Untitled document
Mental Health (Forms and Patient's Rights) Regulations 2006
S.R. No. 39/2006
TABLE OF PROVISIONS
Regulation Page
1.Objective
2.Authorising provision
3.Principal Regulations
4.Patient's rights
5.New regulation 7A inserted
7A.Treatment plans
6.Schedule 1 amended
7.Schedule 2 amended
8.Schedule 3 amended
9.Schedule 6 amended
10.New Schedule 10 substituted
SCHEDULE 10—Statement of Legal Rights and Entitlements and Other Information—Continuing Treatment Involuntary Patient (Section 12A–12D)
11.New Schedules 12 and 13 inserted
SCHEDULE 12—Statement of Legal Rights and Entitlements and Other Information—Assessment Orders; Diagnosis, Assessment and Treatment Orders
SCHEDULE 13—Statement of Legal Rights and Entitlements and Other Information—Forensic Patient (Remand and Interim Disposition Orders)
12.New Schedule 15 substituted
SCHEDULE 15—Statement of Legal Rights and Entitlements and Other Information—Psychosurgery
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ENDNOTES
STATUTORY RULES 2006
S.R. No. 39/2006
Mental Health Act 1986
Mental Health (Forms and Patient's Rights) Regulations 2006
The Governor in Council makes the following Regulations:
Dated: 4 April 2006
Responsible Minister:
BRONWYN PIKE
Minister for HealthRUTH LEACH
Clerk of the Executive Council
1.Objective
The objective of these Regulations is to amend the Mental Health Regulations 1998 in relation to the—
(a)prescribed class of persons who may discuss treatment plans with a patient; and
(b)prescribed forms relating to involuntary treatment; and
(c)statements of a patient's rights.
2.Authorising provision
These Regulations are made under section 142 of the Mental Health Act 1986.
3.Principal Regulations
In these Regulations, the Mental Health Regulations 1998[1] are called the Principal Regulations.
4.Patient's rights
(1)For the heading to Part 3 of the Principal Regulations substitute—
"PART 3—PATIENT'S RIGHTS".
(2)In regulation 7 of the Principal Regulation, for paragraph (e)(ii) and "be in the form set out in Schedule 11." substitute—
"(ii)a person detained in an approved mental health service under section 20BJ(1) or 20BM of the Crimes Act 1914 of the Commonwealth—
be in the form set out in Schedule 11;
(f)in the case of a person subject to an assessment order, or a diagnosis, assessment and treatment order, be in the form set out in Schedule 12;
(g)in the case of a forensic patient subject to a remand or interim disposition order, be in the form set out in Schedule 13.".
5.New regulation 7A inserted
After regulation 7 of the Principal Regulations insert—
"7A.Treatment plans
For the purposes of section 19A(6)(b) of the Act, the prescribed class is those health service providers who are—
(a)either—
(i)registered nurses; or
(ii)psychologists registered under section 6 of the Psychologists Registration Act 2000; or
(iii)social workers; or
(iv)occupational therapists; and
(b)employed by a public sector mental health service within the meaning of section 120A of the Act.".
6.Schedule 1 amended
In Schedule 1 to the Principal Regulations—
(a)for "TO THE *ADMITTING REGISTERED MEDICAL PRACTITIONER/" substitute "TO THE *REGISTERED MEDICAL PRACTITIONER EMPLOYED BY AN APPROVED MENTAL HEALTH SERVICE/";
(b)after "To arrange for a" insert "registered medical practitioner employed by an approved mental health service or a".
7.Schedule 2 amended
In Schedule 2 to the Principal Regulations, for "TO THE *ADMITTING REGISTERED MEDICAL PRACTITIONER/" substitute "TO THE *REGISTERED MEDICAL PRACTITIONER EMPLOYED BY AN APPROVED MENTAL HEALTH SERVICE/".
8.Schedule 3 amended
In Schedule 3 to the Principal Regulations, in Forms 1 and 2, after "under section 12(6)" insert ", section 12AA(7)".
9.Schedule 6 amended
In Schedule 6 to the Principal Regulations—
(a)for "To be completed by registered medical practioner/" substitute "To be completed by the registered medical practitioner employed by an approved mental health service/";
(b)omit "The abovenamed person has been taken to the approved mental health service.";
(c)omit "I have been requested to assess the abovenamed person.";
(d)after "FAMILY NAME (BLOCK LETTERS) of *registered medical practitioner" insert "employed by an approved mental health service".
10.New Schedule 10 substituted
For Schedule 10 to the Principal Regulations substitute—
"SCHEDULE 10
Regulation 7(d)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—CONTINUING TREATMENT INVOLUNTARY PATIENT (SECTION 12A–12D)
Mental Health Act 1986
Mental Health Regulations 1998
IN SUMMARY
When you are a continuing treatment involuntary patient you—
·will have a treatment plan and can be involved in planning your treatment;
·have a right to obtain a second opinion from a psychiatrist about your treatment;
·have a right to appeal to the Mental Health Review Board against being a continuing treatment involuntary patient;
·have a right to obtain legal advice and have a lawyer represent you;
·can talk to and have a friend or family member represent you;
·can complain about your treatment.
You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor to help you do these things.
ABOUT THIS STATEMENT
This statement provides information about being a continuing treatment involuntary patient and your legal rights and entitlements under the Mental Health Act 1986.
A member of the treating team will talk to you about this information and answer your questions.
The information must be explained in a language or way that you can understand. This statement may be translated into other languages. You can ask a member of the treating team if it is available in your preferred language. Copies of the Mental Health Act 1986 are available at the mental health service.
If at any time you have questions about this information or your rights, ask someone to explain. You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor.
CONTINUING TREATMENT INVOLUNTARY PATIENTS
You are being detained in the mental health service so you can receive treatment for a mental disorder.
You were first placed on an involuntary treatment order, but that order has now been discharged. However, you are still being detained because your psychiatrist or the chief psychiatrist believes that all of the following criteria for continuing treatment apply to you—
·you appear to have a mental disorder;
·you would cause serious physical harm to yourself if you are not detained and treated in the mental health service;
·treatment can be obtained for your mental disorder in the mental health service.
To have decided these things, your psychiatrist or the chief psychiatrist would have talked with you, considered your recent behaviour and may have sought information from members of the treating team, members of your family, your primary carer or a guardian (if you have one).
Application for continuing treatment
Your psychiatrist or the chief psychiatrist may apply for you to be detained in the mental health service for a period of up to 3 months.
The Secretary to the Department of Human Services will arrange for a committee of 3 psychiatrists to make a decision about 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 and treated or not. The committee must make its decision within 7 days of the application being made; if it does not you will be discharged from being a continuing treatment involuntary patient.
If the committee believes that all of the criteria for continuing treatment apply to you, the committee will consent to your continuing detention and treatment for a period of up to 3 months. At the end of that time, your psychiatrist or the chief psychiatrist may apply 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 criteria for continuing treatment apply to you, your psychiatrist must discharge you and you will be free to leave. You can then discuss continuing treatment on a voluntary basis with your case manager or psychiatrist.
TREATMENT
Your psychiatrist will prepare a treatment plan that is designed to meet your specific needs. You have the right to be involved in planning your treatment and the psychiatrist 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. Your psychiatrist or another member of the treating team will discuss your treatment plan with you, and give you a copy.
Your psychiatrist and other members of the treating team will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. They will review and update your treatment plan on a regular basis.
You may have a friend or advocate with you when you are discussing your treatment with your psychiatrist.
Family members and other caregivers can provide valuable support and care to you while you are receiving treatment for your illness. Generally, they will 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 treating team can give them the information, even if you don't agree.
Second opinions
It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this from within the mental health service, or they can help you choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. You can discuss the second opinion with your treating psychiatrist. However, your treating psychiatrist is responsible for making the final decision about the treatment you receive.
Access to information
It is your right under Freedom of Information (FOI) laws to request access to documents about your personal information that are held by the mental health service.
If you wish to access the information, you can ask a member of the treating team or the mental health service's FOI officer to help you make an FOI application.
Organisations that may be able to help you with an FOI application are described at the end of this statement.
Leave of Absence
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 a member of the treating team. Your psychiatrist will make the final decision about a request for leave.
Seclusion and Restraint
Seclusion
Seclusion is when a person is kept alone in a room where the doors and windows are locked from the outside. 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 injuring themselves or others or to prevent the person from continuing to destroy property.
Approval and Monitoring of Seclusion and Mechanical Restraint
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 a seclusion room or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash.
A nurse must review your physical and mental condition at least every 15 minutes. A doctor must also examine you at least every 4 hours, unless your psychiatrist thinks less frequent examinations are appropriate. If you are being restrained you must be monitored continuously.
Letters and telephone calls
You can contact people by letter or telephone. Your mail will not be opened.
Transfer
You may be transferred to a different mental health service if your psychiatrist believes that you would benefit from the transfer or if it is necessary for your treatment. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. If you are transferred before the appeal is heard, the Board will decide whether you should be returned to the original service when it hears the appeal.
Discharge from continuing treatment involuntary patient status
If the chief psychiatrist believes that any of the criteria for continuing treatment no longer apply to you, you must be discharged from being a continuing treatment involuntary patient and you will be free to leave. However, if both you and your psychiatrist think that you would benefit from further treatment at the mental health service, you can ask to be allowed to stay in the service on a voluntary basis.
If at any time you want to be discharged from being a continuing treatment involuntary patient, you should talk to your psychiatrist or other members of the treating team, or you can appeal to the Mental Health Review Board. Whether or not you appeal, the Board will automatically review you within 2 weeks of the committee consenting to you becoming a continuing treatment involuntary patient and then at least every 12 months until you are discharged. Your psychiatrist will also regularly review you to see if you should be discharged.
APPEAL AND REVIEW: THE MENTAL HEALTH REVIEW BOARD
This section of the statement contains information about your rights and entitlements to appeal and review by the Mental Health Review Board.
The functions of the Board
The Mental Health Review Board is an independent tribunal that—
·hears appeals from continuing treatment involuntary patients who want to be discharged;
·reviews all continuing treatment involuntary patients within 14 days of the committee's consent to continuing involuntary treatment, to decide if they can be discharged;
·reviews all continuing treatment involuntary patients at least every 12 months to decide if they can be discharged;
·hears appeals from patients who do not want to be transferred to a different mental health service.
At each appeal or review, the Board will also review your treatment plan.
Appeals to the Board
It is your right to appeal to the Mental Health Review Board at any time. If you want to appeal, ask a member of the treating team for an Appeal Form, fill it in and ask the team member to send it to the Board. If no appeal form is available, you can write a letter or email to the Board that 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. If you need help to fill in the form or with anything else, you should ask a member of the treating team, a friend, a family member, a lawyer or a community visitor to help you.
The Board's contact details
To fax, mail or email an appeal to the Board, or to find out further information, use the contact details below—
Executive Officer
Mental Health Review Board
[insert appropriate contact details]
Preparing for the Board hearing
The Board will send you a notice advising the date, time and place at which your review or appeal will be heard. Your psychiatrist and case manager will also be notified of the hearing. It is your right to attend the hearing unless the Board decides that this would be bad for your health. You are encouraged to attend and present your case. You can have someone attend to offer support or speak for you, for example, an advocate, a lawyer, a private doctor, a friend or a family member. If you are unable to attend the hearing, you should tell the Board as soon as possible.
The Board will also 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].
Before the hearing, read the documents that will be given to the Board for your hearing (see below) and think about what you are going to say to the Board. You may also want to give the Board written information. Your family and friends or someone you respect may wish to write letters or come to the hearing in support of your appeal or review.
If you have special needs, such as an interpreter, you should discuss these with a member of the treating team or contact the Board. The Board will arrange for an interpreter if necessary.
Organisations that may be able to help you with your appeal or review are described at the end of this statement.
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 and your psychiatrist's report to the Board, at least 24 hours before the hearing.
However, your psychiatrist may apply to the Board to prevent you from seeing a document or part of a document if it is believed that—
·seeing the document will cause serious harm to your health or the health or safety of another person; or
·the information in a document was given in confidence; or is personal information about another person.
If an application is made to prevent you seeing a document or part of a document, a member of the treating team will tell you about this and explain the process. The Board will make the final decision whether you see the whole document or part of the document or none of the document.
If the Board decides you should not see a document or part of any document, it may allow your representative to see it instead.
The Board hearing
Hearings will be held at the mental health service. 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 you being a continuing treatment involuntary patient, it may be conducted by one person—a lawyer, a psychiatrist or a community member of the Board.
The hearing will be informal and private, unless the Board decides that it is in your best interests or the public interest for the hearing to be open. Your doctor and other members of the treating team will give information to the Board. You and your representative will be able to ask questions and explain your side of the case, for example, why you believe you should not be a continuing treatment involuntary patient.
If you are too ill to attend the hearing, the Board may visit you in your ward.
The Board's decision on appeal or review of continuing treatment involuntary patient status
The Board must decide whether all the criteria for being a continuing treatment involuntary patient still apply to you and whether your continued detention is still necessary.
Discharge from continuing treatment involuntary patient status
If the Board is satisfied that any of the criteria for being a continuing treatment involuntary patient no longer apply to you and your continued detention is not necessary, you will be discharged. You will be free to leave the mental health service. However, if 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 on a voluntary basis.
Continuation of continuing treatment involuntary patient status
If the Board doesn't discharge you, you will continue to receive treatment as a continuing treatment involuntary patient.
The Board will also review your treatment plan to decide whether the proper procedures have been followed in making the plan, for example, were your wishes taken into account and did the psychiatrist consider alternative treatments? The Board must be satisfied that the plan can be implemented by the mental health service.
At the end of the hearing, the Board will tell you its decision and the reasons for it. You will be given a written copy of the decision. If you want written reasons for the decision, 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. You can appeal again to the Board at any time.
Review of the Board's decision
If you disagree with the Board's decision you can apply to the Victorian Civil and Administrative Tribunal (VCAT) for a review of the Board's decision. VCAT is an independent tribunal with the power to confirm or overturn the decision of the Board.
Applications must be made in writing within 28 days of receiving the Board's decision or, if you requested a statement of reasons from the Board, within 28 days of receiving that statement, to—
Victorian Civil and Administrative Tribunal
[insert appropriate contact details]COMPLAINTS
You should be treated with dignity and respect and be protected from abuse when you receive treatment and care from the mental health service. If you are unhappy about any part of your treatment or care, you can complain. A good place to start is with your case manager, primary nurse or another member of the treating team, the complaints liaison officer or consumer consultant in the hospital or the Director of Psychiatry at the mental health service.
You can also complain directly to the Health Services Commissioner or to the Chief Psychiatrist.
If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of the treating team, a friend, a family member, a lawyer or a community visitor.
IMPORTANT CONTACTS
The organisations you can contact for assistance and more information are described below. The service will provide you with their contact details.
·The Mental Health Review Board is an independent tribunal that hears appeals from continuing treatment involuntary patients, involuntary patients, hospital order patients and security patients who want to be discharged from their involuntary treatment status. It also automatically reviews these patients.
·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. They also investigate complaints and report on their inquiries and investigations.
·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.
·Victoria Legal Aid provides free legal advice about a range of issues. It may also provide legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings.
·The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment.
·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 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. The Commissioner can help patients access their health information.
·The Ombudsman investigates complaints about government departments.
You can also ask your case manager or any member of the treating team about other local organisations and support groups which may be able to help you.
_______________".
11.New Schedules 12 and 13 inserted
After Schedule 11 to the Principal Regulations insert—
'SCHEDULE 12
Regulation 7(f)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—ASSESSMENT ORDERS; DIAGNOSIS, ASSESSMENT AND TREATMENT ORDERS
Mental Health Act 1986
Mental Health Regulations 1998
IN SUMMARY
When you are on an assessment order, or a diagnosis, assessment and treatment order, you—
·will have a treatment plan and can be involved in planning your treatment;
·have a right to obtain a second opinion from a psychiatrist about your treatment;
·have a right to appeal to the Mental Health Review Board against being on the order;
·have a right to obtain legal advice and have a lawyer represent you;
·can talk to and have a friend or family member represent you;
·can complain about your treatment.
You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor to help you do these things.
ABOUT THIS STATEMENT
This statement provides information about being on an assessment order or a diagnosis, assessment and treatment order and your legal rights and entitlements under the Mental Health Act 1986.
The information must be explained in a language or way that you can understand. This statement may be translated into other languages. You can ask a member of the treating team if it is available in your preferred language. Copies of the Mental Health Act 1986 are available at the mental health service.
A member of the treating team will talk to you about this information and answer your questions.
If at any time you have questions about this information or your rights, ask someone to explain. You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor.
ASSESSMENT ORDERS—DIAGNOSIS, ASSESSMENT AND TREATMENT ORDERS
"Assessment orders" and "diagnosis, assessment and treatment orders" are made by a court under the Sentencing Act 1991. If a person with a mental illness is found guilty of an offence, the court may decide that the person should first be assessed and treated in a mental health service under one of these orders before it gives the person a sentence or makes another order.
You have been admitted to a mental health service as an involuntary patient under the following court order. A member of the treating team will tell you which order applies to you and will tick the correct box—
o
An assessment order
The court ordered that you be assessed in a mental health service for up to 72 hours before being returned to court.
o
A diagnosis, assessment and treatment order
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.
The court made the order after deciding that all of the following three criteria for assessment and treatment apply to you—
·you appear to be mentally ill and require treatment for your illness;
·the treatment you need can be obtained in a mental health service;
·because of your mental illness, you need to be admitted and detained in the mental health service 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.
Once you are admitted on an assessment order or diagnosis, assessment and treatment order, you must remain in the mental health service and receive treatment for mental illness.
TREATMENT
Your psychiatrist will prepare a treatment plan that is designed to meet your specific needs. You have the right to be involved in planning your treatment and the psychiatrist 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. Your psychiatrist or another member of the treating team will discuss your treatment plan with you and give you a copy.
Your psychiatrist and other members of the treating team will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. They will review and update your treatment plan on a regular basis.
You may have a friend or advocate with you when you are discussing your treatment with your psychiatrist.
Family members and other caregivers can provide valuable support and care to you while you are receiving treatment for your illness. Generally, they will 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 treating team can give them the information, even if you don't agree.
Second opinions
It is your right to get a second opinion about your psychiatric condition and treatment. Your case manager or psychiatrist can arrange this from within the mental health service, or they can help you choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. You can discuss the second opinion with your treating psychiatrist. However, your treating psychiatrist is responsible for making the final decision about the treatment you receive.
Access to information
It is your right under Freedom of Information (FOI) laws to request access to documents about your personal information that are held by the mental health service.
If you wish to access the information, you can ask a member of the treating team or the mental health service's FOI officer to help you make an FOI application.
Organisations that may be able to help you with an FOI application are described at the end of this statement.
Leave of Absence
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 a member of the treating team. Your psychiatrist will make the final decision about a request for leave.
Seclusion and Restraint
Seclusion
Seclusion is when a person is kept alone in a room where the doors and windows are locked from the outside. 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 injuring themselves or others or to prevent the person from continuing to destroy property.
Approval and Monitoring of Seclusion and Mechanical Restraint
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 a seclusion room or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash.
A nurse must review your physical and mental condition at least every 15 minutes. A doctor must also examine you at least every 4 hours, unless your psychiatrist thinks less frequent examinations are appropriate. If you are being restrained you must be monitored continuously.
Letters and telephone calls
You can contact people by letter or telephone. Your mail will not be opened.
Transfer
You may be transferred to a different mental health service if your psychiatrist believes that you would benefit from the transfer or if it is necessary for your treatment. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. If you are transferred before the appeal is heard, the Board will decide whether you should be returned to the original service when it hears the appeal.
Discharge from involuntary patient status
You will be discharged and returned to the court for sentencing or another order at the end of the time specified in the assessment order, or diagnosis, assessment and treatment order.
If the chief psychiatrist or the Mental Health Review Board or the court (following an application by your psychiatrist) believes that any of the three criteria for assessment and treatment no longer apply to you and your continued detention as an involuntary patient is no longer necessary, you must be discharged and returned to the court for sentencing or another order. If at any time you want to be discharged from being an involuntary patient, you should talk to your psychiatrist or other members of the treating team, or you can appeal to the Mental Health Review Board. Whether or not you appeal, the Board will automatically review you within 8 weeks of you becoming an involuntary patient and then at least every 12 months if you continue as an involuntary patient. Your psychiatrist will also regularly review you to see if you should be discharged.
APPEAL AND REVIEW: THE MENTAL HEALTH REVIEW BOARD
This section of the statement contains information about your rights and entitlements to appeal and review by the Mental Health Review Board.
The Functions of the Board
The Mental Health Review Board is an independent tribunal that—
·hears appeals from involuntary patients who want to be discharged;
·reviews all involuntary patients within 8 weeks of being placed on an order to decide if they can be discharged;
·reviews all involuntary patients at least every 12 months to decide if they can be discharged;
·hears appeals from patients who do not want to be transferred to a different mental health service.
At each appeal or review, the Board will also review your treatment plan.
Appeals to the Board
It is your right to appeal to the Mental Health Review Board at any time. If you want to appeal, ask a member of the treating team for an Appeal Form, fill it in and ask the team member to send it to the Board. If no appeal form is available, you can write a letter or email to the Board that 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. If you need help to fill in the form or with anything else, you should ask a member of the treating team, a friend, a family member, a lawyer or a community visitor to help you.
The Board's contact details
To fax, mail or email an appeal to the Board, or to find out further information, use the contact details below—
Executive Officer
Mental Health Review Board
[insert appropriate contact details]
Preparing for the Board hearing
The Board will send you a notice advising the date, time and place at which your review or appeal will be heard. Your psychiatrist and case manager will also be notified of the hearing. It is your right to attend the hearing unless the Board decides that this would be bad for your health. You are encouraged to attend and present your case. You can have someone attend to offer support or speak for you, for example, an advocate, a lawyer, a private doctor, a friend or a family member. If you are unable to attend the hearing, you should tell the Board as soon as possible.
Before the hearing, read the documents that will be given to the Board for your hearing (see below) and think about what you are going to say to the Board. You may also want to give the Board written information. Your family and friends or someone you respect may wish to write letters or come to the hearing in support of your appeal or review.
If you have special needs, such as an interpreter, you should discuss these with a member of the treating team or contact the Board. The Board will arrange for an interpreter if necessary.
Organisations that may be able to help you with your appeal or review are described at the end of this statement.
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 and your psychiatrist's report to the Board, at least 24 hours before the hearing.
However, your psychiatrist may apply to the Board to prevent you from seeing a document or part of a document if it is believed that—
·seeing the document will cause serious harm to your health or the health or safety of another person; or
·the information in a document was given in confidence; or is personal information about another person.
If an application is made to prevent you seeing a document or part of a document a member of the treating team will tell you about this and explain the process. The Board will make the final decision whether you see the whole document or part of the document or none of the document.
If the Board decides you should not see a document or part of any document, it may allow your representative to see it instead.
The Board hearing
Hearings will be held at the mental health service. 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 you being an involuntary patient, it may be conducted by one person—a lawyer, a psychiatrist or a community member of the Board.
The hearing will be informal and private, unless the Board decides that it is in your best interests or the public interest for the hearing to be open. Your doctor and other members of the treating team will give information to the Board. You and your representative will be able to ask questions and explain your side of the case, for example, why you believe you should not be on an involuntary treatment order.
If you are too ill to attend the hearing, the Board may visit you in your ward.
The Board's decision on appeal or review of involuntary status
The Board must decide whether all the 3 criteria for assessment and treatment still apply to you and whether your continued detention in the mental health service as an involuntary patient is still necessary.
Discharge from involuntary status
If the Board decides that your continued detention is not necessary, the Board must discharge you from your order and you will be returned to the court to receive a sentence or other order.
Continuation of involuntary status
If the Board decides that your continued detention is necessary, the Board will confirm your order and you must stay at the mental health service.
The Board will also review your treatment plan to decide whether the proper procedures have been followed in making the plan, for example, were your wishes taken into account and did the psychiatrist consider alternative treatments? The Board must be satisfied that the plan can be implemented by the mental health service.
At the end of the hearing, the Board will tell you its decision and the reasons for it. You will be given a written copy of the decision. If you want written reasons for the decision, 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. You can appeal again to the Board at any time.
Review of the Board's decision
If you disagree with the Board's decision you can apply to the Victorian Civil and Administrative Tribunal (VCAT) for a review of the Board's decision. VCAT is an independent tribunal with the power to confirm or overturn the decision of the Board.
Applications must be made in writing within 28 days of receiving the Board's decision or, if you requested a statement of reasons from the Board, within 28 days of receiving that statement, to—
Victorian Civil and Administrative Tribunal
[insert appropriate contact details]COMPLAINTS
You should be treated with dignity and respect and be protected from abuse when you receive treatment and care from the mental health service. If you are unhappy about any part of your treatment or care, you can complain. A good place to start is with your case manager, primary nurse or another member of the treating team, the complaints liaison officer or consumer consultant in the hospital or the Director of Psychiatry at the mental health service.
You can also complain directly to the Health Services Commissioner or to the Chief Psychiatrist.
If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of the treating team, a friend, a family member, a lawyer or a community visitor.
IMPORTANT CONTACTS
The organisations you can contact for assistance and more information are described below. The service will provide you with their contact details.
·The Mental Health Review Board is an independent tribunal that hears appeals from involuntary patients, hospital order patients and security patients who want to be discharged from their involuntary treatment status. It also automatically reviews these patients.
·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. They also investigate complaints and report on their inquiries and investigations.
·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.
· Victoria Legal Aid provides free legal advice about a range of issues. It may also provide legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Mental Health Review Board hearings.
·The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment.
·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 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. The Commissioner can help patients access their health information.
·The Ombudsman investigates complaints about government departments.
You can also ask your case manager or any member of the treating team about other local organisations and support groups which may be able to help you.
_______________
SCHEDULE 13
Regulation 7(g)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—FORENSIC PATIENT (REMAND AND INTERIM DISPOSITION ORDERS)
Mental Health Act 1986
Mental Health Regulations 1998
IN SUMMARY
When you are a forensic patient you—
·will have a treatment plan and can be involved in planning your treatment;
·have a right to obtain a second opinion from a psychiatrist about your treatment;
·have a right to obtain legal advice and have a lawyer represent you;
·can talk to and have a friend or family member represent you;
·can complain about your treatment.
You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor to help you do these things.
ABOUT THIS STATEMENT
This statement provides information about being a forensic patient on a remand order or an interim disposition order, and your legal rights and entitlements under the Mental Health Act 1986.
The statement also provides information about rights and entitlements some forensic patients have under the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997.
A member of the treating team will talk to you about this information and answer your questions.
The information must be explained in a language or way that you can understand. This statement may be translated into other languages. You can ask a member of the treating team if it is available in your preferred language.
Copies of the Mental Health Act 1986 and the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 are available at the mental health service.
If at any time you have questions about this information or your rights, ask someone to explain. You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor.
FORENSIC PATIENTS
You have been admitted to a mental health service as a forensic patient so you can receive treatment for a mental disorder.
There are several ways you may have been admitted as a forensic patient. A member of the treating team will tell you which of the following applies to you and tick the correct box—
o
A remand order
A court has remanded you in custody, for the time specified in the order, to await further court proceedings.
o
An interim disposition order made by the Magistrates' Court
The Magistrates' Court placed you on an interim disposition order because you left a mental health facility in another state without permission or you did not comply with a supervision order in another state, and you came to Victoria.
o
An interim disposition order made by the Victorian Minister
You were transferred to Victoria and placed on an interim disposition order by the Victorian Minister.
TREATMENT
Your psychiatrist will prepare a treatment plan that is designed to meet your specific needs. You have the right to be involved in planning your treatment and the psychiatrist 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. Your psychiatrist or another member of the treating team will discuss your treatment plan with you and give you a copy.
Your psychiatrist and other members of the treating team will regularly discuss with you your diagnosis, medication, methods of treatment, alternative treatments and available services. They will review and update your treatment plan on a regular basis.
You can have a friend or advocate with you when you are discussing your treatment with your psychiatrist.
Family members and other caregivers can provide valuable support and care to you while you are receiving treatment for your illness. Generally, they will 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 treating team can give them the information, even if you don't agree.
Second opinions
It is your right to get a second opinion about your psychiatric condition and treatment. Your case coordinator or psychiatrist can arrange this from within the mental health service, or they can help you choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee. You can discuss the second opinion with your treating psychiatrist. However, your treating psychiatrist is responsible for making the final decision about the treatment you receive.
Access to information
It is your right under Freedom of Information (FOI) laws to request access to documents about your personal information that are held by the mental health service.
If you wish to access the information, you can ask a member of the treating team or the mental health service's FOI officer to help you make an FOI application.
Organisations that may be able to help you with an FOI application are described at the end of this statement.
Seclusion and Restraint
Seclusion
Seclusion is when a person is kept alone in a room where the doors and windows are locked from the outside. 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 injuring themselves or others or to prevent the person from continuing to destroy property.
Approval and Monitoring of Seclusion and Mechanical Restraint
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 a seclusion room or are restrained, staff must give you appropriate bedding, clothing, food and drink when you want them. They must also provide you with adequate toilet arrangements, including the opportunity to wash.
A nurse must review your physical and mental condition at least every 15 minutes. A doctor must also examine you at least every 4 hours, unless your psychiatrist thinks less frequent examinations are appropriate. If you are being restrained you must be monitored continuously.
Security Conditions
While you are in the mental health service, your psychiatrist may apply any security conditions that are considered necessary, for example limiting your phone calls or opening your mail. Security conditions are applied to ensure your health or safety, or for the protection of members of the public.
Letters and telephone calls
You can contact people by letter or telephone, unless your psychiatrist has applied a security condition to you.
Transfer
You may be transferred to a different mental health service if the chief psychiatrist believes that you would benefit from the transfer or if it is necessary for your treatment. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Forensic Leave Panel (see below).
LEAVE
Leave of absence allows forensic patients on interim disposition orders to leave the mental health service for a variety of purposes. Leave is always subject to security conditions and time limits.
There are three types of short-term leave available to forensic patients on interim disposition orders: special leave of absence, on-ground leave and limited off-ground leave.
Special leave
Your psychiatrist can grant special leave of absence. Special leave of absence is for specific purposes, such as medical treatment, court appearances, or special events (such as funerals). Special leave cannot exceed 24 hours, or seven days in the case of medical treatment.
You or someone on your behalf can apply to your psychiatrist stating the special circumstances for which you need special leave. If your 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. If your psychiatrist refuses to grant you special leave, you can appeal to the Forensic Leave Panel.
On-ground leave and limited off-ground leave
To obtain on-ground leave or limited off-ground leave, you must make an application to the Forensic Leave Panel.
On-ground leave allows forensic patients on interim disposition orders to leave the mental health service, but the leave is limited to a defined area around the mental health service known as the surrounds.
Limited off-ground leave allows forensic patients on interim disposition orders to go beyond the surrounds of the mental health service. Generally, limited off-ground leave is only permitted during the day between the hours of 6.00 a.m. and 9.00 p.m. It can be granted outside these hours, but only for a maximum of three days in any seven-day period. Leave can be granted for a period of up to six months. At the end of this time, an application can be made to the Forensic Leave Panel to have the leave renewed.
The purpose of on-ground leave and limited off-ground leave is to help with the treatment and rehabilitation of forensic patients.
Forensic Leave Panel
The Forensic Leave Panel is an independent tribunal that hears—
·applications for on-ground and limited off-ground leave from forensic patients;
·appeals from forensic patients who have been refused special leave of absence by their psychiatrist;
·appeals from forensic patients who do not want to be transferred to a different mental health service.
Applications to the Forensic Leave Panel
If you would like on-ground leave or limited off-ground leave, you should talk to the treating team. They will be able to give you advice and discuss your choices. If your treating team believes you are ready for leave, they will update your treatment plan and prepare a leave plan. It is important the treating team is involved because the Forensic Leave Panel will want to know whether they support your application and how it relates to your treatment plan and your leave plan.
To apply for on-ground leave or limited off-ground leave or to appeal against the refusal of special leave or against a transfer, ask a member of your treating team for the correct form, fill it in and ask the team member to send it to the Panel. If no forms are available, you can write a letter to the Panel setting out your name, the name of the mental health service and the type of leave you want. The application or letter should be mailed or faxed to—
Executive Officer
Forensic Leave Panel
[insert appropriate contact details]
If you need help to fill in the form or help with anything else, you should ask a member of the treating team, a friend, a family member, a lawyer or a community visitor to help you.
Preparing for the Panel hearing
The Panel will arrange for you to be given a notice advising the date, time and place at which your application or appeal will be heard. It is your right to attend the hearing and present your case, and you are encouraged to do so. You can have someone attend to offer support or speak for you, for example, an advocate, a lawyer, a friend or a family member. If you are unable to attend the hearing, you should tell the Panel as soon as possible.
Before the hearing, read the documents that will be given to the Panel for the hearing (see below) and think about what you are going to say to the Panel. You might also want to give the Panel written information. Your family and friends or someone you respect might wish to write letters or come to the hearing in support of your application.
If you have special needs, such as the need for an interpreter, you should discuss these with a member of the treating team or contact the Panel. The Panel will arrange for an interpreter if necessary.
Organisations that might be able to help you with your application or appeal are described at the end of this statement.
Access to documents for the hearing
You or your representative will be given the opportunity to read any documents to be given to the Panel for your hearing at least 24 hours before the hearing. These will include your clinical file, your psychiatrist's report, a profile about you and your leave plan. However, an application can be made to the Panel to prevent you from seeing a document or part of a document if it is believed that—
·seeing the document will cause serious harm to your health or the health or safety of another person; or
·the information in a document was given in confidence; or is personal information about another person.
If an application is made to prevent you seeing a document or part of a document, a member of the treating team will tell you about this and explain the process. The Panel will make the final decision about whether you see the whole document or part of the document or none of the document. If the Panel decides you should not see a document or part of any document, it might allow your representative to see it instead.
The Panel hearing
Your hearing will be held at the mental health service. The Panel members are a judge, a community member, the chief psychiatrist and a medical practitioner.
The hearing will be informal and private, unless the Panel decides it is in your best interests or the public interest for the hearing to be open. The Panel is not bound by strict rules of practice, such as those in a court, and can inform itself in any way it thinks fit. Your psychiatrist and other members of the treating team will give information to the Panel. You and your representative will be able to ask questions and explain your side of the case; for example, why you believe you should be given leave of absence.
The Panel's reasons for the decision
Approval of leave
If the Panel is satisfied the proposed leave will help your rehabilitation and your safety or the safety of members of the public will not be seriously endangered, it might grant your leave. It will place conditions on the leave; for example, that members of staff escort you at all times. You and your representative will be given a copy of the order, which will list the type of leave granted and the conditions of the leave.
Leave can be granted for a period of up to six months. At the end of this time, you can apply to the Panel to have the leave renewed. You can also apply at any time to have the conditions of the leave varied if your circumstances have significantly changed, for example, if a new rehabilitation program has become available.
Refusal of leave
If the Panel refuses your application for leave, you should talk to your case coordinator or another member of the treating team and discuss the reasons. They might be able to help you make another application that is more likely to be granted. While you remain a forensic patient you can apply for leave to the Panel at any time. Your psychiatrist and other members of the treating team will also regularly review your progress to see whether to make a new application for leave.
Special leave
If you have appealed to the Panel because your psychiatrist has refused you special leave, the Panel might grant the special leave if it believes there are special circumstances and the safety of members of the public will not be seriously endangered.
Transfer
If you have appealed to the Panel against a transfer to another mental health service, the Panel will decide whether you should be transferred or not. If you are transferred before the appeal is heard, the Panel will decide whether you should be returned to the original service when it hears the appeal.
Reasons for the decision
At the end of the hearing, the Panel will tell you its decision and the reasons for it. You will be given a written copy of the order. If you want written reasons for the Panel's decision, you must request them in writing from the Panel. The Panel must provide you with a statement of reasons within 14 days of your request.
Suspension of leave
If at any time the chief psychiatrist believes your safety or the safety of members of the public will be seriously endangered, your leave or part of your leave can be suspended. You will be told if your leave is suspended. If you are not already in the mental health service, you must return there. You will be given written notification of the suspension from the chief psychiatrist. If you do not return, police or other prescribed people can apprehend you at any time.
Extended leave
Extended leave allows forensic patients on custodial supervision orders to leave the mental health service and live in the community for periods of up to 12 months.
Some forensic patients on interim disposition orders made by the Minister might also be granted extended leave by the Minister. The Minister will apply conditions to the extended leave; for example the place where you will live, and where and how often you should receive treatment.
A grant of extended leave is one of the orders a court can make if it converts your interim disposition order to a custodial supervision order (see "Ending the Order" below).
For more information about extended leave, you can ask a member of the treating team for a copy of the statement of rights for forensic patients on custodial supervision orders.
ENDING THE ORDER
Remand orders and interim disposition orders are generally only intended to last for short periods of time. This section of the statement explains how these orders finish and has information about your rights and entitlements under the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997.
Remand orders
If you are on a remand order, you will be returned to the court at the end of the time specified in the court order.
Interim disposition order made by the Magistrates' Court
If you are on an interim disposition order made by the Magistrates' Court, the Secretary to the Department of Human Services must apply to the Supreme Court for a review of that order within 7 days after the order is made.
At the review, the court may—
·make a custodial supervision order. You must then remain in the mental health service as a forensic patient. If this happens, you will be given a new statement explaining your rights and entitlements as a forensic patient. The court might also grant you extended leave if it is satisfied that granting you leave will not seriously endanger your safety or the safety of members of the public;
·make a non-custodial supervision order. You will be able to live in the community subject to conditions decided by the court;
·order you to be taken back to the state you came from;
·release you unconditionally to live in the community.
It is your right to attend any court hearing and to have a lawyer represent you. Organisations that might be able to give you advice and help with legal representation are described at the end of this statement.
Interim disposition order made by the Victorian Minister
If you are on an interim disposition order made by the Victorian Minister, the Secretary to the Department of Human Services must apply to the Supreme Court for a review of that order within 6 months after your transfer.
At the review, the court may—
·make a custodial supervision order. You must then remain in the mental health service as a forensic patient. If this happens, you will be given a new statement explaining your rights and entitlements as a forensic patient. The court might also grant you extended leave if it is satisfied that granting you leave will not seriously endanger your safety or the safety of members of the public;
·make a non-custodial supervision order. You will be able to live in the community subject to conditions decided by the court;
·release you unconditionally to live in the community.
COMPLAINTS
You should be treated with dignity and respect and be protected from abuse when you receive treatment and care from the mental health service. If you are unhappy about any part of your treatment or care, you have a right to complain. A good place to start is with your case coordinator, primary nurse or another member of the treating team, the complaints liaison officer or consumer consultant in the hospital or the Clinical Director of the mental health service.
You can also complain directly to the Health Services Commissioner or to the Chief Psychiatrist.
If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of the treating team, a friend, a family member, a lawyer or a community visitor.
IMPORTANT CONTACTS
The organisations you can contact for assistance and more information are described below. The service will provide you with their contact details.
·The Forensic Leave Panel is an independent Panel. Its main function is to hear applications for leave of absence by forensic patients.
·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. They also investigate complaints and report on their inquiries and investigations.
·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 Forensic Leave Panel or Court hearings or about other legal matters.
·Victoria Legal Aid provides free legal advice about a range of issues. It may also provide legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Forensic Leave Panel or Court hearings.
·The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment.
·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 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. The Commissioner can help patients access their health information.
·The Ombudsman investigates complaints about government departments.
You can also ask your case coordinator or any member of the treating team about other local organisations and support groups which may be able to help you.
_______________'.
12.New Schedule 15 substituted
For Schedule 15 to the Principal Regulations substitute—
"SCHEDULE 15
Regulation 8(b)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—PSYCHOSURGERY
Mental Health Act 1986
Mental Health Regulations 1998
IN SUMMARY
If your psychiatrist or neurosurgeon recommends that you have psychosurgery you—
·will be provided with information about psychosurgery and can ask questions about it;
·have a right to refuse psychosurgery;
·have a right to obtain medical and legal advice;
·have a right to obtain a second opinion from a psychiatrist about psychosurgery;
·have a right to have a friend, family member or lawyer represent you;
·have a right to withdraw your consent at any time before psychosurgery is performed;
·can complain about your treatment.
You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor to help you do these things.
ABOUT THIS STATEMENT
This statement has been given to you because your psychiatrist has recommended that you would benefit from psychosurgery. It provides information about the treatment and your legal rights and entitlements under the Mental Health Act 1986.
Copies of the Mental Health Act 1986 are available at the mental health service.
Your psychiatrist or a member of the treating team will talk to you about this information and your rights and entitlements and answer your questions.
This information must be explained in a language or way that you can understand. This statement may be translated into other languages. You can ask a member of your treating team if it is available in your preferred language.
If at any time you have questions about this information or your rights, ask someone to explain. You can ask a member of the treating team, a friend, a family member, a lawyer, an advocate or a community visitor.
You can also get information from the Psychosurgery Review Board at—
[insert appropriate contact details]
PSYCHOSURGERY: YOUR RIGHTS AND ENTITLEMENTS
Psychosurgery is an operation on the brain and may be used to treat people with severe mental disorders that have not responded to other treatments. Examples of the disorders are major depression, obsessive-compulsive disorder and 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 or neurosurgeon will talk to you about psychosurgery and explain how it works and how it can help your illness. The psychiatrist or neurosurgeon will discuss possible side effects and alternative treatments, ask your views and answer any questions you might have.
When you are discussing psychosurgery with your psychiatrist or neurosurgeon, you can have a friend, a family member, a lawyer or an advocate with you for support. It is your right to have that person represent you before you consent to psychosurgery.
Advice and second opinions
It is your right to get legal and medical advice. It is also your right to get a second opinion about whether you need psychosurgery. Your case manager or psychiatrist can arrange this from within the mental health service or they can help you choose your own psychiatrist. If you choose a private psychiatrist you may have to pay a fee.
Consenting to psychosurgery
You will only be considered for psychosurgery if you can give informed consent to the treatment.
You have the right to refuse psychosurgery.
Informed consent
Informed consent is when you agree to have psychosurgery after you have been told—
·what psychosurgery involves; and
·the benefits, discomforts and risks of psychosurgery; and
·any beneficial alternative treatments; and
·the answers to any questions you have about psychosurgery and you have understood the answers; 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, family member, lawyer or an advocate, or one of the organisations described at the end of this statement.
If you agree to have psychosurgery, you will be asked to sign a form to say you have given informed consent.
Your psychiatrist will then apply to the Psychosurgery Review Board to obtain its consent. The Psychosurgery Review Board will make the final decision.
Withdrawing consent to psychosurgery
If you agree to have psychosurgery, but then change your mind, it is your right to withdraw your consent at any time and the psychosurgery will not proceed. If you want to withdraw your consent, you should talk to your psychiatrist or neurosurgeon. Remember that you can have a friend, a family member, a lawyer or an advocate with you for support or to represent you.
PSYCHOSURGERY REVIEW BOARD
The Psychosurgery Review Board is an independent tribunal that decides 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.
Preparing for the hearing
The Psychosurgery Review Board will send you a notice advising the date, time and place of the hearing, at least 10 days before the hearing. Your advocate or representative (if you have one) and your primary carer will also be notified.
It is your right to attend the hearing and present your case, and you are encouraged to do so. It is also your right to have a friend, a family member, a lawyer or an advocate represent you at the hearing.
If you are unable to attend the hearing, you should tell the Board as soon as possible.
You or your representative will be given copies of the application and all supporting documents before the hearing. You should read the documents and think about what you are going to say to the Board. You may also want to give the Board written information. Your family and friends or someone you respect may wish to write letters or come to the hearing in support of the application.
If you have special needs, such as an interpreter, you should discuss these with a member of the treating team or contact the Board. The Board will arrange an interpreter if necessary.
Organisations that may be able to help you with the application are described at the end of this statement.
The Board hearing
The hearing will be held by either 4 or 5 Board members—a lawyer, 1 or 2 psychiatrists, a neurosurgeon and a nominee of the Victorian Council for Civil Liberties.
The hearing will be informal and private, unless the Board decides that it is in your best interest or in the public interest for the hearing to be open.
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 information. The neurosurgeon may be present if it is considered necessary by the Board.
The Board's decision
When the Psychosurgery Review Board has heard the evidence, it will make its decision.
The Board must decide whether—
·you are capable of giving informed consent;
·you have actually given informed consent;
·the proposed psychosurgery has clinical merit and is appropriate;
·the person proposing to perform the psychosurgery is properly qualified;
·the hospital, service or clinic where the proposed psychosurgery would be performed is an appropriate place;
·all other reasonable treatments have already been tried without sufficient and lasting benefit.
The Board consents to psychosurgery
If the Board is satisfied about the above matters, it will consent to you having psychosurgery and will specify—
·the name of the neurosurgeon authorised to perform the psychosurgery;
·the nature of the psychosurgery to be performed;
·the hospital, service or clinic where the psychosurgery is to be performed;
·the time within which the psychosurgery is to be performed.
You and your representative will be given a written copy of the Board's consent.
The Board refuses consent to psychosurgery
If the Board is not satisfied about the above matters, it must refuse to give its consent and you cannot have psychosurgery.
You will be advised of the refusal and the reasons in writing.
Reports about the psychosurgery
If you have psychosurgery, your neurosurgeon must provide a report about the treatment to the Board within 3 months. Your psychiatrist must also provide reports on your progress within 3 months after the treatment and then within 12 months.
The Board will continue to review your progress on a regular basis, unless you object to this regular review. If you do not want the Board to review your progress, you should discuss this with a member of the treating team or contact the Board.
COMPLAINTS
You should be treated with dignity and respect and be protected from abuse when you receive treatment and care from the mental health service. If you are unhappy about any part of your treatment or care, you can complain. A good place to start is with your case manager, primary nurse or another member of the treating team, the complaints liaison officer or consumer consultant in the hospital, or the Director of Psychiatry at the mental health service.
You can also complain directly to the Health Services Commissioner or to the Chief Psychiatrist.
If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of the treating team, a friend, a family member, a lawyer or a community visitor.
IMPORTANT CONTACTS
The organisations you can contact for assistance and more information are described below. The service will provide you with their contact details.
·The Psychosurgery Review Board is an independent tribunal that decides whether psychosurgery should be performed on any person in the state of Victoria.
·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. They also investigate complaints and report on their inquiries and investigations.
·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 Psychosurgery Review Board hearings or about other legal matters.
·Victoria Legal Aid provides free legal advice about a range of issues. It may also provide legal assistance if you cannot afford a private solicitor and may be able to assist with legal representation at Psychosurgery Review Board hearings.
·The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment.
·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 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. The Commissioner can help patients access their health information.
·The Ombudsman investigates complaints about government departments.
·The Mental Health Review Board is an independent tribunal that hears appeals from involuntary patients, hospital order patients and security patients who want to be discharged from their involuntary treatment status. It also automatically reviews these patients.
You can also ask your case manager or any member of the treating team about other local organisations and support groups which may be able to help you.
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ENDNOTES
[1] Reg. 3: S.R. No. 120/1998. Reprint No. 1 as at 7 December 2004. Reprinted to S.R. No. 157/2004 and subsequently amended by
S.R. Nos 111/2005 and 127/2005.
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