Victorian Numbered Regulations Victorian Numbered Regulationsr. 5
For Schedule 8 to the Principal Regulations substitute —
'SCHEDULE 8
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—RESTRICTED INVOLUNTARY TREATMENT ORDERS
Mental Health Regulations 1998
IN SUMMARY
When you are on a Restricted Involuntary Treatment Order or Restricted Community 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 a Restricted Involuntary Treatment Order or Restricted Community Treatment Order 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 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.
RESTRICTED INVOLUNTARY TREATMENT ORDERS
Restricted Involuntary 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 (other than a serious offence), the court may make a Restricted Involuntary Treatment Order instead of giving the person a sentence. The person is then taken to a mental health service and must be 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 Restricted Involuntary Treatment 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 placed on a Restricted Involuntary Treatment Order apply to you—
• you appear to be mentally ill; and
• your mental illness needs treatment which can be obtained through a Restricted Involuntary Treatment Order; and
• 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.
The court will set a term for your Restricted Involuntary Treatment Order, which must not exceed two years.
Once you are taken to a mental health service, a psychiatrist will either admit you to the service as an inpatient or make a Restricted Community Treatment Order. 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 Restricted Community Treatment Order for you, read the section on Restricted Community Treatment Orders.
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 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.
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 Restricted 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.
Restricted Community Treatment Orders
If your psychiatrist or 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. 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 the Restricted Involuntary Treatment Order
If the chief psychiatrist is satisfied that any of the criteria for a Restricted Involuntary Treatment Order no longer apply to you, you must be discharged from the order 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 the Restricted Involuntary Treatment 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 initially review you within 8 weeks of your being placed on a Restricted Involuntary Treatment Order and then review you at least every 12 months if you continue on the order. Your psychiatrist will also regularly review you to see if you should be discharged.
RESTRICTED COMMUNITY TREATMENT ORDERS
This section of the statement contains information about your rights and entitlements if you are placed on a Restricted Community Treatment Order.
Restricted Community Treatment Orders are orders under the Mental Health Act that enable people on Restricted Involuntary Treatment Orders to live in the community while they receive treatment for their mental illness.
If your psychiatrist or the chief psychiatrist believes you can obtain the treatment you need while you live in the community, you will be placed on a Restricted Community Treatment Order.
You will still be on a Restricted Involuntary Treatment Order, even though you are living in the community on a Restricted Community Treatment Order.
Planning for a Restricted Community Treatment Order
Your psychiatrist or the chief psychiatrist will talk to you about the Restricted Community Treatment Order and the reasons for it. You can be involved in planning the order and your preferences will be taken into consideration. For example, you may have a particular doctor who you wish to supervise the order. Your psychiatrist or the chief psychiatrist will tell you when the order has been made. If your psychiatrist makes the Restricted Community Treatment Order, the psychiatrist must also tell the chief psychiatrist.
Treatment plan
Your psychiatrist will prepare a new 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.
You can be involved in planning your treatment and the psychiatrist will consider your preferences and concerns. Your psychiatrist or another member of the treating team 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 your psychiatrist thinks is appropriate.
Conditions of the Restricted Community Treatment Order
You will be given a copy of the Restricted Community Treatment Order. The order will last until it is either revoked or discharged, or until your Restricted Involuntary Treatment Order is discharged or expires. The Restricted Community Treatment Order sometimes states where you must live. The order may also specify any conditions that your psychiatrist or the chief psychiatrist considers appropriate.
Your psychiatrist or the chief psychiatrist may vary these conditions from time to time, and must 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.
Revoking the Restricted Community Treatment Order
If you do not comply with your Restricted Community Treatment Order or your treatment plan, members of the treating team will try and help you to comply. However, if there is a significant risk that your health will get worse because of your non-compliance, your psychiatrist or the chief psychiatrist may revoke the Restricted Community Treatment Order. Your Restricted Community Treatment Order may also be revoked if your psychiatrist or the chief psychiatrist believes that your illness would be better treated in a mental health service.
If your Restricted Community Treatment Order is revoked, reasonable efforts will be made to tell you and you must then go to the mental health service.
Discharging the Restricted Community Treatment Order
If the chief psychiatrist believes that any of the criteria for being on a Restricted Involuntary Treatment Order no longer apply to you, you must be discharged from the Restricted Community Treatment Order and from the Restricted Involuntary Treatment Order.
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 Restricted Community Treatment 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 initially review you within 8 weeks of being placed on a Restricted Involuntary Treatment Order and then at least every 12 months if you continue on the order. The Board will also review your Restricted Community Treatment Order if you have been on it for 12 months. 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 patients on Restricted Involuntary Treatment Orders who want to be discharged from the order;
• reviews all patients on Restricted Involuntary Treatment Orders within 8 weeks of being placed on the order to decide if they can be discharged;
• reviews all patients on Restricted Involuntary Treatment Orders at least every 12 months to decide if they can be discharged;
• reviews patients who have been on a Restricted Community Treatment Order for 12 months; and
• 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.
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 an appeal 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 any 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 three Board members—a lawyer, a psychiatrist and a community member. If the hearing is the annual review of you being on a Restricted Involuntary 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 a Restricted Involuntary Treatment Order.
The Board will primarily consider your current mental condition and will also consider your medical, psychiatric and forensic history and your social circumstances, when making its decision.
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 a Restricted Involuntary Treatment Order still apply to you.
Discharge from involuntary status
If any of the criteria for a Restricted Involuntary Treatment Order do not apply to you, you will be discharged from the order. If you were on a Restricted Community Treatment Order, you will also be discharged from that 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 the criteria for being on a Restricted Involuntary Treatment Order 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 Restricted Community Treatment Order, it may order your psychiatrist to place you on a Restricted Community Treatment Order. If you are on a Restricted Community Treatment Order, the Board can vary the conditions of the Restricted Community Treatment Order. If the Board revokes your Restricted Community Treatment Order, you must return to 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 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 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, patients on Restricted Involuntary Treatment Orders 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, to investigate complaints and to report on their inquiries and investigations.
• The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It might 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 might 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.
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