MH Legislation Flashcards
15 mental health care principles
1: dignity, equality, courtesy and compassion, no stigma or discrimination
2. protect and uphold the fundamental human rights
3. person-centred and recovery focus
4. easily accessible and safe care
5. choice and self-determination
6. recognise and be sensitive to diversity: individual circumstances e.g. culture, sexual orientation, etc
7. Aboriginal or Torres Strait Islander descent
8. must address physical, medical and dental health needs
9. recognise MH implications of relationships, jobs, etc
10. privacy and confidentiality
11. responsibilities and dependents
12. provision of information re: treatment
13. provision of information re: rights
14. collaborative care with family, carers, etc
15. accountability and improvement
Criteria for involuntary treatment
- The capacity of the patient to make decisions about their treatment.
- Give informed consent.
- A person who does not have the capacity to make decisions cannot give consent.
How does a person show capacity to make a decision?
- Understand information about treatment or explanations about alternative treatments, and warnings of any inherent risks
- Understand how the proposed treatment will impact them
- Understand the matters involved in the decision
- Understand the effect of the decision
- Weigh up factors regarding the information, the matters involved in the decision making process, and the effects of the decision, and
- Communicate their decision.
Do children have capacity?
- A person under the age of 18 (a child) is presumed not to have capacity to make decisions about themselves unless it is shown that the child does have capacity.
- If a child does not have the capacity to consent to treatment, a parent or guardian may be able to provide consent.
- In situations where the psychiatrist deems that the child meets the criteria for an involuntary treatment order, there is no requirement for informed consent from the child’s parent or guardian. However, the views of the parent or guardian must be considered at all times.
Involuntary Treatment Orders
- An inpatient treatment order is one kind of involuntary treatment order and can only be made by a psychiatrist.
- It allows a person to be detained and provided with treatment without consent. This may occur in an authorised hospital or, in certain circumstances, in a general hospital.
Criteria for involuntary treatment order
- The person has a mental illness requiring treatment
- The mental illness presents a significant risk to the health or safety of the person or another person, or a significant risk of serious harm to the person or another person
- The person does not demonstrate the capacity to make a decision about the provision of treatment to themselves
- Treatment in the community cannot reasonably be provided to the person, and
- There is no alternative that would be less restrictive to the person’s freedom of choice and movement
Community Treatment Order
- A community treatment order (CTO) allows a person to be provided with treatment without consent, without being detained in a hospital.
- A community treatment order can only be made by a psychiatrist
Criteria for Community Treatment Orders
- The person has a mental illness requiring treatment
- The mental illness presents a significant risk to the health or safety of the person or another person, or a significant risk of serious harm to the person or another person, or a significant risk of the person suffering serious physical or mental deterioration
- The person does not demonstrate the capacity to make a treatment decision about provision of treatment to themselves
- Treatment in the community can reasonably be provided to the person, and
- There is no alternative that would be less restrictive to the person’s freedom of choice and movement.
Rights under the Mental Health Act
- provision of information: particularly about their rights.
- physical examination.
- request access to their own records
- personal possessions (although there may be restrictions to this).
- interviewed by the psychiatrist
- freedom of communications
- treatment, support and discharge plans
- confidentiality
- further opinion
- review from the Mental Health Tribunal
- not to be ill-treated and the duty of staff to report certain incidents
- make a complaint
Carer & Family Rights
- The 2014 MHA also gives rights to families and carers which include
- Access to treatment information about patient and family/carer rights
- Being notified of significant events such as a transfer, discharge or change in legal status.
Mental Health Advocacy Service
- The role of the advocacy service is to help people to uphold their rights
- They may also represent and assist people at Mental Health Tribunals
- Offer legal representation and advice
- Seek to resolve complaints.
Mental Health Tribunal
Any person who is treated involuntarily under the act can request a review by the tribunal which comprises of:
- A lawyer
- A psychiatrist
- A community member
-The tribunal can review the status of the patient, treatment, specific restrictions to the person’s freedom and invasive treatment such as ECT and Psychosurgery
MH Forms
- When a patient is treated under the mental health act, a legal document must be completed. These are termed “forms”
- A full list of these are provided in this week’s resource section on LMS.
- Authorized Mental Health Practitioners including mental health nurse with + 3yrs experience have specific powers and obligations under the act. Significantly in relation to referral (Form 1A, Seclusion and restraint)
Rights of a voluntary patient
Voluntary patients have the same rights as patients admitted in a general hospital
- Refuse treatment
- Right to be discharged
- Right to vote
- Make a complaint
- Use personal possession in the hospital
- Contact people by letter, phone and to be visited
Authorised hospitals
A hospital or apart of the hospital authorised by the governor of Western Australia to receive and admit patients under the Mental Health Act
Authorised hospitals in Western Australia
Fiona Stanley Hospital, Graylands, Alma street-Fremantle hospital, Mill street – Bentley Health Services, Mimidi Park, Rockingham General Hospital, Midland, Armadale Mental Health Services, Joondalup Health Care Services, D 20 at Sir Charles Gardner Hospital
Unauthorised hospitals in Western Australia
Perth Clinic, The Hollywood Clinic, , 2K at Royal Perth Hospital.
