INPATIENT TREATMENT ORDERS OFFICE OF THE PUBLIC ADVOC (Mental Health Act 2009) WHAT IS AN INPATIENT ITREATMENT ORDER? An inpatient treatment order authorises the holding of a person in a treatment centre so that psychiatric treatment can be given. People who are subject to inpatient treatment orders are required to stay in the centre and receive treatment for a mental illness, even if they don’t want to. People who are subject to an inpatient treatment order can also be required to receive treatment for any other illness. WHEN CAN A PERSON BE DETAINED? The Mental Health Act 2009 (the Act) allows for individuals to receive involuntary inpatient treatment when:(a) the person has a mental illness; and (b) because of the mental illness, the person requires treatment for the person's own protection from harm (including harm involved in the continuation or deterioration of the person's condition) or for the protection of others from harm; and (c) there is no less restrictive means than an inpatient treatment order of ensuring appropriate treatment of the person's illness. In deciding whether there is no less restrictive means of treatment the Act states: consideration must be given, amongst other things, to the prospects of the person receiving all treatment of the illness necessary for the protection of the person and others on a voluntary basis or on a community treatment order. HOW DOES THE INVOLUNTARY INPATIENT PROCESS OPERATE? There are three levels of inpatient treatment orders: Level 1: maximum 7 days This order can be made initially by a psychiatrist, authorised medical practitioner (medical practitioners with advanced mental health training), medical practitioner or authorised health professional (nurse, social worker, psychologist or occupational therapist with special mental health training). This order must be reviewed within 24 hours by a psychiatrist or authorised medical practitioner (not being the one who made the initial order) who can confirm or revoke the order at that time or at any time during the level 1 period. If this cannot be done in the first 24 hours, then the review must occur as soon as possible. Level 2: maximum 42 days This order can be made by a psychiatrist or authorised medical practitioner before the expiry of a level 1 order. It can be varied or revoked by a psychiatrist or authorised medical practitioner at any time during the order. Level 3: maximum 12 months (6 months for a child) This order can only be made by the Guardianship Board upon application from the Director of an approved treatment centre (or his/ her nominee) for a person on a 12 current level 2 or level 3 order. The Public Advocate can also apply for these orders. The Board must review orders pertaining to children 3 months after the order was made. The Board can on application vary or revoke an order while the order is in force. WHAT STEPS ARE REQUIRED WHEN SOMEONE IS ON AN INPATIENT TREATMENT ORDER? The following categories of people have particular authority under the Act to transport persons who are believed to have a mental illness or are the subject of certain orders. • mental health clinician, • ambulance officer, • medical officer or a flight nurse from the Royal Flying Doctor Service; • member of the police force. The person who is the subject of an inpatient treatment order must receive a statement of rights and a copy of the order, or variation or revocation of order. Assistance should be provided for those who have difficulty understanding the information provided including interpreter assistance. When a psychiatrist or an authorised medical practitioner makes, revokes or varies an order, a guardian, medical agent, relative, carer or friend of that person should also receive this information unless their whereabouts cannot be located or it is considered not to be in the person’s best interests to release this information. Treatment and Care Plans should be developed for all people on L2 and L3 orders in collaboration with the person and their significant others. A person who is subject to an inpatient treatment order can request the involvement of a guardian, medical agent, relative, carer or friend or advocate in significant meetings with treatment centre staff. CAN ORDERS BE APPEALED? All decisions to make level 1 and level 2 inpatient treatment orders can be appealed by application to the Guardianship Board. Level 3 inpatient treatment orders made by the Guardianship Board can be appealed to the Administrative and Disciplinary Division of the District Court. Appeals can be made by the patient, the Public Advocate, a guardian, medical agent, relative, carer or friend of the person to whom the order applies, treatment centre staff or anyone who has a proper interest (ie genuine interest in the person’s welfare). A legal representation scheme is provided free of charge to all persons who are subject to an order under appeal. The Office of the Public Advocate maintains a list of solicitors who will undertake this work at the scheduled fee, and this list is used by the Guardianship Board and the District Court. Other parties to an appeal will need to make their own arrangements for legal representation. The Guardianship Board has additional responsibilities for reviewing the circumstances surrounding the making of inpatient treatment orders. The Board can also be requested to review its orders at any time. Office of the Public Advocate (OPA) An independent statutory office accountable to the South Australian Parliament September 2013 Level 7, ABC Building 85 North East Road, Collinswood SA 5081 Tel (08) 8342 8200 Toll Free 1800 066 969 Fax (08) 8342 8250 Email [email protected] Web www.opa.sa.gov.au