Transcript The Mental Health Bill 2014

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Assessment & treatment
Least restrictions on rights and dignity
Support persons to make/participate in decisions
Provide oversight & safeguard
Role of carers & support persons
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Presumption of capacity to make treatment decisions regardless
of age or legal status
Understand the information given, able to remember, use or weigh
information & communicate the decision
Person gives informed consent if they: have the capacity, given
adequate information, given the opportunity to make decision,
consent freely & has not withdrawn consent
What if a patient does not have capacity or does not give informed
consent to a course of treatment?
• Authorised Psychiatrist can make a treatment decision (except
ECT/neurosurgery)
• Must be no less restrictive way for patient to be treated
• In determining the treatment, authorised Psychiatrist must consider:
- Patients views and preferences including in an advance statement
- Views of nominated person, guardian, carer, parent of patient < 16
years
- Likely consequences for the patient if treatment is not performed
- Any second Psychiatric opinion given to authorised Psychiatrist
Supported decision making:
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Second Psychiatric Opinion- Intended to promote selfdetermination and possible alternative treatments. Treating
authorised Psychiatrist to consider the second opinion
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Advance statements- Gives person greater control over preferences.
Clinicians aswell as carers, guardians &/or nominated person
understand treatment preferences. Advance statement is effective
from the time it is made until it is revoked. Regardless of legal status
anyone can make an advance statement so long as they understand
what it is & the consequences of making one.
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Nominated person- Supports the patient, receives information
about the care & is consulted about the patient’s treatment at all
stages. Exercise rights. Is NOT able to make treatment decisions on
behalf of the patient. Regardless of legal status anyone can
nominate a nominated person so long as they understand what it is
& the consequences of making one.
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Advocates- Government will fund advocacy support services for
people receiving public mental health services. Assist people to
understand & exercise their rights, may also make representations
on behalf of people receiving mental health services
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Seeks to minimise the use and duration of compulsory
treatment provided in the least restrictive manner possible
Establishes compulsory treatment orders comprising:
Assessment Orders (s. 28)
Temporary Treatment orders (s. 45)
Treatment orders (s. 52)
Criteria for Assessment order (registered medical practitioner or mental health
practitioner) :
a) The person appears to have a mental illness; and
b) Because the person appears to have a mental illness, they appear to need
immediate treatment to prevent(i) serious deterioration in the person’s mental or physical health; or
(ii) serious harm to the person or to another person; & requires
immediate treatment to prevent deterioration or serious harm to self or
others; and
c) If the person is made subject to an Assessment Order they can be assessed; and
d) There is no less restrictive means reasonably available to enable the person to
be assessed.
Community (Max 24 hours) Inpatient (Max 72 hrs for transport, max 24 hrs when
person received at hospital, AP can extend < 72 hours)
Temporary Treatment Order (Authorised Psychiatrist has
determined person has a mental illness):
• Community or Inpatient- duration of 28 days unless revoked
earlier.
• Must take into the persons views/preferences, advance
statements, views of nominated person, guardian/carer,
parent (< 16). Notify nominated person/carer/parent
• MHT must occur if order not revoked before 28 days
Treatment Order (made by the Mental Health Tribunal):
• After the hearing, MHT must:
a) Make a Treatment Order in respect of a person if the
treatment criteria apply to the person;
- The duration of the order; and
- Whether order is Community or Inpatient
b) Revoke the Order if the Tribunal is not satisfied that the
treatment criteria apply
Treatment Order duration:
• Community (Max 12 months; Max 3 months person <18 years)
• Inpatient (Max 6 months; Max 3 months person < 18 years)
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Setting (inpatient or community) may be varied by authorised
Psychiatrist. End of the Treatment Order, Psychiatrist may make
an application to the MHT for further Treatment Order.
The Mental Health Tribunal will make treatment orders
• Will consider factors including patient’s recovery goals and
treatment preferences, views of nominated person, carer,
guardian or parent of young person & any second Psychiatric
opinion
ECT Patient has given informed consent; or with the approval of
the MHT. If under 18, irrespective of capacity to give informed
consent must be approved by the MHT (voluntary or
compulsory)
• A course of ECT will not exceed 12 within 6 month period
Restrictive Interventions will be subject to improved safety and
accountability:
• Includes bodily restraint (mechanical & physical) and seclusion
• Notification to patients nominated person, guardian, carer, parent if
under 18.
Statement of rights to be provided to patients, nominated person,
carer & parent if patient is < 16 years old. Includes;
- To make or participate in decisions about their treatment
- Right to have an advanced statement & nominated person
- To be legally represented and supported by a support person
- To apply to the MHT
- To discuss their treatment and care with the community visitors
Mental Health Complaints Commissioner (Lynn Barr)
• Will accept, assess, manage, investigate & endeavour to resolve
complaints
• Assist mental health services to develop/improve policies &
procedures to resolve complaints
Chief Psychiatrist will provide clinical leadership, support & advice
to public mental health service providers informed by:
• Clinical audits & reviews
• Reportable deaths
• Develop guidelines, policies and practice directions
Community visitors
• Will continue visiting, providing support & monitor services
• Assist in the resolution of issues, seek support from other bodies
& make complaints to the Commissioner
Disclosure of health information (privacy/carers rights & needs)
• Consent or treatment purposes
• Information disclosed to carers where a decision will directly
affect the carer
• Information must be disclosed to nominated persons, guardians &
parents if patient < 16 years
Mental Health Act Reform webpage:
www.health.vic.gov.au/mentalhealth/mhactreform
• Enquiry phone line: 1300 656 692 and/or
Email: [email protected]
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