Victorian Consolidated Regulations

2 Reg. 3(2)(b): S.R. No. 45/2001. - SCHEDULE 7

STATEMENT OF LEGAL RIGHTS AND ENTITLEMENTS AND OTHER INFORMATION-INVOLUNTARY
PATIENT Mental Health Act 1986 Section 18 Mental Health Regulations 2008
Regulation 9(a) Schedule 7 IN SUMMARY When you are on an involuntary treatment
order or a 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; ·
have rights under the Charter of Human Rights and Responsibilities. 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, or contact one of
the organisations described at the end of this statement. ABOUT THIS STATEMENT
This statement provides information about being on an involuntary treatment
order or a 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 1986 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. Charter of Human Rights and
Responsibilities The Victorian Charter of Human Rights and Responsibilities
Act 2006 seeks to promote and protect certain human rights. The Charter
defines the protected rights and requires public mental health services to act
compatibly with these rights. The Charter also specifies when and how rights
can be limited by law. For example, under the Mental Health Act 1986 you may
be detained in a mental health service if it is necessary to protect your
health or safety or the safety of others. However, any restrictions on your
liberty and any interference with your rights, privacy, dignity and
self-respect must be kept to the minimum necessary in the circumstances. If
you have any questions about the Charter or how it might affect your
treatment, contact one of the organisations described at the end of this
statement. INVOLUNTARY TREATMENT ORDERS Involuntary treatment orders are
orders under the Mental Health Act 1986 that require people with a mental
illness to receive treatment for their illness. A doctor has recommended that
you be placed on an involuntary treatment order so you can receive treatment
for a mental illness. In the doctor's opinion all of the following criteria
for involuntary treatment in the Mental Health Act 1986 apply to you- · you
appear to be mentally ill (mental illness is defined in the Act as a medical
condition that is characterised by a significant disturbance of thought, mood,
perception or memory); and · your mental illness requires immediate treatment
and that treatment can be obtained by placing you on an 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; and · you have either refused or are unable to consent
to necessary treatment; and · there is no less restrictive way for you to
receive adequate treatment for your mental illness.

Initial review of involuntary treatment orders Within 24 hours of being placed
on the order, a psychiatrist from the mental health service will examine you
to decide if all of these criteria apply to you. If they do, the psychiatrist
will confirm the order and you will remain an involuntary patient under the
Mental Health Act 1986. The psychiatrist will then either admit you to the
mental health service or make a community treatment order for you. If
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 community treatment order for you, read the section on
community treatment orders. If the psychiatrist does not believe all of the
criteria for involuntary treatment apply to you, the involuntary treatment
order will be discharged. You can discuss continuing treatment on a voluntary
basis with your case manager or psychiatrist. If you have been an inpatient
and both you and the psychiatrist think you would benefit from further
treatment at the mental health service, you can ask to stay on a voluntary
basis. If you have any questions about the review by the psychiatrist, such as
when the psychiatrist will come to see you, ask a member of the treating team.
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
your psychiatrist will consider your preferences and concerns. The
psychiatrist will also take into account the wishes of any guardian, family
member or primary carer who is involved in providing ongoing care to you
(unless you object), any beneficial alternative treatments and any significant
risks of the treatment. 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 Opinion 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 and privacy laws to apply for
access to documents about your personal information that the mental health
service holds. If you wish to access the information, you can ask a member of
the treating team or the mental health service's freedom of information
officer to help you make an application. Organisations that may be able to
help you with a freedom of information application are described at the end of
this statement. INPATIENT TREATMENT This section of the statement has
information about your rights and entitlements if you are admitted to a mental
health service on an 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 himself or herself or others or to prevent the person from
persistently destroying 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 registered 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 at the appropriate times. You can ask staff
for 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.

Community treatment orders If your psychiatrist believes that you can live in
the community while you receive the treatment you need, you may be placed on a
community treatment order. To find out more about these orders, read the
section in this statement on community treatment orders and ask a member of
the treating team to explain them. Discharge from involuntary patient status
If your psychiatrist believes that any of the criteria for involuntary
treatment no longer apply to you, you must be discharged as an involuntary
patient 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 stay in the service on a voluntary basis. If at
any time you want to be discharged from being an involuntary patient, 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 the order within 8 weeks of you becoming an
involuntary patient and then at least every 12 months if you continue as an
involuntary patient. Your psychiatrist will also regularly review you to see
if you should be discharged. COMMUNITY TREATMENT ORDERS This section of the
statement contains information about your rights and entitlements if you are
placed on a community treatment order. A community treatment order (CTO) is an
order under the Mental Health Act 1986 that enables an involuntary patient to
live in the community while he or she receives treatment for his or her mental
illness. If your psychiatrist believes you can obtain the treatment you need
while you live in the community, you will be placed on a CTO. You will still
be an involuntary patient on an involuntary treatment order, even though you
are living in the community on a CTO. Planning for a community treatment order
Your psychiatrist will talk to you about the CTO and prepare a new treatment
plan. You can be involved in planning your order and 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. Your
preferences will be taken into consideration. For example, you may have a
particular doctor that you wish to supervise the order.

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 the authorised
psychiatrist thinks is appropriate. Conditions of the community treatment
order You will be given a copy of the CTO. It will say how long the order will
last, which can be for up to 12 months. The CTO sometimes states where you
must live if this is necessary for the treatment of your illness. Your
psychiatrist may vary these conditions from time to time and will 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. Your psychiatrist can extend the CTO if the criteria for
involuntary treatment still apply to you and the treatment you need can
continue to be obtained through the order. If your CTO is extended, the Mental
Health Review Board will review the extension. If your psychiatrist does not
extend your CTO, it will expire and you will no longer be an involuntary
patient. Revoking the community treatment order If you do not comply with your
order or your treatment plan, members of the treating team will try to help
you to comply. However, if you still do not comply and there is a significant
risk that your health will get worse because of your non-compliance, your
psychiatrist may revoke the CTO and you must return to the mental health
service for treatment. Your CTO may also be revoked if your psychiatrist
believes that your illness would be better treated in a mental health service.
If your CTO is revoked, reasonable efforts will be made to tell you and you
must then go to the mental health service.

Discharging the community treatment order If your psychiatrist believes that
any of the criteria for involuntary treatment no longer apply to you, you must
be discharged from the CTO and from being an involuntary patient. 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 CTO, 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 the order within 8 weeks of you becoming an
involuntary patient and then at least every 12 months if you continue as an
involuntary 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 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 involuntary patients on involuntary
treatment orders or community treatment orders who want to be discharged from
the order; · reviews all involuntary patients within 8 weeks of being placed
on an involuntary treatment order to decide if they can be discharged from the
order; · reviews all involuntary 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; · reviews the extension of
all community treatment orders. 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 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 the need for 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 can 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 about 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 are held either
at hospitals or community mental health services. Your hearing will usually be
heard by 3 Board members-a lawyer, a psychiatrist and a community member. If
the hearing is the annual review of your involuntary treatment order or the
review of the extension of your community 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 an
involuntary treatment order. 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 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 of involuntary status The Board
must decide whether all the criteria for involuntary treatment still apply to
you. Discharge from involuntary status If any one of the criteria for
involuntary treatment does not apply, you will be discharged from the order
and from being an involuntary patient. If you were on a 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 stay on a
voluntary basis. Continuation of involuntary status If the Board decides that
all of the criteria for involuntary treatment 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 community treatment order (CTO), it may order your psychiatrist to
place you on a CTO. If you are on a CTO, the Board can vary the conditions of
the order. If the Board revokes your CTO, 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 mental health service can
implement the plan. At the end of the hearing, the Board will tell you its
decision and the reasons for it. You will be given a written copy of the
decision. 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.
Applications 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] Organisations that may be able
to help you with an application are described at the end of this statement.
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
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 mental health 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.
[insert appropriate contact details]

· 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, investigate complaints and report on their
inquiries and investigations.
[insert appropriate contact details]

· The Mental Health Legal Centre is an independent legal service that
specialises in mental health legal issues. It might be able to arrange
representation for you at Mental Health Review Board hearings or give advice
about other legal matters.
[insert appropriate contact details]

· 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
may be able to assist with legal representation at Mental Health Review Board
hearings.
[insert appropriate contact details]

· The Public Advocate assists, advises and advocates for people with serious
complaints about mental health and disability services and treatment.
[insert appropriate contact details]

· The Victorian Equal Opportunity and Human Rights Commission helps people to
resolve complaints about discrimination, has specific functions in relation to
the Charter of Human Rights and Responsibilities and can give advice about the
Charter. Services include an enquiry line and a confidential, free and
impartial complaint resolution service.
[insert appropriate contact details]

· The chief psychiatrist is a senior Department of Human Services official
appointed under the Mental Health Act 1986, 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.
[insert appropriate contact details]

· The Health Services 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.
[insert appropriate contact details]

· The Ombudsman investigates complaints about government departments.
[insert appropriate contact details]

You can also ask your case manager or any member of the treating team about
other local organisations and support groups that may be able to help you.
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