L11: Legislative Frameworks For Psychs Flashcards
To whom does the Act apply?
Patients who:
- are admitted to a MH facility voluntarily (informal patient)
- are admitted or detained against their wishes (called involuntary patients)
- are required to receive treatment in the community
- have committed a criminal of offence and are mentally ill: forensic or correctional patients
NSW Mental Health Act, 2007
- governs the care and treatment of ppl with a mental illness
Key principles - ppl are entitled to best care and treatment, least restrictive of their freedom, and least interference w their rights and dignity
- treatment is to ensure the proper protection of patients as well as te public
- the adverse affects of mental illness are minimized
Informal admission
- hosp of MH patients who agree to or ask for admission I.e voluntary
- called informal patients
- informed consent: permission for specific treatment, person must be deemed capable of giving informed consent
Formal (involuntary) admission categories
(against wishes)
- involuntary patient: gen on advice of MH practitioner - need certificate
- forensic patient: having committed an offence and being currently mentally I’ll
- community treatment order (CTO): separate card
Community Treatment Order
- legal order made by the MH Review Tribunal, magistrate or suitably qualified person in a hosp o community based service.
- valid for 12 months
- sets out terms under which person must accept medication, therapy, rehab etc
Generally order when
a) person is currently mentally ill
b) not mentally ill, but is judged likely to be mentally ill within 3 months
c) a CTO is judged to be the least restrictive alternative for treatment
Formal (involuntary) admission can only be carried out when the following criteria are met:
Mentally ill person:
- has a mental illness
- is at serious risk of harm to self and others including physical harm, reputation, rship, finances, self neglect
- has a continuing condition, incl any likely deterioration taken into account; and
- no other less restrictive care available
Mentally disordered person:
- displaying irrational behaviour
- significant risk of harm to self or others
- no other less restrictive care is available
Exclusions to formal (involuntary) admission criteria
Cannot be regarded as “Mentally ill” or “mentally disordered” for the purpose of the Act merely because of the presence or lack of:
- religious beliefs
- sexual preference/orientation
- sexual promiscuity
- immoral or illegal conduct
- has a developmental disability
- takes or has taken alcohol or any other drug
- engages in anti-social behaviour
Pathways that a person can be Formally (involuntarily) Admitted, under the provisions of the Mental health Act:
- ‘scheduling’ by Medical Practitioners: most common pathway. In country areas can be MH practitioners (need certificate)
- admission by Police or by Ambulance officers after apprehension. Forensic patients or at risk of self or other harm
- at request of a primary carer, relative or friend. Only in remote areas by written request to the medical superintendent of the hosp.
- by Order of the Court when a person appears before a magistrate and is judged mentally ill
- information of a welfare officer
- following an order by a magistrate for a medical examination
Once formally detained as a mentally ill or mentally disordered person, there is a standardized process that takes place, including:
- can be detained for up to 3 days,
- must be examined every 24 hrs by a doctor
- must be discharged when no longer mentally disordered
- can be detained for 3 x 3 day periods within a month
- interpreter provided where appropriate
One difference is that when a person is detained as ‘mentally disordered’ the process is handled internally by the hospital, whereas when a person is detained as ‘mentally ill’ an external review process applies because the consequences are more serious
Must be seen by a magistrate if you are being detained as a mentally ill person (not required if deemed mentally disordered)
- must be legally represented before the magistrate
- must be medicated at a minimum level until seen by the magistrate
- must appear before the magistrate in street clothes
- interpreter provided where appropriate
- must be discharged if no longer a mentally ill person
AHPRA PBA Mandatory reporting
- Psychology Board guidelines for mandatory notifications:
• S.39 of the Health Practitioner Regulation National Law Act 2009. Provides direction for registered health practitioners, employers of practitioners and education providers - aim is prevent the public being placed at risk of harm
- notify if they believe that another practitioner has behaved in a way which presents a serious risk to the public
- does not require a student to make a mandatory notification, but students should be familiar with guidelines
- threshold to notify is high, and should only be taken on sufficient grounds, guidelines make these clear
- notification made to AHPRA, who then refer to the appropriate board (I.e. Psychologists Board of Australia)
What is notifiable conduct?
S.140 of the National Law defines ‘notifiable conduct’ as where a practitioner has:
- practiced the practitioner’s profession while intoxicated by alcohol or drugs
- engaged in sexual misconduct in connection with the practice of the practitioner’s profession; or
- placed the public at risk of substantial harm in the practitioners practice of the prof because the practitioner has an impairment; or
- placed the public at risk of harm because the practitioner has practised the prof in a way that constitutes a sig departure from accepted prof standards
Privacy Act 1988.
Relevant info sheets
28 - data quality
25 - sharing health info to provide a health service (only for main reason it was collected)
24 - disclosure of health info of an incapacitated patient with fam, partners or others ‘responsible’ for patient: either to provide care or treatment, or for compassionate reasons. However, such disclosures may not go against a patient’s known wishes.
22 - charging a fee for access to client info (cannot be excessive)
21 - denial of access to health info
18 - making individuals aware info being collected about them
9 - research
6 - securing personal info
5 - access and use of intermediaries
4 - access and correction
Emergencies and disasters - Privacy act suspended
Definition of Mental Illness
A condition that seriously impairs, either temporarily or permanently, the mental functioning of a person and is characterized by the presence of any one or more of the following symptoms or signs:
- delusions
- hallucinations
- serious disorder of thought form
- severe disturbance of mood
- sustained or repeated irrational behaviour indicating that person is having a delusion or hallucinations
NB the focus on symptoms rather than on diagnosis. Conditions like dementia as anorexia are therefore not seen as falling within the Act’s definition of mental illness.
What happens after someone who has been formally (involuntarily) admitted arrives at hospital: (5)
- person must be given a form explaining their legal rights
- examination by a doctor within 12 hrs
- if neither mentally ill or disordered must be discharged
- if either mentally ill or disordered there must be a second examination
- is some cases 3rd examination required
