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Mental Health (Amendment) Regulations 1996

Legislation · Victoria · 2020
i Mental Health (Amendment) Regulations 1996 S.R. No. 51/1996 TABLE OF PROVISIONS Regulation Page 1. Objective 1 2. Authorising provisions 1 3. Commencement 1 4. Principal Regulations 1 5. Amendment of objectives 2 6. Amendment of regulation 5 2 7. New Part IIA inserted 3 PART IIA—REGISTER OF MAJOR NON-PSYCHIATRIC TREATMENT 3 7. Form of register of major non-psychiatric treatment 3 8. References to Chief General Manager substituted 4 9. Substitution of form of return of ECT performed 4 12. Monthly return 4 10. Revocation of prescribed interest on patient's accounts 4 11. New Part VIA inserted 4 PART VIA—CONFIDENTIALITY 4 17A. Release of confidential patient information 4 12. Amendment of regulation 18 5 13. Amendment of regulation 19 5 14. Amendment of regulation 20 5 15. Amendment of regulation 21 5 16. Schedules substituted 5 SCHEDULE 1 6 SCHEDULE 2 7 SCHEDULE 2A 9 SCHEDULE 2B 11 SCHEDULE 2C 13 17. Form of special warrant amended 15 18. Schedule 3A inserted 15 SCHEDULE 3A 15 19. Schedule 10 substituted 16 20. Schedule 11 substituted 18 SCHEDULE 11 18 -- 1 of 74 -- Regulation Page ii 21. Amendment of Schedule 13 19 22. Revocation of Schedule 14 19 23. Schedules 15 to 21 substituted 19 SCHEDULE 15 20 SCHEDULE 16 25 SCHEDULE 17 32 SCHEDULE 18 38 SCHEDULE 19 42 SCHEDULE 20 47 SCHEDULE 20A 53 SCHEDULE 20B 59 SCHEDULE 21 64 24. Amendment of Schedule 22 71 ═══════════════ NOTES 72 -- 2 of 74 -- 1 STATUTORY RULES 1996 S.R. No. 51/1996 Mental Health Act 1986 Mental Health (Amendment) Regulations 1996 The Governor in Council makes the following Regulations: Dated: 25 June 1996 Responsible Minister: ROB KNOWLES Minister for Health A. WILTSHIRE Acting Clerk of the Executive Council 1. Objective The objective of these Regulations is to amend the Mental Health Regulations 1987 to give effect to the Mental Health (Amendment) Act 1995. 2. Authorising provisions These Regulations are made under sections 9, 18, 80, 85, 100, 120A and 142 of the Mental Health Act 1986. 3. Commencement These Regulations come into operation on the day that section 4 of the Mental Health (Amendment) Act 1995 comes into operation. 4. Principal Regulations In these Regulations, the Mental Health Regulations 1987 1 are called the Principal Regulations. -- 3 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 2 5. Amendment of objectives In regulation 3 of the Principal Regulations, for paragraph (b) substitute— "(b) to fix the limits of patient's accounts; and (c) to prescribe any other matters authorised by the Mental Health Act 1986.". 6. Amendment of regulation 5 (1) In regulation 5(1) and 5(2) of the Principal Regulations, for "a psychiatric in-patient service" (wherever occurring) substitute "an approved mental health service". (2) In regulation 5(2) of the Principal Regulations, for "medical practitioner" substitute "registered medical practitioner". (3) In regulation 5(3) of the Principal Regulations— (a) in paragraph (a), after "Schedule 2A" insert "or Schedule 2B (as the case requires)"; (b) in paragraph (b), for "psychiatric in-patient service" substitute "approved mental health service". (4) After regulation 5(3) of the Principal Regulations, insert— '(3A) For the purposes of section 9(7A)(c) of the Act, the prescribed form is the form in Schedule 2C. (3B) 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 approved mental health service and engaged in the provision of acute psychiatric assessment and treatment functions in the community— r. 5 -- 4 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 3 (a) a registered nurse; (b) a registered psychologist within the meaning of the Psychologists Registration Act 1987; (c) a social worker.' (5) In regulation 5(4) of the Principal Regulations— (a) for "a prescribed medical practitioner" substitute "a prescribed registered medical practitioner"; (b) for "a medical practitioner" (wherever occurring) substitute "a registered medical practitioner"; (c) for paragraph (b) substitute— "(b) the registered medical practitioner who recommended that the person be admitted to and detained in an approved mental health service;". 7. New Part IIA inserted After regulation 6 of the Principal Regulations insert— "PART IIA—REGISTER OF MAJOR NON-PSYCHIATRIC TREATMENT 7. Form of register of major non-psychiatric treatment For the purposes of section 85(2) and (3) of the Act, a register of major non-psychiatric treatment must be in the form in Schedule 3A and the prescribed details are the details required to be inserted on that form.". r. 7 -- 5 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 4 8. References to Chief General Manager substituted In regulations 8, 9, 11, 15 and 21 of, and in Schedules 6, 7, 8, 9 and 12 to, the Principal Regulations, for "Chief General Manager" (wherever occurring) substitute "Secretary". 9. Substitution of form of return of ECT performed For regulation 12 of the Principal Regulations substitute— "12. Monthly return For the purposes of section 80 of the Act, the prescribed form is the form in Schedule 10.". 10. Revocation of prescribed interest on patient's accounts Regulation 14 of the Principal Regulations is revoked. 11. New Part VIA inserted After regulation 17 of the Principal Regulations insert— "PART VIA—CONFIDENTIALITY 17A. Release of confidential patient information For the purposes of section 120A(3)(ca) of the Act, the prescribed classes of staff are the following persons employed in a relevant psychiatric service— (a) a registered nurse; (b) a registered psychologist within the meaning of the Psychologists Registration Act 1987; (c) a social worker; (d) an occupational therapist.". r. 8 -- 6 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 5 12. Amendment of regulation 18 In regulation 18 of the Principal Regulations, for "medical practitioner" substitute "registered medical practitioner". 13. Amendment of regulation 19 In regulation 19 of the Principal Regulations, for "an Act" substitute "the Act". 14. Amendment of regulation 20 (1) Regulation 20(1) of the Principal Regulations is revoked. (2) In regulation 20(3) of the Principal Regulations, omit "involuntary". (3) After regulation 20(7) of the Principal Regulations insert— "(7A) The printed statement of the rights of a continuing treatment involuntary patient must be in the form in Schedule 20A. (7B) The printed statement of the rights of a patient upon whom it is proposed to perform a major non-psychiatric treatment or major medical procedure must be in the form in Schedule 20B.". 15. Amendment of regulation 21 In regulation 21 of the Principal Regulations, for "a psychiatric in-patient service" substitute "an approved mental health service". 16. Schedules substituted For Schedules 1, 2 and 2A to the Principal Regulations substitute— r. 12 -- 7 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 6 "SCHEDULE 1 Regulation 5(1) Mental Health Act 1986 (Section 9) Mental Health Regulations 1987 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. TO BE COMPLETED AS NECESSARY AUTHORITY TO TRANSPORT I hereby authorise ............................................................................................................................ GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of *a member of the police force, an ambulance officer or any other person 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 of..............................................................................................................................add ress of person making the request signed......................................................................................date.......................... *circle as necessary r. 16 -- 8 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 7 SCHEDULE 2 Regulation 5(2) Mental Health Act 1986 (Section 9) Mental Health Regulations 1987 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.............................................................................................................................. person's address I am a registered medical practitioner and state as follows— THAT I have personally examined the abovenamed person on the.......day of.........................19.... at.............*am/pm. THAT 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 (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. r. 16 -- 9 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 8 THAT 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. THAT 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 doctor's telephone number................................................................................... who examined the abovenamed person on the .........day of......................19...... (being a period not more than 28 days prior to today's date) FACTS COMMUNICATED BY OTHER EXAMINING REGISTERED MEDICAL PRACTITIONER: ................................................................................................................................ ........................................................................................................................ THAT 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 r. 16 -- 10 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 9 signed............................................................................................................ SIGNATURE of recommending registered medical practitioner Qualifications:.......................................................................................................... Address.................................................................................................................... Telephone number............................................date................................................. * circle as necessary SCHEDULE 2A Regulation 5(3) Mental Health Act 1986 (Section 9) Mental Health Regulations 1987 RESTRAINT THIS FORM MUST BE COMPLETED IF RESTRAINT IS USED FOR THE PURPOSE 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 RECOMMENDATION IN THE PRESCRIBED FORM OR † RESTRAINT HAS BEEN APPLIED TO TRANSPORT A PERSON ABSENT 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 am employed by............................................................................................. *police/ambulance/psychiatric service/other (please specify) r. 16 -- 11 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 10 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 r. 16 -- 12 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 11 SCHEDULE 2B Regulation 5(3) Mental Health Act 1986 (Section 9) Mental Health Regulations 1987 SEDATION THIS FORM MUST BE COMPLETED IF SEDATION IS USED FOR THE PURPOSE 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 relating to the abovenamed person OR r. 16 -- 13 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 12 † 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. 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 r. 16 -- 14 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 13 SCHEDULE 2C Regulation 5(3A) Mental Health Act 1986 (Section 9) Mental Health Regulations 1987 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......................................................................................................... person's address I am a mental health practitioner for the purposes of section 9 of the Mental Health Act 1986 and I state as follows— r. 16 -- 15 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 14 THAT (1) I have observed a completed request in the prescribed form relating to the abovenamed person; and (2) a recommendation has not been made in the prescribed form as 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; and (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 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. THAT 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. THAT I base my opinion on the following facts personally observed by me on examination: ...................................................................................................................... ...................................................................................................................... ........................................................................................ r. 16 -- 16 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 15 THAT 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.............................. psychiatric service NOTE: The person who made the request to admit cannot sign this form as a mental health practitioner.". 17. Form of special warrant amended In Schedule 3 to the Principal Regulations, for "medical practitioner" (where twice occurring) substitute "registered medical practitioner". 18. Schedule 3A inserted After Schedule 3 to the Principal Regulations insert— "SCHEDULE 3A Regulation 7 Mental Health Act 1986 (Section 85) Mental Health Regulations 1987 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 ......................................19........ PRISM No Patient's family name, first initial r. 17 -- 17 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 16 Copies of written consents to major non-psychiatric treatment are attached for all patients listed above. ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of *delegated/authorised psychiatrist Signed.................................................................date.................................... *circle as necessary". 19. Schedule 10 substituted For Schedule 10 to the Principal Regulations substitute— r. 19 -- 18 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 17 r. 19 -- 19 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 18 20. Schedule 11 substituted For Schedule 11 to the Principal Regulations substitute— "SCHEDULE 11 Regulation 15 Mental Health Act 1986 (Section 100) Mental Health Regulations 1987 APPLICATION FOR REGISTRATION OF A COMMUNITY SUPPORT SERVICE 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 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 r. 20 -- 20 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 19 • 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. FOR ORGANISATIONS OTHER THAN REGISTERED FUNDED AGENCIES UNDER THE HEALTH SERVICES ACT 1988 I enclose a copy of— (i) the minutes authorising application for registration by the person authorised to sign on behalf of the association or organisation; and (ii) the memorandum and articles of association or constitution of the organisation; and (iii) a copy of the most recent annual report; and (iv) a copy of the audited financial statements for the last financial year. ...................................................................................................................... GIVEN NAME(S)/FAMILY NAME (BLOCK LETTERS) of person authorised to sign on behalf of association or organisation Position......................................................................................................... Signed.................................................................date.................................... *circle as necessary". 21. Amendment of Schedule 13 In Schedule 13 to the Principal Regulations, for "month" substitute "the month". 22. Revocation of Schedule 14 Schedule 14 to the Principal Regulations is revoked. 23. Schedules 15 to 21 substituted For Schedules 15, 16, 17, 18, 19, 20 and 21 to the Principal Regulations substitute— r. 21 -- 21 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 20 "SCHEDULE 15 Regulation 20(2) Mental Health Act 1986 Mental Health Regulations 1987 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. Why Am I Here? r. 23 -- 22 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 21 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 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 r. 23 -- 23 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 22 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 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. r. 23 -- 24 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 23 If you are put in seclusion or restrained, staff must give you appropriate bedding, clothing, food and drink when you want them, and 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, 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]. r. 23 -- 25 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 24 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] • 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: r. 23 -- 26 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 25 [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. SCHEDULE 16 Regulation 20(3) Mental Health Act 1986 Mental Health Regulations 1987 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; r. 23 -- 27 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 26 • 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 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. r. 23 -- 28 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 27 … 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 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. 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. r. 23 -- 29 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 28 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 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 restrained, staff must give you appropriate bedding, clothing, food and drink when you want them, and 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 r. 23 -- 30 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 29 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 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 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 ask the member of staff to send it to the Board. If you need help to fill in the form, ask a friend, relative, solicitor, member of r. 23 -- 31 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 30 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. 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 r. 23 -- 32 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 31 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. r. 23 -- 33 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 32 SCHEDULE 17 Regulation 20(4) Mental Health Act 1986 Mental Health Regulations 1987 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 ask someone to explain. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor. r. 23 -- 34 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 33 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 3 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 Commissioner, Correctional Services 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. … 3. You have been found not guilty of an offence by reason of insanity or you have been found unfit to plead and are detained until the Governor's Pleasure is known or during the Governor's Pleasure. 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 r. 23 -- 35 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 34 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, 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 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. r. 23 -- 36 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 35 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 restrained, staff must give you appropriate bedding, clothing, food and drink when you want them, and 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 the Governor in Council, or you are granted bail, you can no longer be treated as a security patient. 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. r. 23 -- 37 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 36 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 ask the member of staff to 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. • 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] r. 23 -- 38 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 37 • 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. r. 23 -- 39 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 38 SCHEDULE 18 Regulation 20(5) Mental Health Act 1986 Mental Health Regulations 1987 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. r. 23 -- 40 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 39 Electroconvulsive Therapy (ECT) 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. r. 23 -- 41 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 40 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 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 r. 23 -- 42 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 41 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 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: r. 23 -- 43 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 42 [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. SCHEDULE 19 Regulation 20(6) Mental Health Act 1986 Mental Health Regulations 1987 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 r. 23 -- 44 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 43 psychiatrist, neurosurgeon or doctor, your case manager, a friend, relative, lawyer or an advocate. 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: • what psychosurgery involves; and • the benefits, discomforts and risks of psychosurgery; and r. 23 -- 45 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 44 • 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 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? r. 23 -- 46 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 45 The hearing will be held by 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 private and informal. 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 or service 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 or service where the psychosurgery is to be performed; • the time within which the psychosurgery is to be performed. You will be given a copy 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. r. 23 -- 47 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 46 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: [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: r. 23 -- 48 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 47 [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. SCHEDULE 20 Regulation 20(7) Mental Health Act 1986 Mental Health Regulations 1987 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; r. 23 -- 49 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 48 • 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. 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. r. 23 -- 50 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 49 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 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. r. 23 -- 51 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 50 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 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. r. 23 -- 52 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 51 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 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. r. 23 -- 53 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 52 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. • 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: r. 23 -- 54 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 53 [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. SCHEDULE 20A Regulation 20(7A) Mental Health Act 1986 Mental Health Regulations 1987 CONTINUING TREATMENT INVOLUNTARY PATIENT 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; r. 23 -- 55 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 54 • 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. 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). r. 23 -- 56 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 55 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 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 r. 23 -- 57 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 56 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 ask the staff member to 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 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. 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. r. 23 -- 58 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 57 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 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 restrained, staff must give you appropriate bedding, clothing, food and drink when you want them, and 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 r. 23 -- 59 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 58 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. • 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: r. 23 -- 60 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 59 [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. SCHEDULE 20B Regulation 20(7B) Mental Health Act 1986 Mental Health Regulations 1987 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; r. 23 -- 61 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 60 • 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. 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, r. 23 -- 62 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 61 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? 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. r. 23 -- 63 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 62 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 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. r. 23 -- 64 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 63 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 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] r. 23 -- 65 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 64 • 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. SCHEDULE 21 Regulation 20(8) Mental Health Act 1986 Mental Health Regulations 1987 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; r. 23 -- 66 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 65 • 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. 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. r. 23 -- 67 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 66 … 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 • 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 r. 23 -- 68 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 67 • 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 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. r. 23 -- 69 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 68 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? 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 private and informal. 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: r. 23 -- 70 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 69 … 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; … 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 Administrative Appeals Tribunal (AAT). The AAT 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: Administrative Appeals Tribunal [insert appropriate address and telephone and facsimile numbers] r. 23 -- 71 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 70 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: [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: r. 23 -- 72 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 71 [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.". 24. Amendment of Schedule 22 In Schedule 22 to the Principal Regulations, for "psychiatric in-patient service" substitute "approved mental health service". ═══════════════ r. 24 -- 73 of 74 -- S.R. No. 51/1996 Mental Health (Amendment) Regulations 1996 72 NOTES 1 S.R. No. 257/1987. Reprinted to S.R. No. 42/1995 and subsequently amended by S.R. No. 10/1996. -- 74 of 74 --