Nominated support persons

Role of the nominated support person

The role of a nominated support person takes effect when the person who appointed the nominated support person becomes a patient (that is if they are being assessed or treated on a compulsory basis).

A nominated support person for a patient will:

• advocate for the views and preferences expressed by the patient, including any preferences they have written in an advance statement of preferences
• support the patient to make and participate in decisions
• advocate for any appropriate supports that would assist the patient to communicate and participate in decision making
• support the patient to understand information and decisions
• support the patient to communicate their views, preferences, decisions, questions or concerns
• support the patient to exercise any rights the patient has under the Act.

A nominated support person will be given information and be consulted at key points in the patient’s treatment and care such as when a patient is placed on a Temporary Treatment Order or where there is a Mental Health Tribunal hearing.

Designated mental health services must make reasonable efforts to support a nominated support person to perform their role

When a designated mental health service becomes responsible for a patient’s assessment or treatment that service must take all reasonable steps to find out if a patient has a nominated support person.

If there is a nominated support person, the service must take all reasonable steps to support them to perform their role. This may include allowing the nominated support person to view documents related to the persons treatment and care, providing the nominated support person with information and giving them reasonable opportunities to attend meetings between the patient and their treating team.

Appointing a nominated support person

A person can appoint a nominated support person at any time, provided they understand what that means and the consequences of making someone their nominated support person.

Anyone can be a nominated person.

Before appointing a nominated support person, you should:

• talk to the person you are planning to nominate about the support you want, and the person’s availability and ability to take on the role
• understand that the person will be consulted about your treatment and be given information about your health
• discuss with the nominated support person how you expect them to respond to contacts from the treating team and how you want your personal information handled.

A nominated support person appointment can be made using the nominated support person form but will be valid as long as it:

• is in writing and states the name and contact details of the nominated support person
• is signed and dated by the person making the nomination
• is witnessed by an adult (the witness cannot be the person who is being made the nominated support person)
• includes a statement signed by the witness stating that:
  • in their opinion, the nominating person understands what the nomination is and that they may revoke it
  • in their opinion, the nominating person is making the nomination of their own free will
  • they observed the nominating person sign the nomination
  • they (the witness) are an adult.

The appointment of the nominated support person is complete when the nominated support person signs a statement accepting the nomination.

Before accepting a nomination, the nominated support person should consider if they are available, willing and able to undertake the role and to do so in a way that will support a constructive relationship between the patient and their treating team.

Ending an appointment

Once appointed, a person remains a nominated support person until:

• the person who made the nomination revokes the appointment or appoints a new nominated support person; or
• the nominated support person resigns from the role.

Revoking a nominated support person appointment

A revocation of a nominated support person appointment must:

• be in writing and state that the nomination is revoked
• be signed and dated by the person revoking the nomination
• be witnessed by an adult witness
• include a statement signed by the witness stating that -
  • in their opinion, the person understands what a revocation is and the consequences of the revocation including that the nominated support person will no longer have the responsibilities, or perform the role, of a nominated support person
  • in their opinion, the person is revoking the nomination of their own free will
  • they observed the person revoking nomination
  • they (the witness) are an adult.

If a person revokes a nomination, they must take reasonable steps to let the nominated support person know and, if they are being treated as a compulsory patient, must inform the relevant authorised psychiatrist.

Resigning as a nominated support person

A nominated support person may resign from the role at any time. The resignation must:

• be in writing, include the person’s full name and state that the person resigns from the role of nominated support person; and
• be signed and dated by the nominated support person.

A nominated support person who resigns must take reasonable steps to let the person who appointed them know and, if the person is receiving compulsory assessment or treatment, must inform the relevant authorised psychiatrist.

A person who has been appointed as a nominated person before 1 September 2023 becomes a nominated support person under the Mental Health and Wellbeing Act 2022 and that appointment remains valid unless the nomination is revoked or the nominated support person resigns from the role.

Consultation and notification of a nominated support person

Consultation

A nominated support person should be consulted as required by the Act, including, when:

• an authorised psychiatrist makes a treatment decision for a patient, including a decision about medical treatment
• restrictive interventions are being authorised
• a Temporary Treatment Order is made, varied, revoked or expires
• an Authorised Psychiatrist applies to the Tribunal for the making of a Treatment Order
• the Mental Health Tribunal makes a Treatment Order
• the setting of a Temporary Treatment Order or Treatment Order is determined or varied
• a Court Assessment Order, a Temporary Treatment Order or a Treatment Order is varied to allow assessment or treatment of a patient by another designated mental health service
• the Mental Health Tribunal conducts a hearing to determine an application to review an order variation
• the Mental Health Tribunal conducts a hearing to determine the setting of a Treatment Order after a community treatment order is varied to an inpatient treatment order, or conducts a hearing following application for revocation of a Temporary Treatment Order or Treatment Order
• a psychiatrist gives a second psychiatric opinion
• the Chief Psychiatrist reviews a patient’s treatment following an application for review after a second psychiatric opinion report is made
• the authorised psychiatrist makes an application to the Mental Health Tribunal to perform a course of electroconvulsive treatment on an adult patient or young patient
• the authorised psychiatrist determines whether a security or forensic patient will be taken to another designated mental health service
• an authorised psychiatrist grants, varies or revokes a patient a leave of absence
• the Justice Secretary grants, varies or revokes monitored leave for a security patient
• an application is made to the Mental Health Tribunal to transfer a compulsory patient to an interstate mental health facility

In many circumstances, the obligation to consult the nominated person arises only to the extent that is reasonable in the circumstances. For example, if the Mental Health Tribunal sends the nominated person a notice of the patient’s hearing but the nominated person does not attend, the Mental Health Tribunal’s obligations are fulfilled.

Notification

A nominated support person should be informed as required by the Act, including when:

• an Assessment Order, Court Assessment Order, Temporary Treatment Order or Treatment Order is made, varied, revoked or expires (or an assessment order is extended)
• the Mental Health Tribunal lists a matter for hearing
• a Court Assessment Order is completed
• a patient’s right to communicate is restricted
• an authorised psychiatrist makes a treatment decision for a patient that is not in accordance with the patient’s advance statement of preferences (in which case written reasons must be provided to the nominated support person)
• restrictive interventions are used on a person
• a second psychiatric opinion report is made (the psychiatrist must ensure reasonable steps are taken to provide the nominated support person with a copy of the report)
• an authorised psychiatrist determines that, contrary to a second psychiatric opinion, the criteria apply to a patient or the authorised psychiatrist does not adopt all of the recommendations of a second psychiatric opinion (in which cases written reasons must be provided to the nominated support person)
• the Chief Psychiatrist has reviewed a patient’s treatment following an application for review after a second psychiatric opinion report is made (reasonable steps must be taken to notify the nominated support person of the outcome of the review in writing)
• the Mental Health Tribunal grants or refuses to grant an application for the performance of electroconvulsive treatment on a patient
• the authorised psychiatrist grants, varies or revokes a patient a leave of absence
• the Justice Secretary grants, varies or revokes monitored leave for a security patient
• a patient is absent without leave from a designated mental health services
• the Chief Psychiatrist makes a written direction to a designated mental health service in respect of the mental health services provided to the person
• a security or forensic patient is received at a designated mental health service or taken to another designated mental health service
• a security patient is discharged as a security patient
• when an interstate transfer order or an interstate transfer of treatment order is made for a patient

In many circumstances, the obligation to notify the nominated support person arises only to the extent that is reasonable in the circumstances. For example, an authorised psychiatrist must ensure that reasonable attempts have been made to telephone the nominated support person to tell them that the patient’s Treatment Order has been varied.

If a patient doesn’t have a nominated support person

There is no requirement for a patient to have a nominated support person. The Act requires the mental health and wellbeing service provider to support the patient to make decisions and participate in decision making, understand information and their rights and communicate their views, preferences, questions, or decisions.

In addition, a patient may be supported by a non-legal mental health advocate or their family, carer or other supporters if appropriate.

Nominated support person forms

.