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Psychosurgery

• What Are My Rights?
• About Your Rights
• Psychosurgery
• Second Opinion
• Advocacy
• Do I Have To Have Psychosurgery?
• What Is Informed Consent?
• What if I Change My Mind?
• Psychosurgery Review Board
• Can I Complain?
• Important Contacts

What Are My Rights?

You have the right to:

• obtain a second opinion from a psychiatrist of your choice about whether you need psychosurgery;
• say ‘No’ to psychosurgery;
• 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 psychosurgery with your psychiatrist or doctor;
• withdraw your consent at any time before psychosurgery is performed;
• 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 psychiatrist has recommended that you would benefit from Psychosurgery. Most importantly, it tells you what your legal rights are under the Mental Health Act 1986 in relation to psychosurgery.

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 psychosurgery or your rights, ask someone to explain. This may be your psychiatrist, neurosurgeon or doctor, your case manager, a friend, relative, lawyer or an advocate.

You can also get information from the Psychosurgery Review Board at:

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

Psychosurgery

What Is Psychosurgery?

Psychosurgery is an operation on the brain and may be used to treat people with severe psychiatric disorders which have not responded to other treatments. Examples of the disorders are major depression, obsessive compulsive disorder or severe anxiety disorder where these have caused extreme distress for the person suffering from the illness. Its use is limited and is subject to strict control by the Psychosurgery Review Board.

Before recommending psychosurgery, your psychiatrist and neurosurgeon will give you a thorough physical, psychiatric and psychological examination, taking into account your illness, its severity and your medical history. You may be referred to a major teaching hospital for further evaluation of treatment.

Your psychiatrist will explain the treatment, the procedures, how it works, discuss possible side-effects, 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 psychosurgery. Your case manager, psychiatrist or neurosurgeon 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 psychosurgery with your psychiatrist or neurosurgeon, 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 Psychosurgery?

You will only be considered for psychosurgery if you give informed consent to the treatment.

You have the right to refuse psychosurgery.

What Is Informed Consent?

Informed consent is when you agree to have psychosurgery after you have been told and understood the following:

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

Before you decide whether you want to have psychosurgery, it is important that you are well informed. If you have any questions, you should ask your psychiatrist or neurosurgeon 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 psychosurgery.

If you agree to have psychosurgery, you will be asked to sign a form to say you have given informed consent and your psychiatrist will then apply to the Psychosurgery Review Board to obtain its consent. The Psychosurgery Review Board makes the final decision.

What If I Change My Mind?

If you agree to have psychosurgery, but then change your mind, you can withdraw your consent at any time and the psychosurgery will not proceed.

Psychosurgery Review Board

What Is the Board?

The Psychosurgery Review Board is an independent board which was set up with the purpose of deciding whether psychosurgery should be performed on any person in the state of Victoria. The Psychosurgery Review Board must consent before any person can have psychosurgery. You cannot have psychosurgery if the Psychosurgery Review Board does not consent.

When the Psychosurgery Review Board receives an application from your psychiatrist for you to have psychosurgery, it will arrange a hearing to decide whether you should have psychosurgery.

How Will I Find Out About the Hearing?

At least 10 days before the hearing, the Psychosurgery Review Board will send you a notice advising the date, time and place of the hearing and the nature of the proceedings. You are encouraged to attend the hearing. You can arrange to have a lawyer, friend or relative attend to offer support or speak for you. If you are unable to attend the hearing you should tell the Board as soon as possible.

What Will Happen at the Hearing?

The hearing will be held by either 4 or 5 Board members-usually a lawyer, 1 or 2 psychiatrists, a neurosurgeon and a nominee of the Victorian Council for Civil Liberties.

The hearing will be private and informal. Before the hearing, you or your representative will be given copies of the application and all supporting documents. Your psychiatrist will provide information at the hearing about why you should have psychosurgery. You and your representative will be able to ask questions and to give evidence. The neurosurgeon may be present if it is considered necessary by the Board.

How Will the Board Decide If I Should Have Psychosurgery?

The Board must be satisfied that:

• you are capable of giving informed consent;
• you have actually given informed consent;
• the proposed psychosurgery has clinical merit and is appropriate;
• the person proposing to perform the psychosurgery is properly qualified;
• the hospital or service where the proposed psychosurgery would be performed is an appropriate place;
• all other reasonable treatments have already been tried without sufficient and lasting benefit.

If the Board is satisfied as to these matters it will consent to you having psychosurgery. If it is not satisfied, it must refuse to give its consent.

What Happens After the Hearing?

When the Psychosurgery Review Board has heard the evidence, it will make its decision.

If the Board consents to you having psychosurgery, it will specify:

• the name of the neurosurgeon authorised to perform the psychosurgery;
• the nature of the psychosurgery to be performed;
• the hospital or service where the psychosurgery is to be performed;
• the time within which the psychosurgery is to be performed.

You will be given a copy of the Board’s consent in writing.

If the Board refuses to give consent, you cannot have psychosurgery and you will be advised of this in writing.

If you have psychosurgery, the Board will ensure that your progress is regularly monitored.

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, psychiatrist or neurosurgeon 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) 9603 9500
Toll Free: 1300 309 337

• The Mental Health Legal Centre is an independent legal service which specialises in mental health legal issues. The Centre can give advice about your legal rights in relation to psychosurgery. It may be able to arrange representation for you at Psychosurgery 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
Toll Free: 1800 555 887

• Victoria Legal Aid provides free legal advice about a range of issues, including your rights in relation to psychosurgery, legal assistance if you cannot afford a private solicitor, and may be able to assist with legal representation at Psychosurgery 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 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
Level 17, 50 Lonsdale Street
Melbourne 3000
Tel: (03) 9096 7571
Fax: (03) 9096 7697

• 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: 1300 309 337
email: publicadvocate@justice.vic.gov.au

• 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
Fax: (03) 8601 5299

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.