAVE PANEL HOW IT CAN HELP YOU What Are My Rights? You have the right to: • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • contact people by letter or phone, unless these rights have been limited by a security condition; • complain. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative, lawyer or community visitor. About Your Rights This brochure has been given to you to tell you about the Forensic Leave Panel and how it can help you. A member of staff will talk to you about the Forensic Leave Panel and explain your rights. They will tell you whether you are a forensic patient or forensic resident and explain the difference. If at any time you have questions about the Panel or your rights, ask someone to explain. You may choose to ask a member of staff, your case manager, a friend, relative, lawyer or community visitor. If you have a guardian, the guardian will also be given the information and will be able to act on your behalf. You can also get information from the Forensic Leave Panel by calling [insert telephone number]. What Is The Forensic Leave Panel? Sch. 13 -- 78 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 76 The Forensic Leave Panel is an independent panel. Its main function is to hear applications for leave of absence by forensic patients and forensic residents who are on custodial supervision orders. There are two types of leave of absence the Panel can consider—On-Ground Leave and Limited Off- Ground Leave. On-ground leave allows you to leave the mental health service, but you will be limited to a defined area around the mental health service known as the surrounds. Limited off-ground leave allows you to go beyond the surrounds of the mental health service. The Panel also hears appeals from: • forensic patients and forensic residents who are on custodial supervision orders and have been refused special leave of absence; and • forensic patients who do not want to be transferred to another mental health service. How Can I Apply To The Panel? Leave of Absence If you want leave of absence, you should discuss this with your case manager or a member of staff. They will be able to talk about your choices and give you advice. It is important that they are involved because the Panel will want to know how the leave application relates to the plan for managing your condition. To apply for leave of absence, ask a member of staff for an [insert title of appropriate application form] form, fill it in and ask the staff member to send it to the Panel. If you need help to fill in the form, you should ask a friend or relative, your case manager, a member of staff, a lawyer or community visitor to help you. If no forms are available, you can write a letter to the Panel setting out your name, the name of the mental health service and the type of leave you want. The application should be mailed or faxed to: Executive Officer Forensic Leave Panel [insert appropriate address and telephone and facsimile numbers] Appeal If you want to appeal to the Panel because you have been refused special leave or you are a forensic patient and you do not want to be transferred to another mental health service, ask a member of staff for an [insert title of appropriate appeal form] form, fill it in and ask the staff member to send it to the Panel. If no forms are available, you can write a letter to the Panel setting out your name, the name of the mental health service and what you want to appeal about. The appeal can be mailed or faxed to the above address. Sch. 13 -- 79 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 77 How Should I Prepare For The Hearing? The Panel will arrange for you to be given a notice advising the date, time and place at which your application or appeal will be heard. It is your right to attend the hearing and present your case. You can have someone attend to offer support or speak for you—for example, an advocate, a lawyer, a friend or relative. If you are unable to attend the hearing, you should tell the Panel as soon as possible. Before the hearing, read the documents which will be given to the Panel for your hearing (see below) and think about what you are going to say to the Panel. You may also want to give the Panel written information. Your family and friends or someone you respect may wish to write letters or come to the hearing in support of your application. If you have special needs, such as an interpreter, you should discuss these with a member of staff or contact the Panel. The Panel will arrange an interpreter if necessary. Will I Have Access to Documents for the Hearing? You or your representative will be given the opportunity to read any documents to be given to the Panel for your hearing at least 24 hours before the start of the hearing. An application can be made to the Panel to prevent you seeing a document or part of a document if it is considered that: • seeing the document or part of the document will cause serious harm to your health or the health or safety of another person; or • the information in the document was given in confidence; or • the information in the document is personal information about another person. If an application is made to prevent you seeing a document or part of a document a staff member will tell you and explain the process. The Panel will make the final decision whether you see the whole document or part of the document or none of the document. If the Panel decides that you should not see a document or part of a document, it may allow your representative to see it instead. What Happens At The Hearing? Your hearing will usually be held at the mental health service by 3 or 4 Panel members. If you are: • a forensic patient—the Panel will be a judge, a community member, the chief psychiatrist and a medical practitioner. • a forensic resident—the Panel will be a judge, a community member and a psychologist. Sch. 13 -- 80 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 78 The Panel's hearings will be informal and private, unless the Panel decides that it is in your best interest or in the public interest for the hearing to be open. The Panel is not bound by strict rules of practice like a court and can inform itself in any way it thinks fit. Staff and workers involved in your treatment, care and support will give information to the Panel. You and your representative can ask questions and explain your side of the case—for example, why you believe you should be given leave of absence. The Panel's Decision At the end of the hearing, the Panel will advise you of its decision and the reasons for it. You will be given a written copy of the order. If you want written reasons for the Panel's decision, you must request them in writing from the Panel. The Panel must provide you with a statement of reasons within 14 days of your request. Leave of Absence The Panel cannot grant on-ground leave or limited off-ground leave if it believes your safety or the safety of members of the public will be seriously endangered. If you have appealed to the Panel because you have been refused special leave, the Panel may grant the special leave if it believes that there are special circumstances and the safety of members of the public will not be seriously endangered. If the Panel approves leave of absence, it may place conditions on the leave—for example, that you be escorted by a member of staff at all times. You and your representative will be given a copy of the order, which will list the type of leave granted and the conditions of the leave. If the Panel refuses leave of absence, you should talk to your case manager or another member of staff and discuss the reasons. You may be able to make another application which addresses the reasons. While you remain on a custodial supervision order, you can apply for leave to the Panel at any time. Your case manager and other staff and workers will also regularly review your progress to see if it is appropriate for you to have leave. Transfer of Forensic Patient If you are a forensic patient and have appealed against a transfer to another mental health service, the Panel must consider whether you would benefit by moving to a different service or whether a transfer is necessary for your treatment. The Panel may: • confirm the transfer; or • stop the transfer; or • return you to the original mental health service if you have already been transferred. Sch. 13 -- 81 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 79 Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor, and may be able to assist with legal representation at court or Forensic Leave Panel hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at court or Forensic Leave Panel hearings and advise about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Villamanta Legal Service is an independent, statewide Community Legal Centre that specialises in disability related legal issues. It will provide you with information about your rights and may be able to arrange legal representation for you at court or Forensic Leave Panel hearings. You can contact the Service at: [insert appropriate address and telephone and facsimile numbers] • Community Visitors are people who visit services at least once a month to inquire into the adequacy of services and facilities, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] Sch. 13 -- 82 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 80 • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • Forensic Leave Panel is an independent Panel. Its main function is to hear applications for leave of absence by forensic patients and forensic residents. You can contact the Panel at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff, about other local organisations and support groups which may be able to help you. _______________ Sch. 13 -- 83 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 81 SCHEDULE 14 Regulation 8(a) STATEMENT OF RIGHTS—ELECTROCONVULSIVE THERAPY Mental Health Act 1986 (Section 75) Mental Health Regulations 1998 ELECTROCONVULSIVE THERAPY ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • obtain a second opinion from a psychiatrist of your choice about whether you need ECT; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing ECT with your psychiatrist or doctor; • complain about your treatment. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure has been given to you because your psychiatrist has recommended that you would benefit from a course of Electroconvulsive Therapy (ECT). Most importantly, it tells you what your legal rights are under the Mental Health Act 1986 in relation to ECT. Your psychiatrist or a member of clinical staff will talk to you about your rights and answer your questions. If at any time you have questions about ECT or your rights, ask someone to explain. This may be your psychiatrist, doctor, case manager, a friend, relative, lawyer or an advocate. Electroconvulsive Therapy (ECT) Sch. 14 -- 84 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 82 What is ECT? ECT is a procedure in which generalised seizures, induced by the passage of an electrical current through the brain under general anaesthesia, and muscle relaxation are used for therapeutic purposes. The most common use for ECT is in the treatment of people with severe depression, but it is sometimes used to treat other mental illnesses such as mania, schizophrenia, catatonia and other neuropsychiatric conditions. Before recommending ECT, your psychiatrist will arrange for you to have a thorough physical, psychiatric and psychological examination. The psychiatrist will also explain the treatment, how it works, discuss possible side-effects, alternative treatments, ask your views and answer any questions you might have about the treatment. Second Opinion It is your right to get a second opinion about whether you need ECT. Your case manager or psychiatrist can arrange this or you can choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. Advocacy When you are discussing ECT with your psychiatrist, it is your right to have a friend, relative, lawyer or an advocate with you for support or to represent you. Do I Have To Have ECT? If your psychiatrist believes that you are able to give informed consent, you can only be given ECT if you agree. If you are able to give informed consent, you have the right to refuse ECT. What Is Informed Consent? Informed consent is when you agree to have ECT after you have been told and understood the following: • what ECT involves; and • the benefits, discomforts and risks of ECT; and • beneficial alternative treatments; and • the answers to any questions you have about ECT; and • whether the person recommending ECT or the doctor who will perform the ECT has any financial relationship with the service, hospital or clinic where the ECT will be given; and • your legal rights and other entitlements. Before you decide whether you want to have ECT, it is important that you are well informed. If you have any questions, you should ask your Sch. 14 -- 85 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 83 psychiatrist or seek advice from a friend, relative, lawyer or an advocate, or one of the organisations listed at the end of this brochure. It is your right to be represented by an advocate or a lawyer before you consent to the ECT. If you agree to have ECT, you will be asked to sign a form to say you have given informed consent. Your psychiatrist will discuss with you how many treatments are recommended. You may consent to have up to 6 treatments. If your doctor believes you need more than the initial 6 treatments you will be asked to consent to each further course of up to 6 treatments. What If I Change My Mind? If you agree to have ECT, but then change your mind, you can withdraw your consent at any time and the treatments will be stopped, unless your psychiatrist believes that you are not able to give informed consent. What If I Am Not Able To Give Informed Consent? If your psychiatrist believes you are not able to give informed consent and ECT is necessary or if ECT is urgently needed, your psychiatrist can consent for you, even if you refuse. If this happens, your psychiatrist should explain to you why the treatment is necessary or urgent. Before giving you ECT without your consent your psychiatrist must make all reasonable efforts to notify your primary carer (a relative or friend who is primarily responsible for providing support or care to you) or your guardian (if you have one) about the proposed ECT. Can I Complain? It is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about any part of your treatment you have a right to complain. A good place to start is with your case manager, a member of staff, the complaints liaison officer, your doctor or psychiatrist or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: Sch. 14 -- 86 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 84 [insert appropriate address and telephone and facsimile numbers] • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. The Centre can give you advice about your legal rights in relation to ECT. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, including your rights in relation to ECT, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. The chief psychiatrist monitors the use of ECT in Victoria. If you have a specific concern about ECT, you can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: Sch. 14 -- 87 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 85 [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 14 -- 88 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 86 SCHEDULE 15 Regulation 8(b) STATEMENT OF RIGHTS—PSYCHOSURGERY Mental Health Act 1986 (Section 76) Mental Health Regulations 1998 PSYCHOSURGERY ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • obtain a second opinion from a psychiatrist of your choice about whether you need psychosurgery; • say "No" to psychosurgery; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing psychosurgery with your psychiatrist or doctor; • withdraw your consent at any time before psychosurgery is performed; • complain about your treatment. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure has been given to you because your psychiatrist has recommended that you would benefit from Psychosurgery. Most importantly, it tells you what your legal rights are under the Mental Health Act 1986 in relation to psychosurgery. Your psychiatrist or a member of clinical staff will talk to you about your rights and answer your questions. If at any time you have questions about psychosurgery or your rights, ask someone to explain. This may be your psychiatrist, neurosurgeon or doctor, your case manager, a friend, relative, lawyer or an advocate. Sch. 15 -- 89 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 87 You can also get information from the Psychosurgery Review Board at: [insert appropriate address and telephone and facsimile numbers] Psychosurgery What is Psychosurgery? Psychosurgery is an operation on the brain and may be used to treat people with severe psychiatric disorders which have not responded to other treatments. Examples of the disorders are major depression, obsessive compulsive disorder or severe anxiety disorder where these have caused extreme distress for the person suffering from the illness. Its use is limited and is subject to strict control by the Psychosurgery Review Board. Before recommending psychosurgery, your psychiatrist and neurosurgeon will give you a thorough physical, psychiatric and psychological examination, taking into account your illness, its severity and your medical history. You may be referred to a major teaching hospital for further evaluation of treatment. Your psychiatrist will explain the treatment, the procedures, how it works, discuss possible side-effects, ask your views and answer any questions you might have about the treatment. Second Opinion It is your right to get a second opinion about whether you need psychosurgery. Your case manager, psychiatrist or neurosurgeon can arrange this or you can choose your own doctor. If you choose a private doctor you may have to pay a fee. Advocacy When you are discussing psychosurgery with your psychiatrist or neurosurgeon, it is your right to have a friend, relative, lawyer or an advocate with you for support or to represent you. Do I Have To Have Psychosurgery? You will only be considered for psychosurgery if you give informed consent to the treatment. You have the right to refuse psychosurgery. What Is Informed Consent? Informed consent is when you agree to have psychosurgery after you have been told and understood the following: Sch. 15 -- 90 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 88 • what psychosurgery involves; and • the benefits, discomforts and risks of psychosurgery; and • beneficial alternative treatments; and • the answers to any questions you have about psychosurgery; and • whether the person recommending psychosurgery or the neurosurgeon who will perform the psychosurgery has any financial relationship with the service, hospital or clinic where the proposed psychosurgery will be performed; and • your legal rights and other entitlements. Before you decide whether you want to have psychosurgery, it is important that you are well informed. If you have any questions, you should ask your psychiatrist or neurosurgeon or seek advice from a friend, relative, lawyer or an advocate, or one of the organisations listed at the end of this brochure. It is your right to be represented by an advocate or a lawyer before you consent to psychosurgery. If you agree to have psychosurgery, you will be asked to sign a form to say you have given informed consent and your psychiatrist will then apply to the Psychosurgery Review Board to obtain its consent. The Psychosurgery Review Board makes the final decision. What If I Change My Mind? If you agree to have psychosurgery, but then change your mind, you can withdraw your consent at any time and the psychosurgery will not proceed. Psychosurgery Review Board What Is The Board? The Psychosurgery Review Board is an independent board which was set up with the purpose of deciding whether psychosurgery should be performed on any person in the state of Victoria. The Psychosurgery Review Board must consent before any person can have psychosurgery. You cannot have psychosurgery if the Psychosurgery Review Board does not consent. When the Psychosurgery Review Board receives an application from your psychiatrist for you to have psychosurgery, it will arrange a hearing to decide whether you should have psychosurgery. How Will I Find Out About The Hearing? At least 10 days before the hearing, the Psychosurgery Review Board will send you a notice advising the date, time and place of the hearing and the nature of the proceedings. You are encouraged to attend the hearing. You can Sch. 15 -- 91 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 89 arrange to have a lawyer, friend or relative attend to offer support or speak for you. If you are unable to attend the hearing you should tell the Board as soon as possible. What Will Happen At The Hearing? The hearing will be held by either 4 or 5 Board members usually a lawyer, 1 or 2 psychiatrists, a neurosurgeon and a nominee of the Victorian Council for Civil Liberties. The hearing will be informal and private, unless the Board decides that it is in your best interest or in the public interest for the hearing to be open. Before the hearing, you or your representative will be given copies of the application and all supporting documents. Your psychiatrist will provide information at the hearing about why you should have psychosurgery. You and your representative will be able to ask questions and to give evidence. The neurosurgeon may be present if it is considered necessary by the Board. How Will The Board Decide If I Should Have Psychosurgery? The Board must be satisfied that: • you are capable of giving informed consent; • you have actually given informed consent; • the proposed psychosurgery has clinical merit and is appropriate; • the person proposing to perform the psychosurgery is properly qualified; • the hospital, service or clinic where the proposed psychosurgery would be performed is an appropriate place; • all other reasonable treatments have already been tried without sufficient and lasting benefit. If the Board is satisfied as to these matters it will consent to you having psychosurgery. If it is not satisfied, it must refuse to give its consent. What Happens After The Hearing? When the Psychosurgery Review Board has heard the evidence, it will make its decision. If the Board consents to you having psychosurgery, it will specify: • the name of the neurosurgeon authorised to perform the psychosurgery; • the nature of the psychosurgery to be performed; • the hospital, service or clinic where the psychosurgery is to be performed; • the time within which the psychosurgery is to be performed. Sch. 15 -- 92 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 90 You will be given notice of the Board's consent in writing. If the Board refuses to give consent, you cannot have psychosurgery and you will be advised of this in writing. If you have psychosurgery, the Board will ensure that your progress is regularly monitored. Can I Complain? It is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about any part of your treatment, you have a right to complain. A good place to start is with your case manager, a member of staff, the complaints liaison officer, your doctor, psychiatrist or neurosurgeon or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. The Centre can give you advice about your legal rights in relation to psychosurgery. It may be able to arrange representation for you at Psychosurgery Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, including your rights in relation to psychosurgery, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Psychosurgery Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: Sch. 15 -- 93 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 91 [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 15 -- 94 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 92 SCHEDULE 16 Regulation 8(c) STATEMENT OF RIGHTS MAJOR NON-PSYCHIATRIC TREATMENT OR MAJOR MEDICAL PROCEDURE Mental Health Act 1986 (Section 77) Mental Health Regulations 1998 MAJOR NON-PSYCHIATRIC TREATMENT AND MAJOR MEDICAL PROCEDURE ABOUT YOUR RIGHTS What Are My Rights? You have the right to: • obtain a second opinion from a doctor or specialist of your choice about whether you need the major non-psychiatric treatment or the major medical procedure; • obtain legal advice and have a lawyer represent you; • talk to and have a friend or relative represent you; • have someone of your choice with you when you are discussing the treatment with your psychiatrist or doctor; • complain about your treatment. If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. About Your Rights This brochure has been given to you because your doctor or psychiatrist has recommended that you would benefit from a particular Major Non- Psychiatric Treatment or Major Medical Procedure. Most importantly, it tells you what your legal rights are under the Mental Health Act 1986. Your psychiatrist or a member of clinical staff will talk to you about your rights and answer your questions. If at any time you have questions about the non-psychiatric treatment or your rights, ask someone to explain. This may be your psychiatrist, doctor, case manager, a friend, relative, lawyer or an advocate. Sch. 16 -- 95 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 93 Non-Psychiatric Treatment What Is Non-Psychiatric Treatment? Non-psychiatric treatment is any surgical operation, anaesthetic or course of treatment or medication which is primarily intended to treat a physical condition and not your mental disorder. Under the Mental Health Act, there are 2 types of major non-psychiatric treatment. " Major Non-Psychiatric Treatment Major Non-Psychiatric Treatment is: • any surgery performed under a general or regional anaesthetic; • the use of general or regional block anaesthetic for any purpose; • a course of contraceptive medication commenced during involuntary admission; • chemotherapy; • radiotherapy. " Major Medical Procedure Major Medical Procedure is: • termination of pregnancy; • any procedure resulting in permanent sterilisation (both female and male); • donation of non-regenerative tissue. Your psychiatrist or doctor will tell you which type of non-psychiatric treatment applies to you and tick the correct box, explain the treatment and how it works, discuss possible side-effects, alternative treatments, ask your views and answer any questions you might have about the treatment. Second Opinion It is your right to get a second opinion about whether you need the non- psychiatric treatment. Your case manager or psychiatrist can arrange this or you can choose your own doctor. If you choose a private doctor you may have to pay a fee. Advocacy When you are discussing the non-psychiatric treatment with your psychiatrist or doctor, it is your right to have a friend, relative, lawyer or an advocate with you for support or to represent you. Do I Have To Have The Treatment? Sch. 16 -- 96 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 94 If your psychiatrist believes that you are able to give informed consent, you can only be given the major non-psychiatric treatment or major medical procedure if you agree. If you are able to give informed consent, you have the right to refuse the treatment. What Is Informed Consent? Informed consent is when you agree to have a major non-psychiatric treatment or major medical procedure after you have been told and understood the following: • what the treatment involves; and • the benefits, discomforts and risks of the treatment; and • beneficial alternative treatments; and • the answers to any questions you have about the treatment; and • whether the person recommending the treatment or the doctor who will perform the treatment has any financial relationship with the service, hospital or clinic where the treatment will be given or performed; and • your legal rights and other entitlements. Before you decide whether you want to have the treatment, it is important that you are well informed. If you have any questions, you should ask your psychiatrist, doctor or other specialist or seek advice from a friend, relative, lawyer or an advocate, or one of the organisations listed at the end of this brochure. It is your right to be represented by an advocate or a lawyer before you consent to the treatment. If you agree to have the non-psychiatric treatment, you will be asked to sign a form to say you have given informed consent. What If I Change My Mind? If you agree to have the major non-psychiatric treatment or major medical procedure, but then change your mind, you can withdraw your consent at any time and the treatment will not proceed. What If I Am Not Able To Give Informed Consent? If you are not able to give informed consent and the treatment is necessary, you may be given the treatment, even if you refuse. How consent is given will depend on the type of non-psychiatric treatment. A member of staff will tell you which of the following applies to you and tick the correct box. " Major Non-Psychiatric Treatment Sch. 16 -- 97 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 95 If your psychiatrist believes that you are not able to give informed consent and a major non-psychiatric treatment is necessary, your psychiatrist or your guardian (if you have one) can consent for you, even if you refuse. " Major Medical Procedure If your psychiatrist believes that you are not able to give informed consent and a major medical procedure is necessary and in your best interests, your psychiatrist will apply to have a guardian appointed (if you do not already have one) to help make the decision about whether you should have the treatment. If both your guardian and the Guardianship and Administration Board agree that you are not capable of giving informed consent and the treatment is in your best interests, they may consent to the treatment on your behalf. The treatment can then be given to you, even if you refuse. If you want more information about consent to a major medical procedure, you can contact the Guardianship and Administration Board on [insert telephone number]. If any non-psychiatric treatment is needed to save your life, it can be given to you, even if you refuse. Can I Complain? It is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about any part of your treatment, you have a right to complain. A good place to start is with your case manager, a member of staff, the complaints liaison officer, your doctor or psychiatrist or the Director of Psychiatry at the mental health service. If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor. Important Contacts The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below. • Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at: [insert appropriate address and telephone and facsimile numbers] • The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange Sch. 16 -- 98 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 96 representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at: [insert appropriate address and telephone and facsimile numbers] • Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at: [insert appropriate address and telephone and facsimile numbers] • The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at: [insert appropriate address and telephone and facsimile numbers] • The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at: [insert appropriate address and telephone and facsimile numbers] • The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at: [insert appropriate address and telephone and facsimile numbers] • The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at: [insert appropriate address and telephone and facsimile numbers] The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at: [insert appropriate address and telephone and facsimile numbers] You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you. _______________ Sch. 16 -- 99 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 97 SCHEDULE 17 Regulation 9 Mental Health Act 1986 (Section 75) Mental Health Regulations 1998 APPLICATION FOR LICENCE TO PERMIT THE PERFORMANCE OF ELECTROCONVULSIVE THERAPY To the Secretary, I, .................................................................................................................. (Full name of occupier) am the occupier of premises known as........................................................... ...................................................................................................................... (Name of premises eg. Private Hospital, Approved Mental Health Service, Public Hospital) located at....................................................................................................... ...................................................................................................................... (Address of premises) I apply for a licence to perform electroconvulsive therapy at the above premises. In attachment A, I have enclosed a plan of the above premises indicating all areas/suites where electroconvulsive therapy is to be performed. Signature: ..................................................................................................... Date:............................... Attachment A A plan of the premises indicating all areas/suites where electroconvulsive therapy is to be performed. _______________ Sch. 17 -- 100 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 98 SCHEDULE 18 Regulation 10 Mental Health Act 1986 (Section 76) Mental Health Regulations 1998 LICENCE AUTHORISING PERFORMANCE OF ELECTROCONVULSIVE THERAPY Licence Number ...................................................................................................................... (Name of Occupier) is the occupier of premises known as............................................................. ...................................................................................................................... (Name of premises eg. Private Hospital, Approved Mental Health Service, Public Hospital) located at....................................................................................................... (Address of premises) This licence authorises the performance of electroconvulsive therapy at the above premises in the areas/suites shown in Attachment A. This licence is in force from to , and is subject to the terms and conditions contained in Attachment B. Signature:...................................................................................................... Title:............................................................................................................. (Secretary or delegate) Date: Attachment A A plan of the premises where electroconvulsive therapy is to be performed. Attachment B The terms and conditions to which the licence is subject. _______________ Sch. 18 -- 101 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 99 SCHEDULE 19 Regulation 11 Mental Health Act 1986 (Section 77(2)) Mental Health Regulations 1998 APPLICATION FOR RENEWAL OF AN ELECTROCONVULSIVE THERAPY LICENCE Licence Number To the Secretary, I, .................................................................................................................. (Full name of occupier) am the occupier of premises known as........................................................... ...................................................................................................................... (Name of premises eg. Private Hospital, Approved Mental Health Service, Public Hospital) located at....................................................................................................... ...................................................................................................................... (Address of premises) The abovenamed premises are licensed to permit the performance of electroconvulsive therapy. The licence expires on................................................................................... I apply for the renewal of this licence on the same terms and conditions. Signature:...................................................................................................... Date:.......................... _______________ Sch. 19 -- 102 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 100 SCHEDULE 20 Regulation 12 Mental Health Act 1986 (Section 78(2)) Mental Health Regulations 1998 APPLICATION FOR AMENDMENT OF AN ELECTROCONVULSIVE THERAPY LICENCE Licence Number To the Secretary, I, .................................................................................................................. (Full name of occupier) am the occupier of premises known as........................................................... ...................................................................................................................... (Name of premises eg. Private Hospital, Approved Mental Health Service, Public Hospital) located at....................................................................................................... ...................................................................................................................... (Address of premises) The abovenamed premises are licensed to permit the performance of electroconvulsive therapy. The licence expires on................................................................................... I apply for the amendment of this licence as follows: Present term or condition:.............................................................................. Proposed amendment:.................................................................................... Reasons for proposed amendment:................................................................. Signature:...................................................................................................... Date:........................... _______________ Sch. 20 -- 103 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 101 SCHEDULE 21 Regulation 13 FORM OF MONTHLY RETURN BY HOLDERS OF LICENCE TO PERFORM ELECTROCONVULSIVE THERAPY Mental Health Act 1986 Mental Health Regulations 1998 ELECTROCONVULSIVE THERAPY RETURN Date / / (year) (Start a new page for each day. A page records electroconvulsive therapy performed on one day only. Individual pages should be compiled to form the monthly return to the chief psychiatrist) TO THE CHIEF PSYCHIATRIST FROM..................................................... Name of premises (eg. Private Hospital, Approved Mental Health Service, Public Hospital) Name of anaesthetist..................................................................... UR No. 1 Sex (M/F) Date of birth Country of birth MHA Status 2 (I)nvoluntary (S)ecurity (F)orensic (N)o status Type2 (B)ilateral (U)nilateral Consent 2 (P)atient (A)uthorised psychiatrist Principal diagnosis relating to ECT (Use ICD Code No. Name of Doctor administering ECT ............................................................................................. ... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person completing this return Designation......................................................................... Signed................................................................................. I submit this return of electroconvulsive therapy performed at these premises as part of the monthly return to the chief psychiatrist ........................................................................................................ ... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of *delegated/authorised psychiatrist or occupier of licensed premises *circle as necessary Signed.................................................Date................................. 1 State-wide mental health UR number or private hospital UR number 2 Information should be recorded using the code letter in the brackets. _______________ Sch. 21 -- 104 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 102 SCHEDULE 22 Regulation 14 FORM OF REGISTER OF MAJOR NON-PSYCHIATRIC TREATMENT Mental Health Act 1986 Mental Health Regulations 1998 REGISTER OF MAJOR NON-PSYCHIATRIC TREATMENT FOR.............................................................................................................. approved mental health service Major non-psychiatric treatment was performed on the following patients during the month of ......................(year) UR Number Patients family name, first initial Copies of written consents to major non-psychiatric treatment are attached for all patients listed above. ...................................................................................................................... GIVEN NAMES/FAMILY NAME (BLOCK LETTERS) of *delegated/authorised psychiatrist Signed......................................................date.................................. *circle as necessary _______________ Sch. 22 -- 105 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 103 SCHEDULE 23 Regulation 16 APPLICATION FOR REGISTRATION OF AN ASSOCIATION OR ORGANISATION PROVIDING COMMUNITY SUPPORT SERVICES Mental Health Act 1986 Mental Health Regulations 1998 To the Secretary............................................................................................ On behalf of ................................................................................................. NAME (BLOCK LETTERS) of Association or organisation of................................................................................................................... Address of Organisation I wish to apply for registration of the association/organisation as a community support service under the Mental Health Act 1986. (Please cross) " Service is currently operating " Service will be operating I declare that the registered community support service does or will operate in accordance with the following principles: • that people receiving the service are given the best possible care and treatment appropriate to their needs in the least possible restrictive environment and least possible intrusive manner consistent with the effective giving of that care and treatment; and • that provision is made for persons who are receiving the service to participate in the planning, operation and evaluation of the service; and • that restrictions on and the interference with the rights, privacy, dignity and self-respect of persons receiving the service are kept to the minimum necessary in the circumstances; and • that there are adequate mechanisms for the assessment and review of persons receiving the service; and • that the service provided is accessible and flexible to meet the needs of people with a mental disorder. PART B Sch. 23 -- 106 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 104 FOR ORGANISATIONS WHICH ARE NOT REGISTERED FUNDED AGENCIES UNDER THE HEALTH SERVICES ACT 1988 I enclose a copy of— (a) the minutes authorising the application for registration by the person authorised to sign on behalf of the association or organisation; and (b) the memorandum and articles of association or constitution of the organisation; and (c) a copy of its most recent annual report; and (d) a copy of its audited financial statements for the last financial year. ...................................................................................................................... GIVEN NAMES/ FAMILY NAMES (BLOCK LETTERS) of the person authorised to sign on behalf of association or organisation Date:................................ _______________ Sch. 23 -- 107 of 108 -- S.R. No. 120/1998 Mental Health Regulations 1998 105 SCHEDULE 24 Regulation 17 RECORD OF VISITS BY COMMUNITY VISITORS RETURN FOR THE MONTH OF Mental Health Act 1986 (Section 114) Mental Health Regulations 1998 Date Community Visitor Duration of Visit Areas Inspected Signature of Person in Charge: Name in Full: Date signed: ═══════════════ Sch. 24 -- 108 of 108 --