Untitled document
Mental Health (Statements) Regulations 2004
S.R. No. 157/2004
TABLE OF PROVISIONS
Regulation Page
1.Objective
2.Authorising provision
3.Principal Regulations
4.New regulation 7 substituted
7.Statements to be provided on admission to approved mental health services
5.Statements to be provided with respect to treatment
6.Schedules 7 to 9 substituted
SCHEDULE 7—Statement of Legal Rights and Entitlements
and other Information—Involuntary PatientSCHEDULE 8—Statement of Legal Rights and Entitlements
and other Information—Hospital Order
PatientSCHEDULE 9—Statement of Legal Rights and Entitlements
and other Information—Security Patient
7.Statement for continuing involuntary treatment
8.Schedules 11 to 14 substituted
SCHEDULE 11—Statement of Legal Rights and Entitlements and other Information—Forensic Patient
SCHEDULE 14—Statement of Legal Rights and Entitlements and other Information—Electroconvulsive Therapy
9.New Schedule 16 substituted
SCHEDULE 16—Statement of Legal Rights and Entitlements and other Information—Major
Non‑Psychiatric Treatment
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ENDNOTES
STATUTORY RULES 2004
S.R. No. 157/2004
Mental Health Act 1986
Mental Health (Statements) Regulations 2004
The Governor in Council makes the following Regulations:
Dated: 7 December 2004
Responsible Minister:
BRONWYN PIKE
Minister for HealthDIANE CASEY
Clerk of the Executive Council
1.Objective
The objective of these Regulations is to amend the Mental Health Regulations 1998 to—
(a)prescribe new statements of patient's rights; and
(b)make other amendments to those regulations.
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.New regulation 7 substituted
For regulation 7 of the Principal Regulations substitute—
"7.Statements to be provided on admission to approved mental health services
For the purposes of section 18(1) of the Act, the prescribed printed statement to be given to every person on becoming a patient must—
(a)in the case of a person subject to an involuntary treatment order, be in the form set out in Schedule 7;
(b)in the case of a person subject to a hospital order, be in the form set out in Schedule 8;
(c)in the case of a security patient, be in the form set out in Schedule 9;
(d)in the case of a continuing treatment involuntary patient, be in the form set out in Schedule 10;
(e)in the case of—
(i)a forensic patient subject to a supervision order; or
(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.".
5.Statements to be provided with respect to treatment
In regulation 8(c) of the Principal Regulations, omit "or a major medical procedure".
6.Schedules 7 to 9 substituted
For Schedules 7, 8 and 9 to the Principal Regulations substitute—
'SCHEDULE 7
Regulation 7(a)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—INVOLUNTARY PATIENT
Mental Health Act 1986
Mental Health Regulations 1998
IN SUMMARY
When you are on an Involuntary Treatment Order or a Community Treatment Order (CTO) 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 involuntary treatment order or a community treatment order (CTO) 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 manner that you can understand. This statement is also translated into a number of 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.
INVOLUNTARY TREATMENT ORDERS
Involuntary treatment orders are orders under the Mental Health Act that require people with a mental illness to receive treatment for their illness.
A doctor has recommended you be placed on an involuntary treatment order so you can receive treatment for a mental illness. In the doctor's opinion all of the following criteria for involuntary treatment in the Mental Health Act apply to you—
·you appear to be mentally ill (mental illness is defined in the Act as a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory);
·your mental illness requires immediate treatment and that treatment can be obtained by placing you on an involuntary treatment order;
·because of your mental illness, involuntary treatment is necessary 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;
·you have either refused or are unable to consent to necessary treatment;
·there is no less restrictive way for you to receive adequate treatment for your mental illness.
Initial review of involuntary treatment orders
Within 24 hours of being placed on the order, a psychiatrist from the mental health service will examine you to decide if all of these criteria apply to you. If they do, the psychiatrist will confirm the order and you will remain an involuntary patient under the Mental Health Act.
The psychiatrist will then either admit you to the mental health service or make a community treatment order (CTO) for you. Where possible, you will be treated in the community. If you are admitted as an inpatient, you must stay in the mental health service. Read the section on "Inpatient Treatment" in this statement for more information. If the psychiatrist makes a CTO for you, read the section in this statement on "Community Treatment Orders".
If the psychiatrist does not believe all of the criteria for involuntary treatment apply to you, the involuntary treatment order will be discharged. You can discuss continuing treatment on a voluntary basis with your case manager or psychiatrist. If you have been an inpatient and 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 on a voluntary basis.
If you have any questions about the review, such as when the psychiatrist will come to see you, ask a member of the treating team.
Treatment
Your psychiatrist will prepare a treatment plan that is designed to meet your specific needs. You can 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 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.
INPATIENT TREATMENT
This section of the statement has information about your rights and entitlements if you are admitted to a mental health service on an involuntary treatment order.
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.
Community Treatment Orders (CTO)
If your psychiatrist believes that you can live in the community while you receive the treatment you need, you may be placed on a CTO. To find out more about these orders, read the section in this statement on "Community Treatment Orders" and ask a member of the treating team to explain them.
Discharge from involuntary patient status
If your psychiatrist believes that any of the criteria for involuntary treatment 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 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 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.
COMMUNITY TREATMENT ORDERS
This section of the statement contains information about your rights and entitlements if you are placed on a community treatment order (CTO).
CTOs are orders under the Mental Health Act that enable involuntary patients to live in the community while they receive treatment for their mental illness.
If your psychiatrist believes you can obtain the treatment you need while you live in the community, you will be placed on a CTO. You will still be an involuntary patient on an involuntary treatment order, even though you are living in the community on a CTO.
Planning for a CTO
Your psychiatrist will talk to you about the CTO and prepare a new treatment plan. You can be involved in planning your order and treatment plan. The treatment 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.
Your psychiatrist will discuss your treatment plan with you and give you a copy. The plan will include—
·an outline of your treatment;
·the name of the psychiatrist who will monitor your treatment;
·the name of the doctor who will supervise your treatment;
·the name of your case manager;
·the place and times at which you are to receive treatment;
·how often the supervising doctor must report on your treatment to the monitoring psychiatrist;
·anything else the authorised psychiatrist thinks is appropriate.
Conditions of the CTO
You will be given a copy of the CTO. It will say how long the order will last, which can be for up to 12 months. The CTO sometimes states where you must live if this is necessary for the treatment of your illness. Your psychiatrist may vary these conditions from time to time and will discuss the reasons with you.
If you are unhappy with any of the conditions, you should talk to a member of the treating team or you can appeal to the Mental Health Review Board.
Your psychiatrist can extend the CTO if the criteria for involuntary treatment still apply to you and the treatment you need can continue to be obtained through the order. If your CTO is extended, the Mental Health Review Board will review the extension.
If your psychiatrist does not extend your CTO, it will expire and you will no longer be an involuntary patient.
Revoking the CTO
If you do not comply with your order or your treatment plan, your psychiatrist may revoke the order and you must return to the mental health service for treatment. Members of the treating team will try to help you comply with the order and your treatment plan. However, if there is a significant risk that your health will get worse because of the non-compliance, the CTO will be revoked.
Your CTO may also be revoked if your psychiatrist believes that your illness would be better treated in a mental health service.
If your CTO is revoked, reasonable efforts will be made to tell you and you must then go to the mental health service as an inpatient.
Discharging the CTO
If your psychiatrist believes that any of the criteria for involuntary treatment no longer apply to you, you must be discharged from the CTO and from being an involuntary patient. You can discuss continuing treatment on a voluntary basis with your case manager or psychiatrist.
If at any time you want to be discharged from the CTO, 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 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 on involuntary treatment orders or community treatment orders who want to be discharged;
·reviews all involuntary patients within 8 weeks of being placed on an involuntary treatment order to decide if they can be discharged from the order;
·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;
·reviews the extension of all community treatment orders.
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 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 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 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 treatment order or the review of the extension of your community treatment order, it may be conducted by one person—a lawyer, a psychiatrist or a community member of the Board.
The hearing will be informal and private, unless the Board decides that it is in your best interests or the public interest for the hearing to be open. Your doctor and other members of the treating team will give information to the Board. You and your representative will be able to ask questions and explain your side of the case, for example, why you believe you should not be on an involuntary treatment order.
If you are an inpatient and 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 criteria for involuntary treatment still apply to you.
Discharge from involuntary status
If any one of the criteria does not apply, you will be discharged from your order and from being an involuntary patient. If you were on a Community Treatment Order (CTO), you will no longer be on the order. You can discuss continuing treatment on a voluntary basis with your case manager or psychiatrist. If you were an inpatient, 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 involuntary status
If the Board decides that all of the criteria for involuntary treatment still apply to you, you will continue to receive treatment as an involuntary patient.
If you are an inpatient and the Board considers that the treatment you need can be obtained through a CTO, it may order your psychiatrist to place you on a CTO. If you are on a CTO, the Board can vary the conditions of the CTO.
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 advise you of its decision and the reasons for it. You will be given a written copy of the order. If you want written reasons for the 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.
Appeals must be made in writing within 28 days 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 patient representative in the hospital or the Director of Psychiatry at the mental health service.
You can also complain directly to the Health Services Commissioner or 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, 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, 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 Service 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 staff about other local organisations and support groups which may be able to help you.
__________________
SCHEDULE 8
Regulation 7(b)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—HOSPITAL ORDER PATIENT
Mental Health Act 1986
Mental Health Regulations 1998
IN SUMMARY
When you are on a hospital order or Restricted Community Treatment Order (RCTO) 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 a Hospital Order or Restricted Community Treatment Order (RCTO) 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 manner that you can understand. This statement is also translated into a number of 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.
HOSPITAL ORDERS
Hospital 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 make a hospital order instead of giving the person a sentence. The person is then admitted to a mental health service and is given treatment for their mental 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.
A court has placed you on a hospital order so you can receive treatment for a mental illness. The court made the order after a psychiatrist found that all of the following criteria for being a hospital order patient 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 as a hospital order patient, 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 can 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 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.
INPATIENT TREATMENT
This section of the statement has information about your rights and entitlements while you are admitted to a mental health service on a hospital order.
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.
Restricted Community Treatment Orders (RCTO)
If the chief psychiatrist believes that you can live in the community while you receive the treatment you need, you may be placed on a Restricted Community Treatment Order (RCTO). To find out more about these orders, read the section in this statement on "Restricted Community Treatment Orders" and ask a member of the treating team to explain them.
Discharge from hospital order patient status
If the chief psychiatrist is satisfied that any of the criteria for being a hospital order patient no longer apply to you and your continued detention as a hospital order patient is no longer necessary, you must be discharged as a hospital order 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 on a voluntary basis.
If at any time you want to be discharged from being on a hospital order, 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 a hospital order patient and then at least every 12 months if you continue as a hospital order patient. Your psychiatrist will also regularly review you to see if you should be discharged.
RESTRICTED COMMUNITY TREATMENT ORDERS (RCTO)
This section of the statement contains information about your rights and entitlements if you are placed on a Restricted Community Treatment Order (RCTO).
RCTOs are orders under the Mental Health Act that enable hospital order patients to live in the community while they receive treatment for their mental illness.
You will be placed on a RCTO if the chief psychiatrist believes you can obtain the treatment you need while you live in the community and all the following criteria for a RCTO apply to you—
·you appear to be mentally ill and require treatment for your illness;
·the treatment you need can be obtained on a RCTO;
·because of your mental illness, you need to be on a RCTO for your health or safety (whether to prevent a deterioration of your physical or mental condition or otherwise) or for the protection of members of the public.
You will still be a hospital order patient, even though you are living in the community on a RCTO.
Planning for a RCTO
Your psychiatrist will talk to you about the RCTO and prepare a new treatment plan. You can be involved in planning your order and treatment plan. The treatment 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.
Your psychiatrist will discuss your treatment plan with you and give you a copy. The plan will include—
·an outline of your treatment;
·the name of the psychiatrist who will monitor your treatment;
·the name of the doctor who will supervise your treatment;
·the name of your case manager;
·the place and times at which you are to receive treatment;
·how often the monitoring psychiatrist must report on your treatment to the chief psychiatrist;
·anything else the authorised psychiatrist thinks is appropriate.
Making the RCTO
The chief psychiatrist will make the RCTO and send it to the Mental Health Review Board for approval. The RCTO does not come into effect until the Mental Health Review Board approves it. The Board will have a hearing to decide whether or not to approve the RCTO. The Board will send you a notice advising the date, time and place of the hearing. To find out more about the Board, read the section in this statement on "Appeal and Review: the Mental Health Review Board".
Conditions of the RCTO
You will be given a copy of the RCTO. It will say how long the order will last, which can be for up to 12 months. The RCTO sometimes states where you must live. The order may also specify any conditions that the chief psychiatrist considers appropriate. The chief psychiatrist may vary the conditions from time to time, and will discuss the reasons with you.
If you are unhappy with any of the conditions, you should talk to a member of the treating team or contact the chief psychiatrist directly.
The chief psychiatrist can extend the RCTO if the criteria for being on a RCTO still apply to you and the treatment you need can continue to be obtained through the order.
If your RCTO is extended, the Mental Health Review Board will review the extension.
Revoking the RCTO
If you do not comply with your order or your treatment plan, the chief psychiatrist may revoke the order.
Your RCTO may also be revoked if the chief psychiatrist believes that your illness would be better treated in a mental health service.
If your RCTO is revoked, reasonable efforts will be made to tell you and you must then go to the mental health service as an inpatient.
Discharging the RCTO
If the chief psychiatrist believes that any of the criteria for being a hospital order patient no longer apply to you, you must be discharged from the RCTO and from being a hospital order patient. You can discuss continuing treatment on a voluntary basis with your case manager or psychiatrist.
If at any time you want to be discharged from the RCTO, 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 at least every 12 months if you continue as a hospital order 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 hospital order patients who want to be discharged;
·reviews all hospital order patients within 8 weeks of their admission to decide if they can be discharged;
·reviews all hospital order 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; and
·reviews the making and extension of all Restricted Community Treatment Orders (RCTO).
At each appeal or review, the Board will also review your treatment plan.
Your Right to Appeal 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 and 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 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 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 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 you being a hospital order 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 hospital order patient.
If you are an inpatient and too ill to attend the hearing, the Board may visit you in your ward.
The Board's Decision on Appeal or Review
The Board must decide whether all the criteria for being a hospital order patient still apply to you and whether your continued detention as a hospital order patient is still necessary.
Discharge from inpatient treatment
If the Board is satisfied that any of the criteria for a hospital order no longer apply to you and your continued detention as a hospital order patient is not necessary, you must be discharged from the order.
Discharge from Restricted Community Treatment Orders
If you are on a RCTO, and the Board considers that the criteria for a RCTO and the criteria for a hospital order no longer apply to you, you must be discharged from both the RCTO and the hospital order.
After Discharge
If you are discharged, you can discuss continuing treatment on a voluntary basis with your case manager or psychiatrist. If you were an inpatient, 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 involuntary status
If the Board decides that all the criteria for being a hospital order patient or on a RCTO still apply to you, you will continue to receive treatment, either as an inpatient or on a RCTO.
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 advise you of its decision and the reasons for it. You will be given a written copy of the order. If you want written reasons for the 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.
Appeals must be made in writing within 28 days 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 patient representative in the hospital or the Director of Psychiatry at the mental health service.
You can also complain directly to the Health Services Commissioner or 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, 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, 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 Service 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 9
Regulation 7(c)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—SECURITY PATIENT
Mental Health Act 1986
Mental Health Regulations 1998
IN SUMMARY
When you are a security 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 security 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 security 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 manner that you can understand. This statement is also translated into a number of 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 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.
SECURITY PATIENTS
You have been admitted to a mental health service as a security patient so you can receive treatment for a mental 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.
There are two ways you may have been admitted as a security patient. A member of the treating team will tell you which of the following orders applies to you and tick the correct box.
o 1. Restricted Hospital Transfer Order
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. A psychiatrist examined you and found that all of the following criteria for being a security patient apply to you—
·you appear to be mentally ill and require immediate 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 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.
o 2. Hospital Security Order
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 for the time specified in the order. A psychiatrist examined you and found that all of the following criteria for being a security patient 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 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 as a security patient, you must remain in the mental health service and receive treatment for mental illness.
INPATIENT TREATMENT
This section of the statement has information about your legal rights and entitlements while you are admitted to a mental health service as a security patient.
Treatment
Your psychiatrist will prepare a treatment plan that is designed to meet your specific needs. You can 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 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 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.
Leave
Leave allows security patients to leave the mental health service for a variety of purposes, including medical appointments, court appearances and rehabilitation programs. Leave is always subject to security conditions and time limits. There are two types of leave: special leave and leave of absence.
Special leave
Special leave is for specific purposes and cannot exceed 24 hours. You or someone on your behalf can apply to the chief psychiatrist stating the special circumstances for which special leave is needed. 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. If you are refused special leave by the chief psychiatrist, you can appeal to the Mental Health Review Board.
Leave of absence
Leave of absence is for longer periods—up to 6 months—and is generally used to help with your rehabilitation and to prepare you for your return to the community at the end of your sentence. Leave of absence is granted by the Secretary to the Department of Justice. If you would like to have leave of absence, you should talk to a member of the treating team about how to make an application. The Secretary to the Department of Justice 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.
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 14
Regulation 8(a)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—ELECTROCONVULSIVE THERAPY
Mental Health Act 1986
Mental Health Regulations 1998
ABOUT THIS STATEMENT
This statement has been given to you because your doctor or psychiatrist has recommended that you would benefit from a course of Electroconvulsive Therapy (ECT). It provides information about the treatment and your legal rights and entitlements under the Mental Health Act 1986.
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 manner that you can understand. This statement is also translated into a number of 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.
ECT: YOUR RIGHTS AND ENTITLEMENTS
Your psychiatrist will talk to you about ECT and explain how it works and how it can help your illness. The psychiatrist will discuss possible side-effects, alternative treatments, ask your views and answer any questions you might have.
When you are discussing ECT with your psychiatrist, you can have a friend, a family member, a lawyer or an advocate with you for support. It is your right for that person to represent you before you consent to ECT.
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 ECT. 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 ECT
If you are able to give informed consent, you can only be given ECT if you agree. This means that if you are able to give informed consent, you have the right to refuse ECT.
Informed Consent
Informed consent is when you agree to have ECT after you have been told—
·what ECT involves;
·the benefits, discomforts and risks of ECT;
·any beneficial alternative treatments;
·the answers to any questions you have about ECT and you have understood the answers;
·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;
·your legal rights and other entitlements.
Before you decide whether you want to have ECT, it is important that you are well informed. If you have any questions, you should ask your psychiatrist 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 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.
Withdrawing consent to ECT
If you agree to have ECT, but then change your mind, it is your right to 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. If you want to withdraw your consent, you should talk to your psychiatrist. Remember that you can have a friend, a family member, a lawyer or an advocate with you for support or to represent you.
Treatment if you are not able to give informed consent
If you are not able to give informed consent to ECT, your psychiatrist can consent for you if the psychiatrist is satisfied that—
·the ECT is necessary; and
·your physical or mental condition is likely to get worse unless you have ECT; and
·the benefits and risks of ECT, and any other beneficial treatments, have been considered.
Your psychiatrist will talk to you about the ECT before you receive the treatment. Reasonable efforts will be made to notify your primary carer (a family member or friend who is primarily responsible for providing support or care to you) or your guardian (if you have one) about the proposed ECT.
Urgent Treatment
If ECT is urgently needed because of the nature of your mental illness, it can be given to you without your consent. If this happens, your psychiatrist will explain to you why the treatment is urgent.
COMPLAINTS
You should be treated with dignity and respect and be protected from abuse when you are receiving ECT. 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 patient representative in the hospital or the Director of Psychiatry at the mental health service.
You can also complain directly to the Health Services Commissioner or 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.
·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.
·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, 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 Service 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 staff about other local organisations and support groups which may be able to help you.
__________________'.
9.New Schedule 16 substituted
For Schedule 16 to the Principal Regulations substitute—
'SCHEDULE 16
Regulation 8(c)
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATIONMAJOR NON‑PSYCHIATRIC TREATMENT—
Mental Health Act 1986
Mental Health Regulations 1998
ABOUT THIS STATEMENT
This statement has been given to you because your doctor or psychiatrist has recommended that you would benefit from a particular major non-psychiatric treatment. It provides information about your legal rights and entitlements under the Mental Health Act 1986.
Your psychiatrist or a member of the treating team will talk to you about this information and your rights and answer your questions.
This information must be explained in a language or manner that you can understand. This statement is also translated into a number of 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 major non-psychiatric treatment 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.
MAJOR NON-PSYCHIATRIC TREATMENT
The treatment your doctor has recommended is described as a major non-psychiatric treatment. It is primarily intended to treat a physical condition and not your mental illness. The treatments in the following list are major non-psychiatric treatments—
·any surgery performed under a general or regional anaesthetic;
·the use of general or regional block anaesthetic for any purpose;
·chemotherapy;
·radiotherapy.
However, major non-psychiatric treatment does not include "special procedures". These treatments are—
·any procedure that is intended to make a person permanently infertile (sterilisation);
·any procedure carried out for the purposes of medical research;
·termination of pregnancy (abortion);
·removal of tissue for transplantation to another person.
If a doctor recommends you have a "special procedure", you should seek advice from the Public Advocate or one of the other organisations described at the end of this statement.
Treatment
Your psychiatrist or doctor will talk to you about your medical condition, explain the proposed treatment, discuss possible side-effects, alternative treatments, ask your views and answer any questions you might have about the treatment.
Advocacy
When you are discussing the major non-psychiatric treatment with your psychiatrist or doctor, you can have a friend, relative, lawyer or an advocate with you for support. It is your right for that person to represent you before you consent to the treatment.
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 the major 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.
Consenting to Treatment
If you are able to give informed consent, you can only be given the major non-psychiatric treatment if you agree. This means that if you are able to give informed consent, you have the right to refuse the treatment.
Informed Consent
Informed consent is when you agree to have the treatment after you have been told—
·what the treatment involves;
·the benefits, discomforts and risks of the treatment;
·any beneficial alternative treatments;
·the answers to any questions you have about the treatment and you have understood the answers;
·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;
·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, family member, lawyer or an advocate, or one of the organisations described at the end of this statement.
If you agree to have the major non-psychiatric treatment, you will be asked to sign a form to say that you have given informed consent.
Withdrawing Consent
If you agree to have a major non-psychiatric treatment, but then change your mind, it is your right to withdraw your consent at any time and the treatment will not proceed. If you want to withdraw your consent, you should talk to your treating doctor.
Treatment if you are not able to give informed consent
If you are not able to give informed consent and a major non-psychiatric treatment is necessary, you may be given the treatment, even if you refuse.
If you are 18 years or older, consent may be given by the first person listed below who is available, willing and able to make a decision about the proposed treatment (if there is no one in the first category, go to the second and so on)—
·a medical enduring power of attorney (if you have appointed one);
·a person appointed by the Victorian Civil and Administrative Tribunal to make decisions about the proposed treatment (if someone has been appointed);
·a guardian (if you have one);
·an enduring guardian (if you have appointed one);
·the authorised psychiatrist.
If you are under the age of 18 years and you are not able to give informed consent, consent may be given by any of the persons listed below who is available, willing and able to make a decision about the proposed treatment—
·a parent;
·a guardian;
·a child protection manager appointed under section 271 of the Children and Young Persons Act 1989;
·the authorised psychiatrist—but only if there is no parent, guardian, custodian or child protection manager who is available, willing and able to make the decision.
Urgent Treatment
If any major non-psychiatric treatment is needed to save your life, to prevent serious damage to your health or to prevent you from suffering or continuing to suffer significant pain or distress, it can be given to you without your consent.
COMPLAINTS
You should be treated with dignity and respect and be protected from abuse when you receive treatment and care for your medical condition. 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 patient representative in the hospital, your doctor or psychiatrist or the Director of Psychiatry at the mental health service.
You can also complain directly to the Health Services Commissioner or 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.
·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.
·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, 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 Service 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 staff about other local organisations and support groups which may be able to help you.
__________________'.
═══════════════
ENDNOTES
[1] Reg. 3: S.R. No. 120/1998 as amended by S.R. Nos 45/2001, 111/2003 and 149/2004.
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