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Mental Health Review Tribunal

Mental Health Review Tribunal. ANZAPPL Seminar 16 August 2010 John Feneley Deputy President MHRT. The Mental Health Review Tribunal. Mental Health Act 2007 The Mental Health (Forensic Provisions) Act 1990 The NSW Trustee and Guardian Act 2009

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Mental Health Review Tribunal

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  1. Mental Health Review Tribunal ANZAPPL Seminar 16 August 2010 John Feneley Deputy President MHRT

  2. The Mental Health Review Tribunal Mental Health Act 2007 The Mental Health (Forensic Provisions) Act 1990 The NSW Trustee and Guardian Act 2009 • Review of voluntary and involuntary patients and the approval of some surgical procedures and ECT • Approval of involuntary treatment in the community via CTOs • Review of Forensic and Correctional patients • Financial Management Orders

  3. Organisational Structure

  4. Where are we? • The Tribunal is based at Gladesville where hearings can be conducted • The Tribunal panels are also mobile, and travel to psychiatric units and community health care agencies throughout Sydney, Illawarra, Newcastle, Central Coast, Goulburn and Orange • Hearings can be done live or by video conference or telephone (45% live, 40% by AVL and 15% by phone) • Mental health inquiries by AVL

  5. The Tribunal Panel • Three member panels made up of a lawyer, psychiatrist and suitably qualified other member • Mental Health Inquires chaired by single legal member with the option to refer to a full Tribunal panel • Forensic hearings must be presided over by a presidential member of the Tribunal • 110 part-time members

  6. Case Load of the Tribunal 2009-10 • Civil hearings 8 084 • FMO hearings 193 • Forensic hearings 824 9 101 4% (349) more hearings than 2008-09 • Total Civil Hearings 2008-09 8 752 • Total Civil Hearings 2007-08 9 517

  7. Total Number Of Hearings 1991 – 2009/10

  8. Reviews in the civil jurisdiction Mental Health Inquiry 43 Involuntary Patient Reviews 2 572 Appeal against refusal to discharge 255 Applications for CTOs 4 196 Variation and Revocation of CTOs 186 Review of patient on breach of CTO 10 Appeal against Magistrate’s CTO 8 Review of Voluntary Patients 60 Application for Surgery 27 Application for Special Medical Treatment 2 Review of Voluntary patients consent for ECT 9 Application to administer ECT to Involuntary patient 716

  9. Legislative Reform • Mental Health Act 2007 replaced MHA 1990 • Mental Health (Forensic Provisions) Act 1990 • NSW Trustee and Guardian Act replaced the Protected Estates Act 1990 • The Courts and Crimes Legislation Act Further Amendment Act 2008 (no 107) amended the Mental Health Act 2007 to provide for the Tribunal to conduct mental health inquiries. • The provisions are in almost in identical terms as they applied to magistrates and set out in sections 34, 35 and 36

  10. Civil Jurisdiction • The Tribunal has now taken over initial reviews of detained patients previously conducted by magistrates. This will lead to a significant increase in civil hearings in 2010/2011. • The Tribunal now has primary responsibility for determining whether a mentally ill person should receive or continue to receive involuntary care and treatment in NSW, whether in hospital or in the community.

  11. Forensic Jurisdiction • Tribunal has replaced Minister/Governor as determinative authority • Increased transparency (considerations and appeal mechanisms) • Recognised role and interest of victims • Recognised the different security needs forensic patients vs inmates who experience mental illness • Recognised the treatment needs of those suffering from a mental illness whilst detained in a correctional centre • Increased scrutiny and accountability

  12. Review Hearings • The role of the Tribunal is to make decisions according to the legal requirements in the Acts • Must ensure that the principles for the care and treatment of the mentally ill are adhered to

  13. Principles for Care and Treatment • S 68 ‘mentally ill’ and ‘mentally disordered persons are to receive: • The best possible care and treatment in the least restrictive environment, • Provided with timely and high quality treatment and care in accordance with professionally accepted standards, • Provision of care and treatment should be designed, wherever possible, to allow mentally ill/disordered to live, work and participate in the community, • Prescription of medicine should meet the health needs of the person and should be given only for therapeutic or diagnostic needs and not as a punishment or for the convenience of others,

  14. Principles of Care and Treatment Cont’d (e) Should be provided with appropriate information about treatment, treatment alternatives and the effects of treatment, (f) Any restriction on the liberty of patients and other people and any interference with their rights, dignity and self respect to be kept to the minimum in the circumstances, (g) The age-related, gender-related, religious, cultural, language and other special needs should be recognised, (h) Every effort should be made to involve patient/person in the development of treatment plans and plans for ongoing care

  15. How do the objects of the Act impact on the Tribunal? • Tribunal needs to: • Explore the nature and quality of care being provided with treating teams • Seek least restrictive care consistent with safe and effective treatment • Be mindful of the impact of the therapeutic relationship of the team/patient • Constantly balance the rights of an individual patient re providing care/ protecting rights with community interests

  16. MHRT Resources • Hearing Kit and forms (on website) • Information pamphlets for clients on types of orders • Treatment Plan template and guidelines • Flow charts (contained in hearing kit)

  17. Helpful Contact Numbers • Centre for Mental Health & Drug and Alcohol • 9391 9307 • Mental Health Advocacy Service (legal aid) • 9745 4277 • Guardianship Tribunal • 9555 8500 NSW Public Trustee and Guardian • 9252 0523

  18. MHRT How to contact us: 9816 5955 or 1800 815 511 www.mhrt.nsw.gov.au Email: mhrt@doh.health.nsw.gov.au

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