The Mental Health Act 2009 An Overview Jacob Alexander The Adelaide Pre-Vocational Psychiatry Program 2016

Why do we need mental health legislation ? People with mental health disorders can be vulnerable to abuse and violation of their rights Protecting vulnerable citizens may demonstrate a caring community Legislation may also be a tool to promote access to mental health care as well as to promote and protect the rights of these individuals Some people believe that it is also to protect the public from harm

International and National Context UN Principles for the Protection of Persons with Mental Illness 1991 National Mental Health Statement of Rights and Responsibilities 1991 National Mental Health Strategy 1992 Burdekin Report 1993 (HREOC) Mental Health Care Law: 10 Basic Principles (WHO 1996) Stop Exclusion: Dare to Care 2005 (WHO) Not For Service 2005 (MHCA, BMRI, HREOC)

Review of 1993 Act To ensure that mental Health and other relevant legislation in South Australia: Affirms the rights, dignity and civil liberties of mental health consumers and their carers Balances these rights with the community’s legitimate expectations that it be protected from harm Ensure that procedures facilitate care and treatment appropriately Establishes clear principles which enable mental health consumers to receive appropriate services in wither hospitals or in the community Provide a legislative framework for a modern mental health service system in SA

Mental Health Act 2009 Provides a contemporary framework for the treatment, care and rehabilitation of person with serious mental illness Aims to: 1.Bring about recovery as far as is possible 2.Retain freedom, legal rights, dignity and self- respect as far as is consistent with the protection of the person and the community Aligns SA with legislations in other jurisdictions

Key Features Principle of the least restrictive approach to treatment Recognition of the role of family/carers Sharing of information Treatment and Care Plans

Key Reforms Early access to expert assessment Rights of consumers and carers Greater monitoring and accountability Transport arrangements Equity of services for people in country SA

New Provisions Changes to Community Treatment Orders (CTOs) and Inpatient Treatment Orders (ITOs) Authorised Officers Authorised Medical Practitioners Authorised Health Professionals Limited Treatment Centres Chief Psychiatrist Community Visitors Scheme

CTOs and ITOs Community Treatment Orders (CTOs) 1.Facilitates early access to least restrictive treatment and care prior to becoming an inpatient 2.Level 1: up to 28 days 3.Level 2: up to 12 months, 6 months (children) Only made by the SACAT 1.Inpatient Treatment Orders (ITOs) 2.Level 1 : up to 7 days 3.Level 2: up to 42 days 4.Level 3: up to 12 months, 6 months (children). Only made by the SACAT

Authorised Officers The Act establishes the following groups of people as a class of people: Mental Health clinicians (any person working in a mental health role) Ambulance officers RFDS medical officers and flight nurses A class prescribed by the regulations

Authorised Officers contd. Authorised Officers are able to: Take person into care and control Transport or arrange to transport the person Restrain the person using reasonable force Restrain by administering a drug (if authorised under the Controlled Substances Act 1984) Enter and remain in a place where they suspect the person may be Search the person’s clothing or possessions and retain anything that may be cause of harm

Authorised Medical Practitioners The Act provides opportunity to identify individual medical practitioners as Authorised Medical Practitioners (AMPs) Individuals who are judged to have sufficient psychiatric training and experience will be identified as AMPs Authorised Medical Practitioners will have the same role and functions as Psychiatrists are provided under the Act

Authorised Health Professionals Purpose of AHPs is: Improve prompt access to specialist care where needed Assist with equity of service for people in country SA AHPs will also assist with prompt access to care and treatment for people in metropolitan areas

Authorised Health Professionals contd. Powers to: Make a Community Treatment Order (Level 1) and an Inpatient Treatment Order (Level 1) Issue a transport request to transport the person to a treatment centre (ITO Level 1) Responsible for: Ensuring effective communication with consumers Arranging an examination by a psychiatrist or authorised medical professional (AMP) within 24 hours or as soon as practicable and arrange for the person to be able to attend

Authorised Health Professionals contd. Nomination Selection criteria Accreditation training program Appointment arrangements Code of Practice

Limited Treatment Centres Will provide acute care for involuntary patients for up to 7 days when admitted for assessment and treatment under the ACT Will reduce the need for being transferred to approved treatment centres in metropolitan based hospitals 3 LTCs in Whyalla, Berri and Mount Gambier

Chief Psychiatrist Replaced the existing position of Chief Advisor in Psychiatry from 1 July 2010 Has increased powers to safeguard the rights of people accessing mental health services in SA, including the power to monitor and review standards of care Can approve all interstate transfers of involuntary inpatients Will provide an annual report to the Minister Will be responsible for targeted and consistent education, training and information strategies

Community Visitor scheme Further protection of the rights of people admitted to treatment centres in SA Enable the inspection of premises and consultation with consumers and staff to ensure appropriate treatment and care Able to visit treatment centres and other incorporated and private hospitals

Additional information Memorandum of understanding with other states for the transfer of CTOs across state borders Process of appeals against interstate transfer Harbouring