Re Ma

[2006] QMHC 4

MENTAL HEALTH COURT

CITATION:

Re MA [2006] QMHC 004

PARTIES:

APPEAL BY MA AGAINST DECISION OF THE MENTAL HEALTH REVIEW TRIBUNAL

PROCEEDING NO:

No 0202 of 2005

DELIVERED ON:

8 February 2006

DELIVERED AT:

Brisbane

HEARING DATE:

8 February 2006

JUDGE:

ASSISTING PSYCHIATRISTS:

Holmes J

Dr J F Wood
Dr D A Grant

ORDER:

The decision of the Mental Health Review Tribunal confirming the patient’s involuntary treatment order is revoked

CATCHWORDS:

MENTAL HEALTH – CONFINEMENT AND RESTRAINT OF MENTALLY ILL PERSONS AND SIMILAR ORDERS – GENERALLY – where patient appeals against decision of Mental Health Review Tribunal confirming an involuntary treatment order – where patient suffers from bipolar disorder – where involuntary treatment order made while patient was experiencing manic episode – whether the treatment criteria in s 14 of the Mental Health Act 2000 are met – whether the
order should remain in place

Mental Health Act 2000 (Qld), s 14

COUNSEL:

Mr Briggs for the appellant
Mr Tate for the Director of Mental Health, the respondent

SOLICITORS:

Legal Aid Queensland for the appellant
The Director of Mental Health for the respondent

1. HOLMES J:  Ms A appeals against a decision of the Mental Health Review Tribunal made on the 31st of August 2005 confirming an involuntary treatment order.  Today we have heard from her treating psychiatrist, Dr W, and from Dr C who examined her in January 2006.

1. I think it is apparent that the involuntary treatment order, when it was made in August 2005, was properly made.  The opinion of the psychiatrists to whom I have referred is a mutual one to the effect that Ms A suffers from bipolar disorder.  At the time the order was made in August 2005, she was experiencing a manic episode which involved, among other things, suicidal thoughts.  It is clear enough that she was properly admitted to hospital and treated at that time.  But the question is whether the order should remain in place.

1. Turning to the criteria which are set out in section 14 of the Mental Health Act 2000, I am satisfied that Ms A has a mental illness.  The next criterion, which is that of requiring immediate treatment, is difficult to separate in this case from the further criterion that there is an imminent risk of harm to herself or someone else or that she is likely to suffer serious mental or physical deterioration.

1. What Dr W identifies as the area of risk are her ongoing residential hypermanic symptoms which he says were demonstrated to him on examination in January, particularly in the form of thought disorder, and the risk of relapse which is not really quantifiable but certainly exists at some level for any person who has suffered one episode already.  The problem with the residual symptoms that he identifies is the effect they are likely to have on her social interactions, her social functioning and, consequently, her social standing and reputation. 

1. It is, I think, very questionable whether that level of risk of relapse and the residual symptoms identified amount to a likelihood that she would suffer serious mental or physical deterioration.  On the whole, I do not think that that criterion is satisfied.  The criterion of requiring immediate treatment is also correspondingly not satisfied in my view.  Immediate treatment is plainly enough highly desirable, but I do not think one can say it is required.  It does not seem to me that there is a clear and likely prospect of significant harm if Ms A does not remain at this time on an involuntary treatment order.

1. I observe, as both Dr Wood and Dr Grant have pointed out, that her symptoms to date have not driven the treating team to consider that coercive administration of medication was necessary. 

1. In the circumstances, then, I consider that the criteria identified in Section 14(b) and 14(d) of the Mental Health Act are not met.  I am not satisfied there is a requirement of immediate treatment, as opposed to immediate treatment being to her benefit.  Nor am I satisfied of the risk identified in paragraph (d) of the section. 

1. That means that the proper course is to set aside the decision of the Mental Health Review Tribunal, while observing that the conditions operating at the time it was made were rather different and that this Court has had the benefit of a longer period during which Ms A has managed without treatment, and also the opinion of Dr C and the more up-to-date opinion of Dr W.

1. It follows then that the involuntary treatment order will be revoked.