Assessment orders

An assessment order is the first step in initiating compulsory mental health treatment.

Processes are described in this chapter and illustrated in the assessment orders flow chart.

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Assessment orders flow chart

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Purpose of an assessment order

An assessment order enables an authorised psychiatrist to examine the person without the person’s consent to determine whether they have mental illness and need compulsory mental health treatment.

An assessment order can either be a community assessment order or an inpatient assessment order.

If a community assessment order is made the person must be assessed in the community.

If an Inpatient assessment order is made the person must be taken to and detained in a designated mental health service for assessment.

How an assessment order is made

Examination

A registered medical practitioner or an authorised mental health practitioner may make an assessment order if they have examined the person within the previous 24 hours and are satisfied that the compulsory assessment criteria apply to the person.

Compulsory assessment criteria

The examination must be in person unless this is not practicable in which case the examination may be done remotely.

The Chief Psychiatrist will issue guidelines to assist in determining whether or not it is practicable in the circumstances for an examination to be conducted in person. These guidelines will be published on the Department of Health website when finalised.

Before examining the person, the registered medical practitioner or authorised mental health practitioner must identify themselves, inform the person that they will be examined and take reasonable steps to explain the purpose of the examination. There are requirements that must be followed when communicating under the Act.

An assessment order can only be made within 24 hours of the examination. If more than 24 hours have passed, another examination must be conducted before an assessment order can be made.

Determining if the compulsory assessment criteria apply

In determining whether the compulsory assessment criteria apply to a person the registered medical practitioner or authorised mental health practitioner:

• must consider information communicated by the person being examined; and
• may consider any other relevant information including information communicated by any other person.

Setting of an assessment order – community or inpatient

The practitioner making the assessment order must determine whether the order is to be:

• a community assessment order – which means the person must be assessed in the community; or
• an inpatient assessment order – which means the person needs to be taken to a designated mental health service to be assessed.

A registered medical practitioner or authorised mental health practitioner may only make an inpatient assessment order if the practitioner is satisfied that the assessment of the person cannot occur in the community.

Duration of an assessment order

An assessment order comes into force when the order is made and expires:

• in the case of a community assessment order, 24 hours after it is made; and
• in the case of an inpatient assessment order, on the earlier of:
  • 24 hours after the person is received at a designated mental health service; or
  • 72 hours after the order is made.

An authorised psychiatrist must assess a person subject to an assessment order as soon as practicable and before the order expires.

Extending an assessment order

If, after examining the person, the authorised psychiatrist is unable to determine whether the compulsory treatment criteria apply, the authorised psychiatrist may extend the duration of the assessment order for a period of up to 24 hours.

An assessment order may be extended twice before it finally expires.

Contents of an assessment order

An assessment order must state whether the order is a community assessment order or an inpatient assessment order and must include -

• the name of the person to be assessed
• the name, qualification and signature of the person making the order
• the time and date the person was examined
• the time and date the order was made
• whether the order is a community assessment order or an inpatient assessment order
• the designated mental health service which is to be responsible for assessing the person
• the nature and effect of an assessment order
• the duration of the order.

The MHWA 101 form should be used when making an Assessment Order.

Once an assessment order is made

Inpatient assessment order

If an inpatient assessment order is made, the registered medical practitioner or authorised mental health practitioner who makes the order must, as soon as practicable, arrange for the person to be transported to the responsible designated mental health service. Authorised persons may transport the person and have powers under the Act if a person is required to be taken to a designated mental health service.

Informing the person an assessment order has been made

As soon as practicable after the order is made, the registered medical practitioner or authorised mental health practitioner who makes an Assessment order must ensure all reasonable steps are taken to:

• inform the person that they are subject to an Assessment order
• explain the purpose and effect of the Order to the person
• give the person a copy of the Order and a copy of the relevant statement of rights.

The requirements for communicating under the Act must be followed.

Notifying the authorised psychiatrist an assessment order has been made

As soon as practicable after an assessment order is made, the registered medical practitioner or authorised mental health practitioner who makes an assessment order must:

• notify the authorised psychiatrist of the responsible designated mental health service that the Assessment order is made
• give the authorised psychiatrist a copy of the assessment order.

Others to be informed an assessment order has been made

As soon as practicable after being notified that the assessment order has been made, the authorised psychiatrist must ensure all reasonable steps are taken to inform specified associated people that the assessment order has been made and give the people listed below a copy of the order and the statement of rights:

• nominated support person, if they have one
• guardian, if they have one
• carer, if the authorised psychiatrist is satisfied that assessing the person will directly affect the carer and the care relationship
• a parent, if the person is under the age of 16 years.

The requirements for communicating under the Act must be followed.

The authorised psychiatrist must also ensure all reasonable steps are taken to notify the Secretary to the Department of Families, Fairness and Housing if the Secretary has parental responsibility for the person under a relevant child protection order.

For more information on these terms, see Terms and definitions.

Providing treatment during an assessment order

A person subject to an assessment order may only be given treatment for their apparent mental illness if:

• they give informed consent to the treatment (the Act includes specific requirements in relation to informed consent); or
• where the treatment is required as a matter of urgency to prevent serious deterioration in their mental or physical health or serious harm to the person or another person.

A registered medical practitioner employed or engaged by the responsible designated mental health service may authorise the giving of treatment to a person without their informed consent where treatment is urgently required in the above circumstances.

Indications of urgency include circumstances where the person is suffering significant distress or where their physical health or mental health is seriously deteriorating or where a delay in treatment would result in serious harm to the person.

Variation of an assessment order

Variation of setting

The setting of an assessment order can be varied from an inpatient assessment order to a community assessment order, or from a community assessment order to an inpatient order at any time before the person is examined by an authorised psychiatrist.

The variation can be made by a registered medical practitioner or an authorised mental health practitioner. The variation does not need to be made by the same registered medical practitioner or authorised mental health practitioner who made the assessment order.

Variation of an inpatient assessment order to a community assessment order

An inpatient assessment order that is varied to a community assessment order expires at the earlier of the following:

• if the assessment patient had been received at a designated mental health service before variation of the order, 24 hours after the patient was received at the designated mental health service; or
• 24 hours after the variation of the order.

Variation of a community assessment order to an inpatient assessment order

A variation from a community assessment order to an inpatient assessment order may only be made if the registered medical practitioner or authorised mental health practitioner is satisfied that the assessment of the person cannot occur in the community.

Where a community assessment order is varied to an inpatient assessment order, the practitioner who varies the order must, as soon as practicable, arrange for the person to be taken to the designated mental health service.

A community assessment order that is varied to an inpatient assessment order expires 24 hours after the variation is made.

Variation of responsible designated mental health service

At any time before a person is examined by an authorised psychiatrist, a registered medical practitioner or an authorised mental health practitioner may vary an assessment order to specify a different designated mental health service which is to be responsible for assessing the person.

If the varied order is an inpatient assessment order, the practitioner must arrange for the person to be transported to the responsible designated mental health service as soon as practicable.

Information requirements for varied assessment orders

As soon as practicable after the order is made, the registered medical practitioner or authorised mental health practitioner that varies an assessment order must ensure all reasonable steps are taken to:

• inform the person that the assessment order has been varied
• explain the purpose and effect of the variation to the person
• give the person a copy of the varied Order and a copy of the relevant statement of rights.

The requirements for communicating under the Act must be followed.

The registered medical practitioner or authorised mental health practitioner must also ensure the authorised psychiatrist of the responsible designated mental health service is notified of the variation and provided with a copy of the varied order.

The authorised psychiatrist is responsible for notifying associated people of a variation:

• as soon as practicable after the setting of an assessment order is varied; or
• as soon as practicable after a person is received at a designated mental health service after an order is varied to specify a different responsible designated mental health service.

The associated people should be provided with a copy of the varied order and the relevant statement of rights. These associated people are the person’s:

• nominated support person, if they have one
• guardian, if they have one
• carer, if the authorised psychiatrist is satisfied that the variation will directly affect the carer and the care relationship
• a parent, if the person is under the age of 16 years.

The requirements for communicating under the Act must be followed.

The authorised psychiatrist must also ensure all reasonable steps are taken to notify the Secretary to the Department of Families, Fairness and Housing if the Secretary has parental responsibility for the person under a relevant child protection order.

For more information on these terms, see Terms and definitions.

Assessment by the authorised psychiatrist

An authorised psychiatrist must examine a person subject to an assessment order, to determine if the compulsory treatment criteria apply to the person, as soon as practicable after:

• the assessment order is made, for a community assessment order; or
• the person is received at the designated mental health service, for an inpatient assessment order.

Before examining the person, the authorised psychiatrist must identify themselves, inform the person they will be examined under an order and take reasonable steps to explain the purpose of the examination. There are requirements that must be followed when communicating under the Act. If the person requests a copy of the order, the authorised psychiatrist must ensure they receive a copy.

Expiration or Revocation of an Assessment Order

Expiration of an Assessment order

An Inpatient assessment order expires:

• if a person is not received at a designated mental health service within 72 hours of the making of the Inpatient assessment order; or
• 24 hours after the person is received at the designated mental health service, unless the assessment order is extended by the authorised psychiatrist; or
• at the end of the relevant period of extension of the inpatient assessment order if the duration of the assessment order was extended by the authorised psychiatrist.

A Community assessment order expires:

• 24 hours after the assessment order has been made, unless the assessment order is extended by the authorised psychiatrist; and
• at the end of the relevant period of extension of the assessment order.

An assessment order also ends if, after assessing the person subject to the assessment order, the authorised psychiatrist makes a temporary treatment order.

Revocation of an assessment order

An authorised psychiatrist must immediately revoke an assessment order if, after assessing the person subject to the assessment order, the authorised psychiatrist is satisfied that the compulsory treatment criteria do not apply to the person.

As soon as practicable after the assessment order is revoked, the authorised psychiatrist must ensure that reasonable steps are taken to:

• inform the person that they are no longer subject to an assessment order
• explain to the person the reason for the revocation and effect of the revocation of the order
• give written notice of the revocation to the person who was subject to the assessment order. Such notice must include the name, qualification and signature of the authorised psychiatrist who revoked the order and the date and time the order was revoked.

The authorised psychiatrist must also notify the following people as soon as practicable that the order has been revoked and provide them with a copy of the notice of revocation:

• the person’s nominated support person, if they have one
• the person’s guardian, if they have one
• the person’s carer, if the authorised psychiatrist is satisfied that the revocation will directly affect the carer and the care relationship
• the person’s parent, if the person is under the age of 16 years.

The requirements for communicating under the Act must be followed.

The authorised psychiatrist must also ensure all reasonable steps are taken to notify the Secretary to the Department of Families, Fairness and Housing if the Secretary has parental responsibility for the person under a relevant child protection order.

For more information on these terms, see Terms and definitions.

Effect of detention in custody on Assessment Order

An assessment order has no effect while a person is detained in custody.

Detained in custody means a person is held in:

• a prison;
• a remand centre, youth justice centre or youth residential centre;
• a police gaol; or
• immigration detention.

A period of detention in custody does not ‘pause’ the duration of the order. The order will expire at the time it would otherwise have expired had the person not been detained in custody.

Transitional arrangements

An assessment order made under the Mental Health Act 2014 will continue to operate, as though it were an assessment order made under the Mental Health and Wellbeing Act 2022, for the period specified in the order.