Victoria's Mental Health Services

www.health.vic.gov.au/mental health

Patients Rights Index <<

Major Non-Psychiatric Treatment and Major Medical Procedure

• What Are My Rights?
• About Your Rights
• Non-Psychiatric Treatment
• Second Opinion
• Advocacy
• Do I Have To Have the Treatment?
• What Is Informed Consent?
• What if I Change My Mind?
• What if I Am Not Able To Give Informed Consent?
• Can I Complain?
• Important Contacts

What Are my Rights?

You have the right to:

• obtain a second opinion from a doctor or specialist of your choice about whether you need the major non-psychiatric treatment or the major medical procedure;
• obtain legal advice and have a lawyer represent you;
• talk to and have a friend or relative represent you;
• have someone of your choice with you when you are discussing the treatment with your psychiatrist or doctor;
• complain about your treatment.

If you need help to do these things, you can ask someone of your choice to assist you. This may be a member of staff, your case manager, a friend, relative or lawyer, or your psychiatrist or doctor.

About Your Rights

This brochure has been given to you because your doctor or psychiatrist has recommended that you would benefit from a particular Major Non-Psychiatric Treatment or Major Medical Procedure. Most importantly, it tells you what your legal rights are under the Mental Health Act 1986.

Your psychiatrist or a member of clinical staff will talk to you about your rights and answer your questions. If at any time you have questions about the non-psychiatric treatment or your rights, ask someone to explain. This may be your psychiatrist, doctor, case manager, a friend, relative, lawyer or an advocate.

Non-Psychiatric Treatment

What Is Non-Psychiatric Treatment?

Non-psychiatric treatment is any surgical operation, anaesthetic or course of treatment or medication which is primarily intended to treat a physical condition and not your mental disorder. Under the Mental Health Act, there are 2 types of major non-psychiatric treatment.

Major Non-Psychiatric Treatment

Major non-psychiatric treatment is:

• any surgery performed under a general or regional anaesthetic;
• the use of general or regional block anaesthetic for any purpose;
• a course of contraceptive medication commenced during involuntary admission;
• chemotherapy;
• radiotherapy.

Major Medical Procedure

Major medical procedure is:

• termination of pregnancy;
• any procedure resulting in permanent sterilisation (both female and male);
• donation of non-regenerative tissue.

Your psychiatrist or doctor will tell you which type of non-psychiatric treatment applies to you and tick the correct box, explain the treatment and how it works, discuss possible side-effects, alternative treatments, ask your views and answer any questions you might have about the treatment.

Second Opinion

It is your right to get a second opinion about whether you need the non-psychiatric treatment. Your case manager or psychiatrist can arrange this or you can choose your own doctor. If you choose a private doctor you may have to pay a fee.

Advocacy

When you are discussing the non-psychiatric treatment with your psychiatrist or doctor, it is your right to have a friend, relative, lawyer or an advocate with you for support or to represent you.

Do I Have to Have the Treatment?

If your psychiatrist believes that you are able to give informed consent, you can only be given the major non-psychiatric treatment or major medical procedure if you agree. If you are able to give informed consent, you have the right to refuse the treatment.

What Is Informed Consent?

Informed consent is when you agree to have a major non-psychiatric treatment or major medical procedure after you have been told and understood the following:

• what the treatment involves; and
• the benefits, discomforts and risks of the treatment; and
• beneficial alternative treatments; and
• the answers to any questions you have about the treatment; and
• whether the person recommending the treatment or the doctor who will perform the treatment has any financial relationship with the service, hospital or clinic where the treatment will be given or performed; and
• your legal rights and other entitlements.

Before you decide whether you want to have the treatment, it is important that you are well informed. If you have any questions, you should ask your psychiatrist, doctor or other specialist or seek advice from a friend, relative, lawyer or an advocate, or one of the organisations listed at the end of this brochure.

It is your right to be represented by an advocate or a lawyer before you consent to the treatment.

If you agree to have the non-psychiatric treatment, you will be asked to sign a form to say you have given informed consent.

What If I Change My Mind?

If you agree to have the major non-psychiatric treatment or major medical procedure, but then change your mind, you can withdraw your consent at any time and the treatment will not proceed.

What If I'm Not Able to Give Informed Consent?

If you are not able to give informed consent and the treatment is necessary, you may be given the treatment, even if you refuse. How consent is given will depend on the type of non-psychiatric treatment. A member of staff will tell you which of the following applies to you and tick the correct box.

Major Non-Psychiatric Treatment

If your psychiatrist believes that you are not able to give informed consent and a major non-psychiatric treatment is necessary, your psychiatrist or your guardian (if you have one) can consent for you, even if you refuse.

Major Medical Procedure

If your psychiatrist believes that you are not able to give informed consent and a major medical procedure is necessary and in your best interests, your psychiatrist will apply to have a guardian appointed (if you do not already have one) to help make the decision about whether you should have the treatment.

If both your guardian and the Guardianship and Administration Board agree that you are not capable of giving informed consent and the treatment is in your best interests, they may consent to the treatment on your behalf. The treatment can then be given to you, even if you refuse.

If you want more information about consent to a major medical procedure, you can contact the Guardianship and Administration Board on (03) 9660 1555 or Toll Free on 1800 136 829.

If any non-psychiatric treatment is needed to save your life, it can be given to you, even if you refuse.

Can I Complain?

It is your right to be treated with dignity and respect and to be protected from abuse. If you are unhappy about any part of your treatment, you have a right to complain. A good place to start is with your case manager, a member of staff, the complaints liaison officer, your doctor or psychiatrist or the Director of Psychiatry at the mental health service.

If you need help with your complaint, you can ask someone you trust to assist you. This might be a member of staff, a friend, relative, lawyer or community visitor.

Important Contacts

The names, addresses and telephone numbers of people and organisations you can contact for assistance and more information are listed below.

• Community Visitors are people who visit mental health services at least once a month to inquire into the adequacy of services and facilities for the treatment and care of patients, investigate complaints and report on their inquiries and investigations. You can contact them at:

5th Floor
436 Lonsdale Street
Melbourne 3000
Tel: (03) 9819 6087

• The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. It may be able to arrange representation for you at Mental Health Review Board hearings or about other legal matters. You can contact the Centre at:

4th Floor
520 Collins Street
Melbourne 3000
Tel: (03) 9629 4422

• Victoria Legal Aid provides free legal advice about a range of issues, legal assistance if you cannot afford a private solicitor, and may be able to assist with legal representation at Mental Health Review Board hearings. You can contact Victoria Legal Aid at:

350 Queen Street
Melbourne 3000
Tel: (03) 9269 0234
Toll Free: 1800 677 402

• The Public Advocate assists, advises and advocates for people with serious complaints about mental health and disability services and treatment. You can contact the Office of the Public Advocate at:

5th Floor
436 Lonsdale Street
Melbourne 3000
Tel: (03) 9603 9500
Toll Free: 1800 136 829

• The Chief Psychiatrist is a senior departmental official appointed under the Mental Health Act, with special responsibilities in relation to people receiving mental health services. These include the power to investigate complaints and other matters and to take necessary action. You can contact the chief psychiatrist at:

Department of Human Services
555 Collins Street
Melbourne 3000
Tel: (03) 9616 7777

• The Health Services Commissioner is an independent commissioner who investigates and helps to resolve complaints by health care consumers about health services, including mental health services. You can contact the Commissioner at:

30th Floor
570 Bourke Street
Melbourne 3000
Tel: (03) 8601 5200
Toll Free: 1800 136 066

• The Ombudsman investigates complaints about government departments. You can contact the Ombudsman at:

22nd Floor
459 Collins Street
Melbourne 3000
Tel: (03) 9613 6222
Toll Free: 1800 806 314

• The Mental Health Review Board is an independent board which hears appeals from involuntary and security patients who want to get out of a mental health service or off their community treatment order or restricted community treatment order. It also automatically reviews involuntary and security patients. You can contact the Board at:

30th Floor
570 Bourke Street
Melbourne 3000
Tel: (03) 8601 5270
Toll Free: 1800 242 703

You can also ask your case manager or any member of staff about other local organisations and support groups which may be able to help you