On 5 March 2017, the Mental Health Act 2016 (Qld) (the Act) will commence. It is the biggest mental health law reform in Queensland in over 15 years, symbolising the changing attitudes to the examination and treatment of patients suffering from a mental illness.
As we have previously outlined, hospitals and medical practitioners will need to familiarise themselves with the changes to the Act as they relate to:
- Patient rights;
- Treatment and care;
- Seclusion and mechanical restraint; and
- Regulated treatments.
How will it affect patients?
The Act has an increased focus on patient rights and recovery, and strengthens the role of family and support persons. This is achieved through the implementation of standards that that must be met regarding the treatment and care of patients.
Patients can now be visited at any reasonable time and are able to seek a second opinion about their treatment. Patients are now also able to appoint up to two nominated persons to provide support should they lack capacity, with authorised doctors required to discuss treatment and care with the support persons.
Patients also have greater control over their future healthcare with the Act promoting the use of advance health directives and other alternatives to treatment without consent, described as the ‘less restrictive way of treatment’ in a policy to be implemented by the Chief Psychiatrist. A patient is required to be treated under an advance health directive if their treatment needs can be met that way.
How will it affect hospitals and medical practitioners?
Each public hospital with a mental health service is now required to have an ‘independent patient rights adviser’ to assist and advise patients (and support persons) of their rights under the Act.
The Act amends the names of some of the orders made by the Mental Health Review Tribunal. An ‘examination authority’ replaces a ‘justices examination order’, whilst an ‘emergency examination authority’ replaces an ‘emergency examination order’. The Act places more safeguards on each authority but the substance of each is principally unchanged. Hospitals must note that Emergency Examination Authorities are made under the Public Health Act 2005, to deal with persons who are at immediate risk of harm due to a disturbance in their capacity (e.g. intoxication, injury, illness).
Authorised doctors (as appointed by administrator of a mental health service), have the responsibility ensure that:
- Patients receive timely, accurate and appropriate information about their treatment and care;
- Treatment and care provided is, and continues to be, appropriate to the patient’s needs; and
- They record in the patient’s health records the treatment that is planned to be provided, and that which is provided, to a patient.
We have previously outlined that the Act also requires authorised doctors to explain matters with patients (and their support person) at the following stages:
- When making a recommendation for assessment for a patient;
- When a treatment authority is made for a patient.
- When deciding (or amending) the treatment and care for a patient.
As a result of these changes, medical practitioners ought to direct their attention to the presence of any advance health directives in place regarding treatment.
The Act also regulates the use of electroconvulsive therapy and non-ablative neurological procedures as well as implementing strict criteria for the use of seclusion and mechanical restraint.
All staff working in mental health services must understand these changes and amend their clinical practices and processes to meet the requirements of the new Act. Information regarding the transition to the new Act can be found here.
For more general information on the Act, please click here.