Mental Health Review Tribunal Self Help Guide
The purpose of this guide is to enable Mental Health Review Tribunal (MHRT) users to understand the functions and procedures of the MHRT, particularly if you are self-representing. Linked to this guide are four worksheets to help users to work through the MHRT’s requirements and to prepare for a hearing. At the end of this guide is a hearing checklist and definitions of the technical words used in the guide.
- 1 What is a treatment authority?
- 2 What is the Mental Health Review Tribunal?
- 3 Preparing for a hearing at the Mental Health Review Tribunal
- 4 Hearing Checklist
- 5 Definitions - What do these words mean?
- 6 Contact us
A treatment authority is a lawful authority to provide treatment to a person who has a mental illness who is considered not to have capacity to consent to treatment. Treatment authorities were previously known as involuntary treatment orders.
A treatment authority may only be made if an authorised doctor is satisfied that:
- the treatment criteria apply to the person; and
- there is no less restrictive way for the person to receive treatment for the person’s mental illness.
All of the treatment criteria must be satisfied for a treatment authority to be made. The treatment criteria are:
- the person has a mental illness;
- the person does not have capacity to consent to be treated for the illness;
- because of the person’s illness, the absence of involuntary treatment, or the absence of continued involuntary treatment:
- (a) is likely to result in either imminent serious harm to the person or others, or
- (b) the person is suffering serious mental or physical deterioration.
If a treatment authority has been made about you, it means a doctor considers that all of the above apply to you.
There are two categories of treatment authority – inpatient (you must receive treatment as an inpatient in a hospital) and community (you can live in the community but must receive treatment).
What is the Mental Health Review Tribunal?
The Mental Health Review Tribunal or “the Tribunal” is an independent body established under the Mental Health Act 2016.
The Tribunal reviews treatment authorities periodically (at the times specified in the Act) or when you apply to the Tribunal asking it to review your treatment authority. The job of the Tribunal is to consider whether the treatment authority has been made in accordance with the law.
When does the Tribunal hold review hearings?
The Tribunal first reviews a treatment authority within 28 days of it being made. It must then review a treatment authority within 6 months of the first review and again in another 6 months. After that, the Tribunal must review a treatment authority every 12 months.
You can apply to the Tribunal to review your treatment authority at any time. Also, an application can be made on your behalf, such as by your nominated support person.
Who sits on the Tribunal?
There are usually 3 members who make up the Tribunal. There is a legal member, a medical member and a community member. The legal member is a lawyer and the medical member is a psychiatrist (or another doctor if a psychiatrist is not available). The community member is not a lawyer or a doctor. Sometimes the Tribunal will have 5 members, and sometimes only 2 members.
What decisions can the Tribunal make?
At a treatment authority review, the Tribunal may decide to:
- confirm (continue) the treatment authority;
- revoke the treatment authority;
- change the category of treatment authority from inpatient to community or from community to inpatient.
The Tribunal must revoke the treatment authority if it considers the treatment criteria no longer apply to you, or there is a less restrictive way for you to receive treatment and care for your mental illness.
A treating doctor must also revoke your treatment authority if the treatment criteria no longer apply to you.
Attending the hearing
You have a right to attend the hearing and speak with the Tribunal about the treatment authority. Your nominated support person may also attend the hearing and speak on your behalf. You are encouraged to take part in the review and the Tribunal will be interested to hear from you.
You must be given at least 7 days’ notice of the hearing. The Tribunal will send you and your nominated support person/s (if you have appointed one) the notice of your hearing.
If you have a legal representative, the Tribunal should also send the notice to them.
Hearings before the Tribunal are not open to the public.
What assistance is available to me?
You can be represented at the Tribunal by a nominated support person, a lawyer or another person, for example an advocate.
If you wish to have a lawyer represent you at the Tribunal hearing, you may be eligible for assistance from Legal Aid Queensland or a community legal centre. In some limited cases, the Tribunal may be required to provide you with a lawyer.
|Contact Legal Aid Queensland on telephone 1300 651 188 or see its website at http://www.legalaid.qld.gov.au/Home|
|LawRight may also be able to help you through our Tribunal Advocacy Service - see: http://www.lawright.org.au/cms/page.asp?ID=61136 or telephone 07 3846 6317|
Preparing for a hearing at the Mental Health Review Tribunal
How should I prepare for my Tribunal hearing?
Leading up to your review hearing, you should think about what outcome you may want from the hearing. Do you want the treatment authority revoked (stopped) or changed in another way, for example, changed from inpatient to community?
Treatment authority review hearings are usually only 30 minutes long, so it is good to prepare beforehand so you have the chance to speak about the most relevant points at the hearing.
The Tribunal cannot make decisions about your treatment because that is a clinical decision for your doctor. However, if you are having particular difficulty with your treatment you may want to raise this during the hearing.
Think about the treatment criteria and go through the worksheets
You should think about whether you want to focus on one or more of the treatment criteria and work through the worksheet/s in this kit that you think are relevant. You will need to think about each of the treatment criteria and consider whether they apply to you.
If you would like to the Tribunal to revoke (stop) the treatment authority they will have to decide that one (or more) of the treatment criteria does not apply to you.
- If you disagree or are not sure that you have a mental illness you should focus on worksheet 1.
- If you think you have the capacity to make decisions about your treatment, you should focus on worksheet 2.
- If you believe that there is no risk of imminent serious harm to yourself or others, and you are not likely to suffer serious mental or physical deterioration (because of your mental illness) you should focus on worksheet 3.
- If you think you can receive treatment in a less restrictive way i.e. under an ACP 2 – Advanced Health Directive , or managing your own health as a voluntary patient, you should focus on worksheet 4.
The Tribunal makes a decision based on the evidence at the hearing. The types of evidence that the Tribunal considers are:
- what you have to say at the hearing (the Tribunal members will ask you questions and they need to take into account your views and wishes about your treatment)
- what your treating team representative has to say
- what your legal representative or support person has to say.
- your treating team’s clinical report about you
- your self report
- a report from another health professional
- any second opinion reports about your mental illness (reports from psychiatrists carry the most weight, however if you have been seeing a GP for a long period of time, their opinion may also be useful).
If there are any documents (such as medical or other reports) that you would like to show to the Tribunal you can do this on the day (provided there is not too much information). The Tribunal can receive information before your hearing also – so you could choose to submit relevant documents to the Tribunal at least 3 days before the hearing.
The Tribunal’s decision
The Tribunal will tell you their decision at the end of the hearing. After the hearing, you can ask for a statement of reasons for the decision. Getting the Tribunal’s written reasons may help you understand the Tribunal’s decision. It will detail why or why not they decided that each of the treatment criteria applied to you.
Once you ask for a statement of reasons, the Tribunal must provide it to you within 21 days.
There is no time period in which you must request the Tribunal’s reasons. However you should request the Tribunal’s written reasons as soon as possible.
Appealing the decision
If you are unhappy with the Tribunal’s decision you can appeal the decision to the Mental Health Court. Any appeal against an order of the Tribunal must be filed within 60 days of you receiving written notice of the Tribunal’s decision. In some cases, Legal Aid Queensland may be able to help with an appeal.
|Contact Legal Aid Queensland on telephone 1300 651 188 or see its website at http://www.legalaid.qld.gov.au/Home|
Applying for an early review
You have the right to apply for a review of your treatment authority at any time. To apply for an early review you need to complete an application for early review form and send it to the Tribunal. In your application you should highlight any change in circumstances since your last hearing (which relates to your mental health and the treatment criteria).
If you have recently had a review hearing, the Tribunal is only likely to make a different decision if there has been a change in your circumstances.
|Contact the Mental Health Review Tribunal on telephone 3235 9059 or free call 1800 006 478 or see its website at http://www.mhrt.qld.gov.au/|
This checklist may help you check that everything is in place for your hearing.
Do you know the time and place for the hearing?
Have you been given a copy of your treating doctor’s report to the Tribunal (at least 7 days before your hearing)?
Have you been given a copy of any other documents your treating practitioner intends to rely on at the hearing (at least 3 days before your hearing)?
Have you collected and given your treating practitioner and the Tribunal copies of any relevant documents you intend to rely on at the hearing (at least 3 days before your hearing)?
Do you understand what your treating doctor has said about you in the clinical report? Think about whether you agree with the report. You may wish to make notes of any errors that you think you should bring to the attention of the Tribunal (minor errors which don’t impact on the treatment criteria may not be worth addressing).
Have you decided what orders you want the Tribunal to make in relation to your treatment authority?
Think about whether you want to take anyone to the hearing as your support person.
Think about whether you want one of your nominated support persons to represent you at the hearing or if you would like to arrange a lawyer to represent you.
Have you spoken to the independent patient rights adviser? This is optional but might help you understand your rights in relation to the hearing.
If you do not agree with the diagnosis made about you, consider getting a second opinion.
Prepare notes of what you want to tell the Tribunal. You could use the Self report or these worksheets as a guide.
Think about the types of questions the Tribunal may ask you, and how you will respond to those questions. The Tribunal may ask you questions about how you are feeling, your current mental state, how your treatment is going, and whether you would voluntarily comply with any recommended treatment if the treatment authority was cancelled.
Definitions - What do these words mean?
The words below are used throughout this booklet. They have a very specific meaning under the Mental Health Act 2016.
| Applicant review means an application made by you to the Tribunal asking it to review the treatment authority made about you.
Community treatment authority means a category of treatment authority where you live in the community while receiving treatment.
Clinical report is a report prepared by your treating team about you. The clinical report will explain why in the doctor’s opinion the criteria for making a treatment authority have been met. The clinical report is prepared for the review hearing and must be given to the Tribunal 7 days before the hearing. The clinical report must also be given (and explained) to the individual on the treatment authority.
Inpatient treatment authority is a category of treatment authority where you receive treatment in hospital.
Involuntary patient means a person who is under a treatment authority.
Mental Health Review Tribunal is the independent body that decides (among other things) whether the treatment criteria continue to apply to you for a treatment authority.
Mental illness is a condition characterised by a significant disturbance of thought, mood, perception or memory. A treatment authority cannot be made about you unless you have a mental illness.
Nominated support person is the person you have formally appointed in writing as your support person. They receive information about your treatment and can be present at your review hearing at the Tribunal.
Review means an applicant review, periodic review or tribunal review of a treatment authority.
Treating doctor is the doctor who is in charge of your care – they are a member of your treating team.
Treatment authority is an involuntary order that can be made without your consent, giving lawful authority to provide you treatment. A treatment authority used to be known as an Involuntary Treatment Order or ITO.
Treatment criteria are the set of criteria that must be satisfied (i.e. exist) before a treatment authority can be made about you.
The information in this resource is for general information purposes only. If you would like help with a legal problem, you may be eligible for assistance from a LawRight service or clinic.
For more information about the help available, and the process for applying for help, please contact LawRight by:
|Telephone:||07 3846 6317|
|Fax:||07 3846 6311|
|Postal address:||LawRight, PO Box 3631, South Brisbane, Qld 4101|
LawRight does not provide legal advice over the phone.