Victorian Numbered Regulations Victorian Numbered Regulationsr. 6
For Schedule 9 to the Principal Regulations substitute —
"SCHEDULE 9
STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION—SECURITY PATIENT
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 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
• your mental illness needs immediate treatment which can be obtained through a Restricted Hospital Transfer Order; and
• because of your mental illness, you need to be detained and treated in the mental health service 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 detained and treated 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
• your mental illness needs treatment which can be obtained through a Hospital Security Order; and
• because of your mental illness, you need to be detained and treated in the mental health service 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 detained 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 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 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, or 7 days in the case of medical treatment. 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.
Security Conditions
While you are in the mental health service, you are in the custody of your psychiatrist who may apply any security conditions that are considered necessary, for example limiting your phone calls or opening your mail. Security conditions are applied to ensure your health or safety, or for the protection of members of the public.
Letters and telephone calls
You can contact people by letter or telephone, unless your psychiatrist has applied a security condition to you.
Transfer
You may be transferred to a different mental health service if the chief psychiatrist believes that you would benefit from the transfer or if it is necessary for your treatment. If you do not want to be transferred, you should talk to your psychiatrist or you can appeal to the Mental Health Review Board. If you are transferred before the appeal is heard, the Board will decide whether you should be returned to the original service when it hears the appeal.
Discharge from security patient status
You can be held in the mental health service as a security patient only as long as you would have been held at your original place of detention. You will no longer be a security patient if the term of your sentence ends, you are released from custody by a court, you are granted bail, or your Hospital Security Order ends. You can discuss continuing treatment with your case coordinator or psychiatrist.
If the chief psychiatrist is satisfied that any of the criteria for being a security patient no longer apply to you and your continued detention as a security patient is no longer necessary, you may be discharged and returned to your original place of detention. If you are on a Hospital Security Order you will be sent to prison to serve the rest of your sentence, or if you were granted parole while in the mental health service, you will be released into the community.
If at any time you want to be discharged from the mental health service, 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 admission and then at least every 12 months if you continue as a security 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 has 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 security patients who want to be discharged;
• reviews all security patients within 8 weeks of their admission to decide if they can be discharged;
• reviews all security 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;
• hears appeals from security patients who have been refused special leave by the chief psychiatrist.
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 coordinator 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 which 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 will be held at the mental health service. 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 your being a security 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 security patient.
The Board will primarily consider your current mental condition and will also consider your medical and psychiatric history, and your social circumstances when making its decision.
If you are too ill to attend the hearing, the Board may visit you in your ward.
The Board's Decision on Appeal or Review of Security Patient Status
The Board must decide whether all the criteria for being a security patient still apply to you and whether your continued detention as a security patient is still necessary.
Discharge from security patient status
If the Board is satisfied that any of the criteria for being a security patient no longer apply to you and your continued detention as a security patient is not necessary, you will be discharged and—
• if you are on a restricted hospital transfer order, you will be returned to your original place of detention; or
• if you are on a hospital security order you will be sent to prison to serve the rest of your sentence, or if you were granted parole while in the mental health service, you will be released into the community.
If you are discharged, you can discuss continuing treatment on a voluntary basis with your case coordinator or psychiatrist.
Continuation of security patient status
If the Board doesn't discharge you, you will continue to receive treatment as a security patient.
The Board will also review your treatment plan to decide whether the proper procedures have been followed in making the plan, for example, were your wishes taken into account and did the psychiatrist consider alternative treatments? The Board must be satisfied that the plan can be implemented by the mental health service.
At the end of the hearing, the Board will 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 coordinator, 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 coordinator 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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