Children and minors

Chief Psychiatrist policy

This page includes information about the following Chief Psychiatrist policy.

This policy is mandatory for all authorised mental health services (AMHSs). An authorised doctor, authorised mental health practitioner, AMHS administrator, or other person performing a function or exercising a power under the Mental Health Act 2016 must comply with this policy.

You can also find additional fact sheets, forms, clinical notes and resources that are available for this policy under the relevant subtopics on this page.

Introduction

For the purpose of the Mental Health Act 2016, a minor means a person who is under the age of 18 years.

In most instances the same provisions apply for minors as for adults in relation to involuntary assessment, treatment and protection of persons.

However, there are a number of provisions in the Mental Health Act 2016 which relate specifically to minors which aim to promote the best interests of the minor receiving treatment.

Additionally, there are strict legislative requirements regarding:

• the use of regulated practices for minors
• reporting requirements for admissions of minors to inpatient units where adults may also be admitted
• the treatment of minors within a high security unit of an authorised mental health service.

Read our Treatment and care of minors fact sheet (PDF 483 kB) or the Treatment and care of minors policy to learn more.

Capacity to consent and decision making

A minor may consent to treatment if they are deemed to have the maturity and capacity to do so.

Alternatively, a less restrictive way of providing treatment includes parental consent. The Mental Health Act 2016 also provides that the common law in relation to minors consenting to treatment is not affected.

The Capacity assessment for mental health treatment (Gillick competence) child and youth form (PDF 355 kB) is an optional tool developed for documenting the outcome of a capacity assessment with a patient who is a minor.

The form is based on the meaning of ‘capacity’ in Section 14 of the Mental Health Act 2016.

It provides a structured method for obtaining evidence of a minor’s capacity to consent to treatment and helps to identify which areas of capacity are present or lacking.

It also includes the opportunity to recommend and undertake further assessment to demonstrate stability of capacity. There is no requirement for this form to be used, it is provided as a support for practice.

Read our guide on Capacity assessment for mental health treatment – Child and youth (PDF 443 kB) to learn more.

Decision making guide, flowchart and checklist for clinicians

The guide for the Decision maker information checklist – Child and youth (PDF 350 kB) is an optional form for documenting the decision maker for a minor’s mental health treatment and care.

It provides a prompt and record of the important discussions that occur between the clinician, young person and/or parent or guardian about informed consent for inpatient services.

Authorised mental health services (AMHSs) can use the following resources to make sure they are complying with the Mental Health Act 2016 when assessing capacity to consent in children and minors.

Parent or guardian consent

For a minor, treatment under a less restrictive way includes circumstances where a parent provides consent for the treatment.

Under the Mental Health Act 2016, a parent includes:

• the guardian of the minor
• a person who exercises parental responsibility for the minor, other than on a temporary basis
• for a minor of an Aboriginal background, a person who, under Aboriginal tradition, is regarded as a parent of the minor
• for a minor of Torres Strait Islander background, a person who, under Island custom, is regarded as the parent of the minor.

The minor's authorised doctor must provide all of the information required to enable the parent to make an informed decision.

A parent cannot consent to the minor being secluded, mechanically restrained or to the administration of electroconvulsive therapy (ECT).

Notifying the Public Guardian

The Office of the Public Guardian's community visitors program supports minors in care, including in AMHSs.

The program is operated by the Office of the Public Guardian, learn more about the program on their website.

To support the community visitor scheme, the Mental Health Act 2016 requires the Public Guardian to be notified about the:

• use of restraint or seclusion on a minor in an AMHS
• admission of a minor to a high security unit or inpatient unit other than a child and adolescent inpatient unit.

A minor can only be treated in the high security unit if the Chief Psychiatrist has given prior written approval.

In deciding whether to grant approval, the Chief Psychiatrist must consider:

• the minor's mental state
• psychiatric history
• treatment and care needs
• security requirements.

Electroconvulsive therapy (ECT) for children and minors

A minor may receive ECT if it is approved by the Mental Health Review Tribunal.

The Tribunal must consider the views, wishes and preferences of the minor, and their parents when deciding whether or not to approve the ECT.

Learn more about electroconvulsive therapy (ECT)