Program Management Circulars Index <<

Amendment Regarding Involuntary Patients (December 1999)

• Purpose
• Background
• Criteria for Involuntary Admission
• Linking the Illness with the Symptoms
• Deterioration
• Definition of Mental Illness
• Exclusion Criteria
• Guardianship

Purpose

To provide information about amendments to section 8 of the Mental Health Act 1986, (the Act).

Background

Section 8(1) of the Act provides criteria to clearly identify the circumstances which warrant involuntary admission and treatment for mental illness. Section 8 (2) identifies exclusion criteria in considering involuntary admission.

The amendments to the Act alter section 8(1) and add an additional criterion to section 8(2). This circular explains the implications of these changes.

Criteria for Involuntary Admission

Section 8(1) of the Act now states:

A person may be admitted to and detained in an approved mental health service as an involuntary patient in accordance with the procedures specified in the Act only if-

(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 admission to and detention in an approved mental health service; and

(c) because of the person’s mental illness, the person should be admitted and detained for treatment as an involuntary patient 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 the person’s freedom of decision and action.

Linking the Illness With the Symptoms

Section 8(1)(c) of the Act has been amended to clarify that the risks which give rise to involuntary detention must be as a result of the person’s mental illness. While this has always been implicit, it has not been specifically stated in the Act.

Deterioration

Although the Mental Health Review Board has previously interpreted the meaning of ‘health and safety’ in section 8(1)(c), some practitioners remain unclear on the meaning of this term.

Section 8(1)(c) has been amended to clarify that a potential deterioration in a person’s mental or physical health may be taken into account when considering involuntary treatment.

The inclusion of deterioration clearly establishes that there is as much risk attached to passive acts, such as neglect, as there is to suicidal actions.

Definition of Mental Illness

The Act has been amended to include a definition of mental illness. New section 8(1A) provides that:

a person is mentally ill if he or she has a mental illness, being a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory.

This definition is only for the purposes of section 8(1)(a) and has been included to clarify the scope of detention powers under the Act and provide guidance for practitioners, consumers and the general community about the grounds for involuntary detention.

Exclusion Criteria

Section 8(2) of the Act identifies a number of criteria which must not be the sole factor in determining whether a person appears to be mentally ill.

Section 8(2) has been amended to include an additional exclusion criterion which states:

(m) that the person has a particular economic or social status or is a member of a particular cultural or racial group.

Guardianship

The Act has been unclear about whether a person who has a guardian appointed under the Guardianship and Administration Board Act 1986 can be involuntarily admitted.

Section 8 of the Act has been amended to clarify that where involuntary admission is being considered, the medical practitioner must consider the ability of the individual to consent to treatment and not whether the guardian has consented.

This change applies only to appointed guardians and not the legal guardian of children and young people under 18.