Introduction
Some people with a mental illness
need to be treated involuntarily. This involves a loss of certain freedoms.
The Mental Health Review Board is a statutory review tribunal that conducts
hearings to determine whether it is necessary for a person to be treated
as an involuntary patient. In making its decisions, the Board must consider
the right of the individual to receive necessary treatment, the loss of
freedom that the individual experiences when they are treated involuntarily,
and, the interests of the community.
In most circumstances, a division
of the Board will consist of three members: a lawyer, a psychiatrist and
a community member. Every day different divisions of the Board conduct
hearings at mental health services throughout Victoria and some hearings
in regional areas are conducted by videoconference.
When a person appears before
the Board, the Board will hear evidence from that person and one or more
members of their treating team, and will receive submissions from any
representative present on behalf of the patient. The person may also choose
to have a relative or friend present for support or to give evidence.
The Board will consider all the evidence, including the person’s
clinical file. It will then make a decision in accordance with the criteria
contained in the Mental Health Act 1986.
All hearings are conducted in private.
A detailed brochure "Who
We Are and What We Do" can be found in the Publications area
of this website.
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The
Board’s functions
The main
functions of the Board are:
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to hear appeals from involuntary inpatients and security patients
and people on community treatment orders and restricted community
treatment orders who want to be discharged;
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to review all involuntary and security patients within eight weeks
of admission to decide whether their involuntary or security patient
status should continue;
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to review all involuntary and security patients at least every twelve
months to decide if their involuntary or security status should continue;
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to review every decision to extend a community treatment order or
a restricted community treatment order;
-
to hear appeals against refusals to grant special leave to security
patients;
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to hear appeals against intrastate transfer orders and review interstate
transfer orders;
- to review
the treatment plans of involuntary patients and security patients;
While the Board may order that
a person be discharged where the required treatment is not available,
it cannot direct a mental health service to provide a person with particular
treatment. Similarly it has no power to order changes to the treatment
being provided.
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Decisions of the
Board
The Board makes decisions every
time it hears an appeal or conducts a review. Reviews are conducted to
determine whether a person should continue to be treated with involuntary
or security inpatient status. The decisions made in response to a patient’s
appeal will depend on the original decision against which the patient
is appealing. This may be the decision that they be treated as an involuntary
or security patient, transferred, or refused special leave of absence
by the authorised psychiatrist. In practice, consideration of decisions
to treat persons as involuntary patients constitute about 97% of the cases
heard by the Board.
The criteria
for decision making
In making its decisions, the
Board applies certain criteria which are contained in the Mental Health
Act. The criteria applied depend on the person's status under the Act.
The criteria for involuntary patients and for security patients are set
out below. For a detailed description of all categories of patients and
the relevant criteria, see the categories
of involuntary and security patients.
(a) Involuntary Patients
Where the person is treated
as an involuntary patient, these are the criteria that apply:
Section 8(1) of the Mental
Health Act 1986:
(1) The criteria for the involuntary
treatment of a person under this Act are that—
(a) the
person appears to be mentally ill; and
(b) the
person's mental illness requires immediate treatment and that treatment
can be obtained by the person being subject to an involuntary treatment
order; and
(c) because
of the person's mental illness, involuntary treatment of the person
is necessary for his or her health or safety (whether to prevent a deterioration
in the person's physical or mental condition or otherwise) or for the
protection of members of the public; and
(d) the
person has refused or is unable to consent to the necessary treatment
for the mental illness; and
(e) the
person cannot receive adequate treatment for the mental illness in a
manner less restrictive of his or her freedom of decision and action.
In relation to inpatients, the
Board also must consider whether the patient can be treated in the community
on a community treatment order.
(b) Security Patients
Where the person is detained
as a security patient, these are the criteria that apply:
Section 16(2)
of the Mental
Health Act 1986:
(a) the
person appears to be mentally ill; and
(b) the person's mental illness requires immediate treatment and that treatment
can be obtained by the person being subject to an order under this section; and
(c) because
of the person’s mental illness, the person should be admitted
and detained for treatment for his or her health or safety (whether
to prevent a deterioration in the person’s physical or mental
condition or otherwise) or for the protection of members of the public.
and section
16(4):
The Secretary
to the Department of Justice must have regard to the public interest
and all the circumstances of the case including the person’s criminal
record and psychiatric history.
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Outcomes
When the Board discharges a person
The effect of a decision by
the Board to discharge a patient will vary according to the status of
detention to which the individual is subject:
-
An involuntary inpatient who is discharged will be free to choose
whether or not to leave the mental health service and to continue
to receive treatment as a voluntary patient.
-
An involuntary patient on a community treatment order would no longer
be on the order and can make decisions about their future treatment.
-
Restricted involuntary treatment order involuntary patient sent for treatment by way of
a court order would be free to choose whether or not to leave the
mental health service.
-
Restricted involuntary treatment order involuntary patient on a restrictive community treatment
order would no longer be on the order and would be free to choose
whether they wanted to continue their treatment.
-
A continuing treatment involuntary patient would be free to choose
whether to leave the mental health service.
-
A hospital (transfer) order involuntary patient from a prison or
detention centre would be returned to their original place of detention.
-
A hospital order (diagnosis, assessment and treatment) patient would
be returned to court for sentencing or another order.
-
A security patient under a restricted hospital transfer order would
be returned to their original place of detention.
-
A hospital security order patient would be sent to prison to serve
the rest of their sentence.
If the Board discharges an involuntary
patient, it is up to the person to decide whether they want to continue
their treatment or not. A discharge by the Board does not mean that the
person must leave hospital and they should discuss this with their case
manager or treating psychiatrist. A person may wish to remain in treatment
as a voluntary patient.
When
the Board doesn’t discharge a person
If the Board does not discharge a person, then they will remain an involuntary
patient (in hospital or on a community treatment order) or a security
patient. The treating doctor will regularly review the person to see if
the person should be discharged. If the person is still an involuntary
patient after 12 months, the Board will automatically conduct another
review. They can also appeal
to the Board at any time.
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Appeals
Appeals
Against the Board's Decision
If a patient disagrees with
the decision of the Mental Health Review Board they can appeal
again to the Board or they may apply for a review to the Victorian
Civil and Administrative Tribunal (VCAT). VCAT is an independent tribunal
with the power to confirm or overturn the decision of the Board. Applications
for review must be made in writing within 28 days to: General List, Victorian
Civil and Administrative Appeals Tribunal, Level 7, 55 King Street, Melbourne
3000, Telephone: (03) 9628 9755.
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Personnel
Personnel
of the Mental Health Review Board
The staff of the Board includes
an Executive Officer and other staff necessary to ensure its proper functioning.
They are appointed under section 23 of the Mental Health Act. The Executive
Officer has statutory responsibility for the management of the administrative
affairs of the Board, including the selection, training and supervision
of staff, case management and the management of the Board's financial
resources.
Who is on
the Mental Health Review Board?
The Mental
Health Review Board has three types of members: Legal, Psychiatrist and
Community. Legal members must be barristers and solicitors of the Supreme
Court of Victoria of not less than five years’ standing. Psychiatrist
members must be members of the Royal Australian and New Zealand College
of Psychiatrists or the equivalent. Community members are appointed to
represent the views and opinions of members of the community. The President
of the Mental Health Review Board is the only full time member.
How are the members appointed?
The President and members of the Board
are appointed by the Governor in Council. The President is appointed by
Governor in Council on the recommendation of the Minister for Health.
On
5 September 2000, John Lesser was appointed for five years as President
of the Mental Health Review Board by the Governor-in-Council and took
up full time duties on 16 October 2000. John had been a sessional legal
member of the Board from September 1993 and is familiar with the Board's
jurisdiction and role. The previous President, Julian Gardner, resigned
in February 2000 to take up his appointment as the Victorian Public Advocate.
Professor Bob Williams, a legal member of the Board since its inception
in October 1987, held the position of Acting President from February to
September 2000. In September 2005 John Lesser was re-appointed for a further
5 years.
John's continuing aim is to
refine the administration processes and hearing procedures of the Board
so that it maintains and improves its position as a recognised leader
in 'best practice' in the operation of tribunals dealing with mental illness
issues.
The Board members are dedicated
and highly skilled. The staff run a very efficient and effective tribunal
but there is always room for improvement.
Ordinary members of the Board
are also appointed by the Governor in Council and are appointed for up
to five years. Advertisements for new members are placed in the newspapers
as required. Members are then short listed and selected by an interview
panel which makes recommendations to the Minister for Health.
If a person
is interested in appointment to the Board he or she can write to the President
with an expression of interest. When an advertisement for members is made
that person will be notified.
Click here
for detailed information on Employment
Opportunities.
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Organisational Chart
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