Chief Psychiatrist policies
This page includes information about the following Chief Psychiatrist policies.
These policies are 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 these policies.
You can also find additional fact sheets, forms, clinical notes and resources that are available for these policies under the relevant subtopics on this page.
Introduction
Under the Mental Health Act 2016, the Mental Health Court can authorise treatment and care for a person found of unsound mind or unfit for trial in relation to a serious office. Treatment and care is authorised by the following orders.
- Forensic order (mental health)
- Forensic order (disability)
- Treatment support order
The Mental Health Court decides whether a forensic order or treatment support order is necessary. It also decides:
- whether the order is an inpatient or community category
- if the person can receive limited community treatment
- any conditions to impose on the order.
Learn more about what the Mental Health Court decides and the orders it can make.
The Mental Health Act 2016 promotes least restrictive practices, including in relation to patients on forensic and treatment support orders.
Where any rights and liberties of a patient are restricted, these restrictions should only be to the extent required to protect the patient’s safety and welfare, or the safety of others.
Treatment support orders
Treatment support orders authorise involuntary treatment and, if necessary, detention in an authorised mental health service (AMHS).
Treatment support orders can be made by either the Mental Health Court or the Mental Health Review Tribunal for persons charged with a serious offence who have been found of unsound mind or unfit for trial.
The Mental Health Court may make a treatment support order if the:
- person has a mental illness requiring treatment and an
- order is needed to protect the safety of the community, but a forensic order is not warranted.
A treatment support order cannot be made if the person has an intellectual disability, unless the person also has a mental illness requiring treatment.
The Mental Health Review Tribunal may also make a treatment support order, following a review and revocation of a forensic order (mental health). The making of a treatment support order by the Tribunal acts as a ‘step down’ from a forensic order (mental health) as part of a person’s recovery.
Treatment support orders must be a community category, unless the person’s treatment and care needs or the safety or welfare of the person or others cannot reasonably be met in the community.
Read the Treatment and care of patients subject to a forensic order, treatment support order or other identified higher risk patients policy to learn more.
Fact sheets, forms and resources
| Resource | ||
| Fact sheet | Treatment support orders (PDF 74 kB) | |
| Fact sheet | Tips for making application to the Mental Health Review Tribunal for step-down (PDF 561 kB) | |
Forensic orders
There are 2 types of forensic orders.
- Forensic order (mental health) which authorises treatment for a mental illness
- Forensic order (disability) which authorises care for an intellectual disability.
If a person requires both treatment for a mental illness and care for an intellectual disability, a forensic order (mental health) may be made.
Where a person under a forensic order (disability) also requires treatment for a mental illness, and treatment cannot be provided with the person's consent or the consent of a substitute decision maker, treatment under a treatment authority may be appropriate
A forensic order is made when the Mental Health Court considers the order is necessary to protect the person and the safety of the community.
Read the Treatment and care of patients subject to a forensic order, treatment support order or other identified higher risk patients policy to learn more.
Fact sheets, forms and resources
| Resource | ||
| Fact sheet | Forensic orders (PDF 87 kB) | |
| Fact sheet | Care of forensic order (disability) patients (PDF 146 kB) | |
| Fact sheet | Individuals with an intellectual disability (PDF 190 kB) | |
Amending category, conditions and limited community treatment
An authorised doctor is responsible for managing a patient's treatment and care including:
- ongoing review and amendment of the category of the order
- conditions or limited community treatment of a patient’s forensic order or treatment support order.
Read the Forensic orders and treatment support orders – Amending category, conditions and limited community treatment to learn more.
Inpatient category
Patients subject to an inpatient category forensic order or treatment support order may receive treatment or care as an inpatient in an AMHS on a limited or ongoing basis.
Subject to approvals from the Mental Health Court or Mental Health Review Tribunal, patients on an inpatient category order can access limited community treatment.
Limited community treatment supports a patient’s recovery by transitioning the patient from the inpatient environment to living in the community with the appropriate treatment and care. It may include:
- leave on the grounds of an AMHS
- escorted leave outside of an AMHS, or
- overnight leave up to 7 days.
Community category
Under a community category order, a person on a forensic order or treatment support order can receive treatment and care while living in the community.
Fact sheets, forms and resources
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| Resource | ||
| Form | Order / authority amendment (PDF 1152 kB) | |
| Form | Limited community treatment access and return (PDF 589 kB) | |
Risk assessment for higher risk patients
While it's not possible to identify and eliminate risk entirely, the objective of good clinical risk management is to minimise the likelihood of an adverse outcome. Various mechanisms for assessment and review within the service outside of the consumer's treating team are utilised.
AMHS administrators must establish an Assessment and Risk Management Committee (ARMC) at the service in accordance with the Treatment and care of patients subject to a forensic order, treatment support order or other identified higher risk patients policy.
The ARMC’s role is of a clinical nature and functions as a peer review of the treatment and care of patients subject to a forensic order, treatment support order and other identified patients.
The clinical director of the AMHS is responsible for facilitating the operation and function of the ARMC. To the greatest extent possible ARMC membership should comprise persons from multi-disciplinary backgrounds across medical, nursing and allied health.
Read the Treatment and care of patients subject to a forensic order, treatment support order or other identified higher risk patients policy to learn more about risk management requirements and processes. You can also view Attachment 2 of the policy: Terms of Reference for Assessment and Risk Management Committee.
Fact sheets, forms and resources
| Resource | ||
| Framework | Violence risk assessment and management framework (PDF 2773 kB) | |
| Clinical note | Involuntary patient and voluntary high risk patient summary (PDF 377 kB) | |