Program Management Circulars Index <<

Authority to Transport Without Recommendation (June 1996)

• Purpose
• Background
• Criteria for Transport
• Mental Health Practitioner
• Transport
• Restraint
• Sedation
• Documentation
• Admission

Purpose

To provide information about the 'Authority to Transport' section 9(7A) Mental Health Act 1986, (the Act).

Background

Safe transport is a priority for a person requiring involuntary admission to hospital. Staff of community mental health services sometimes encounter difficulties organising transport where a medical practitioner is not available to complete a recommendation. One option for community-based staff has been to request police to use their powers under section 10 to detain and transport the person needing admission.

The Act has been amended to provide an alternative power to transport a person requiring involuntary admission where a medical practitioner is not available to complete a recommendation. This circular sets out the circumstances when this can occur and identifies who can authorise that transport.

Criteria for Transport

Section 9 of the Act has been amended to enable a mental health practitioner to authorise the transport of a mentally ill person to an approved mental health service where a medical practitioner is not available to make a recommendation.

Transport may be authorised where a request has been made and a mental health practitioner believes:

• The person meets the section 8(1) criteria;

and

• A medical practitioner is not available within a reasonable period to consider making a recommendation, despite all reasonable steps having been taken to secure the attendance of one;

and

• The person should be admitted for examination by a medical practitioner for the purposes of making a recommendation.

The Act requires that reasonable efforts be made to secure the attendance of a medical practitioner. While staff will probably seek the attendance of a medical practitioner employed by the mental health service, consideration should also be given to contacting a local general practitioner or a forensic physician (where appropriate).

The authority to transport may only be completed if a medical practitioner is not available within a reasonable 'period'. What is reasonable will vary from case to case. If, for example, a person was becoming increasingly disturbed because of the wait, it might be reasonable to authorise transport without further delay. The reasonableness of any decision will be judged against the clinical needs of the person, the safety of the person and others, and the availability of a medical practitioner.

Mental Health Practitioner

An authority to transport may only be completed by a mental health practitioner. This term is defined in the Mental Health Regulations 1987 as:

• A registered nurse
• A registered psychologist
• A social worker-employed by an approved mental health service and engaged in the provision of acute psychiatric assessment and treatment functions in the community.

A mental health practitioner will be a member of a service whose function is to provide acute assessment and treatment services in the community. This includes Crisis Assessment and Treatment services, Psychogeriatric Assessment services, Homeless Persons' Psychiatric Service and integrated services.

Members of Continuing Care, Clinical and Consultancy services, Mobile Support and Treatment services and Residential and Non-Residential Rehabilitation services are not included in the definition.

Transport

Where a request and authority to transport have been completed, the person may be transferred to an approved mental health service by:

• The person making the request.
• A member of the police force.
• An ambulance officer.
• Any person authorised by the person making the request.

The decision about the most appropriate form of transport must be made in the context of existing protocols with both Ambulance Services Victoria and Victoria Police. Ambulance Services Victoria has lead agency responsibility for emergency transport of people with mental illness. The police may assist where ambulance transport cannot be provided alone due to the risk of violence and harm to the client or others.

In some circumstances, it may be appropriate to use a mental health service vehicle or transport provided by family or friends.

Restraint

A 'prescribed person' [section 9(8) of the Act] may use reasonable restraint if this is necessary for the person to be safely transported.

A 'prescribed person' is a member of the police force, an ambulance officer or an employee of a 'psychiatric service' within the meaning of section 106 of the Act.

Sedation

A person being transported under an authority to transport should not be sedated. If a medical practitioner is available to prescribe sedation, the practitioner should complete a recommendation.

Documentation

The documentation to be completed for an authority to transport is:

• Request (Schedule 1).
• Authority to Transport Without Recommendation (Schedule 2C).
• Restraint (Schedule 2A)-where required.

The request and authority to transport must not be completed by the same person.

The mental health practitioner should document the efforts taken to obtain the attendance of a medical practitioner and the rationale for not waiting for a medical practitioner.

Admission

A person for whom an authority to transport has been completed is to be taken to an approved mental health service. The person must then be examined by a medical practitioner as soon as practicable to decide whether a recommendation should be made.