What orders can the tribunal make
- Involuntary Patient Orders - An Involuntary Patient order is a legal order that authorises the detention of a ‘mentally ill person’ in a mental health facility. The first Involuntary Patient order is made by the Tribunal at a mental health inquiry and can be made for a period of up to three months.
If the mental health facility wishes to extend a person’s involuntary stay beyond the initial period set by the Tribunal at a mental health inquiry, then the mental health facility must apply to the Tribunal for a further Involuntary Patient Order before the first order expires.
- Review of Voluntary Patients - A voluntary patient is a person who voluntarily remains in a mental health facility for treatment, care or observation, or a person who is admitted under section 7 of the Mental Health Act 2007 as a voluntary patient by his or her guardian. Voluntary patients are generally in hospital as they can benefit from inpatient care.
The Tribunal must review a voluntary patient who remains in a mental health facility (in an involuntary or voluntary capacity) for a continuous period of more than 12 months, at least once every 12 months. The Medical Superintendent of the mental health facility must notify the Tribunal of the name of any voluntary patient of the hospital whose case the Tribunal is required to review.
People who have been voluntarily living in and cared for in psychiatric hospitals for long periods of time are also reviewed by the Tribunal as voluntary patients.
- Community Treatment Orders - A Community Treatment Order (CTO) is a legal order made by the Mental Health Review Tribunal or by a Magistrate. It sets out the terms under which a person must accept medication and therapy, counselling, management, rehabilitation and other services while living in the community. It is implemented by a mental health facility that has developed an appropriate treatment plan for the individual person.
A CTO authorises compulsory care for a person living in the community. If a person breaches a Community Treatment Order, by not complying with the conditions of the Order, the person may be taken to a mental health facility and given appropriate treatment, including medication.
CTOs can be made for any period of time up to twelve months. It is possible for a person to have more than one consecutive CTO. The treating team may apply to the Tribunal if they think the person should continue on a community order. If the person does not comply with the conditions of the order then he or she may be in breach of the order and in certain circumstances may be taken to a mental health facility for treatment.
- Reviews of Forensic Patients – A Forensic Patient is a person who has been found by a Court to be unfit to be tried for a criminal offence, and is detained in a hospital, prison or other place; or who is detained in a hospital after being transferred there from a prison ; or who has been found not guilty by a Court, because of mental illness.
The Tribunal must review the case of a forensic patient at least once every six months and make a recommendation to the Minister for Health concerning the person’s continued detention, care and treatment, or the appropriateness of their release. That recommendation may stipulate where the patient is to be detained, under what kind of security, the range and kinds of leave (if any) which can be enjoyed, and, if the patient is on conditional release, the range and kinds of conditions which apply in order to allow the patient's continuing presence in the community.
The Tribunal can also make a determination about whether a person is fit to stand trial
- Electro Convulsive Treatment (ECT) - The Mental Health Review Tribunal becomes involved in decisions about ECT in the following circumstances:
• when the mental health facility is uncertain of a voluntary patient’s capacity to give consent to treatment with ECT. If the Authorised Medical Officer is unsure whether or not a voluntary patient is capable of giving informed consent, the Authorised Medical Officer may apply to the Tribunal for an ECT Consent Inquiry to determine that issue. If the Tribunal decides that the person can consent and the person has given consent in writing, then the hospital may administer ECT treatment. If the Tribunal decides that the person lacks capacity, or if the person has capacity but refuses treatment, then the hospital may not administer ECT while the person is a voluntary patient.
• when the mental health facility proposes ECT for an involuntary patient (for this purpose, this includes patients on an involuntary patient order, detained patients (or assessable persons) who have not been brought before the Tribunal for a mental health inquiry, patients on an adjournment from a mental health inquiry and forensic patients) or a person under the age of 16 years. If a mental health facility intends to administer ECT to any of these involuntary patients, the Authorised Medical Officer must first apply to the Mental Health Review Tribunal for an ECT Administration Inquiry.
- Surgery and Special Medical Treatment - The Tribunal can also decide whether involuntary patients can have surgery or special medical treatment.
- Financial Management Orders - The Tribunal can also order that a person's financial affairs be managed by the NSW Trustee, on a Financial Management Order.