Mental Health Forms and Patient s Rights Regulations S R by ramhood17

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									       Mental Health (Forms and Patient's Rights)
                   Regulations 2006
                          S.R. No. 39/2006


                    TABLE OF PROVISIONS
Regulation                                                       Page

 1.     Objective                                                   1
 2.     Authorising provision                                       1
 3.     Principal Regulations                                       2
 4.     Patient's rights                                            2
 5.     New regulation 7A inserted                                  2
        7A.      Treatment plans                                    2
 6.     Schedule 1 amended                                          3
 7.     Schedule 2 amended                                          3
 8.     Schedule 3 amended                                          3
 9.     Schedule 6 amended                                          4
 10.    New Schedule 10 substituted                                 4
        SCHEDULE 10—Statement of Legal Rights and Entitlements
                    and Other Information—Continuing Treatment
                    Involuntary Patient (Section 12A–12D)      4
 11.    New Schedules 12 and 13 inserted                           15
        SCHEDULE 12—Statement of Legal Rights and Entitlements
                    and Other Information—Assessment Orders;
                    Diagnosis, Assessment and Treatment Orders     15

        SCHEDULE 13—Statement of Legal Rights and Entitlements
                    and Other Information—Forensic Patient
                    (Remand and Interim Disposition Orders)        26
 12.    New Schedule 15 substituted                                39
        SCHEDULE 15—Statement of Legal Rights and Entitlements
                    and Other Information—Psychosurgery            39
                         ═══════════════
ENDNOTES                                                           47




                                      i
              STATUTORY RULES 2006


                      S.R. No. 39/2006
                 Mental Health Act 1986

  Mental Health (Forms and Patient's Rights)
              Regulations 2006
The Governor in Council makes the following Regulations:
Dated: 4 April 2006
Responsible Minister:
  BRONWYN PIKE
  Minister for Health

                                                RUTH LEACH
                                 Clerk of the Executive Council
  1. Objective
          The objective of these Regulations is to amend the
          Mental Health Regulations 1998 in relation to
          the—
           (a) prescribed class of persons who may discuss
               treatment plans with a patient; and
           (b) prescribed forms relating to involuntary
               treatment; and
           (c) statements of a patient's rights.
  2. Authorising provision
          These Regulations are made under section 142 of
          the Mental Health Act 1986.




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           3. Principal Regulations
                   In these Regulations, the Mental Health
                   Regulations 19981 are called the Principal
                   Regulations.
           4. Patient's rights
               (1) For the heading to Part 3 of the Principal
                   Regulations substitute—

                           "PART 3—PATIENT'S RIGHTS".

               (2) In regulation 7 of the Principal Regulation, for
                   paragraph (e)(ii) and "be in the form set out in
                   Schedule 11." substitute—
                        "(ii) a person detained in an approved
                              mental health service under section
                              20BJ(1) or 20BM of the Crimes
                              Act 1914 of the Commonwealth—
                        be in the form set out in Schedule 11;
                    (f) in the case of a person subject to an
                        assessment order, or a diagnosis, assessment
                        and treatment order, be in the form set out in
                        Schedule 12;
                    (g) in the case of a forensic patient subject to a
                        remand or interim disposition order, be in the
                        form set out in Schedule 13.".
           5. New regulation 7A inserted
                   After regulation 7 of the Principal Regulations
                   insert—
                  "7A. Treatment plans
                        For the purposes of section 19A(6)(b) of the
                        Act, the prescribed class is those health
                        service providers who are—
                          (a) either—
                                 (i) registered nurses; or


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                       (ii) psychologists registered under
                            section 6 of the Psychologists
                            Registration Act 2000; or
                       (iii) social workers; or
                       (iv) occupational therapists; and
                  (b) employed by a public sector mental
                      health service within the meaning of
                      section 120A of the Act.".
    6. Schedule 1 amended
            In Schedule 1 to the Principal Regulations—
             (a) for "TO THE *ADMITTING
                 REGISTERED MEDICAL
                 PRACTITIONER/" substitute "TO THE
                 *REGISTERED MEDICAL
                 PRACTITIONER EMPLOYED BY AN
                 APPROVED MENTAL HEALTH
                 SERVICE/";
             (b) after "To arrange for a" insert "registered
                 medical practitioner employed by an
                 approved mental health service or a".
    7. Schedule 2 amended
            In Schedule 2 to the Principal Regulations, for
            "TO THE *ADMITTING REGISTERED
            MEDICAL PRACTITIONER/" substitute
            "TO THE *REGISTERED MEDICAL
            PRACTITIONER EMPLOYED BY AN
            APPROVED MENTAL HEALTH
            SERVICE/".
    8. Schedule 3 amended
            In Schedule 3 to the Principal Regulations, in
            Forms 1 and 2, after "under section 12(6)" insert
            ", section 12AA(7)".




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           9. Schedule 6 amended
                   In Schedule 6 to the Principal Regulations—
                    (a) for "To be completed by registered
                        medical practioner/" substitute "To be
                        completed by the registered medical
                        practitioner employed by an approved
                        mental health service/";
                    (b) omit "The abovenamed person has been
                        taken to the approved mental health
                        service.";
                    (c) omit "I have been requested to assess the
                        abovenamed person.";
                    (d) after "FAMILY NAME (BLOCK
                        LETTERS) of *registered medical
                        practitioner" insert "employed by an
                        approved mental health service".
          10. New Schedule 10 substituted
                   For Schedule 10 to the Principal Regulations
                   substitute—

                                       "SCHEDULE 10

                                                              Regulation 7(d)

                        STATEMENT OF LEGAL RIGHTS AND
                    ENTITLEMENTS AND OTHER INFORMATION—
                     CONTINUING TREATMENT INVOLUNTARY
                           PATIENT (SECTION 12A–12D)

                                    Mental Health Act 1986
                                Mental Health Regulations 1998

                   IN SUMMARY
                   When you are a continuing treatment involuntary patient
                   you—
                       • will have a treatment plan and can be involved in
                         planning your treatment;




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                • have a right to obtain a second opinion from a
                  psychiatrist about your treatment;
                • have a right to appeal to the Mental Health Review
                  Board against being a continuing treatment
                  involuntary patient;
                • have a right to obtain legal advice and have a lawyer
                  represent you;
                • can talk to and have a friend or family member
                  represent you;
                • can complain about your treatment.
            You can ask a member of the treating team, a friend, a
            family member, a lawyer, an advocate or a community
            visitor to help you do these things.
            ABOUT THIS STATEMENT
            This statement provides information about being a
            continuing treatment involuntary patient and your legal
            rights and entitlements under the Mental Health Act 1986.
            A member of the treating team will talk to you about this
            information and answer your questions.
            The information must be explained in a language or way
            that you can understand. This statement may be translated
            into other languages. You can ask a member of the treating
            team if it is available in your preferred language. Copies of
            the Mental Health Act 1986 are available at the mental
            health service.
            If at any time you have questions about this information or
            your rights, ask someone to explain. You can ask a member
            of the treating team, a friend, a family member, a lawyer, an
            advocate or a community visitor.
            CONTINUING TREATMENT INVOLUNTARY
            PATIENTS
            You are being detained in the mental health service so you
            can receive treatment for a mental disorder.
            You were first placed on an involuntary treatment order, but
            that order has now been discharged. However, you are still
            being detained because your psychiatrist or the chief
            psychiatrist believes that all of the following criteria for
            continuing treatment apply to you—




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                        • you appear to have a mental disorder;
                        • you would cause serious physical harm to yourself if
                          you are not detained and treated in the mental health
                          service;
                        • treatment can be obtained for your mental disorder
                          in the mental health service.
                    To have decided these things, your psychiatrist or the chief
                    psychiatrist would have talked with you, considered your
                    recent behaviour and may have sought information from
                    members of the treating team, members of your family, your
                    primary carer or a guardian (if you have one).
                    Application for continuing treatment
                    Your psychiatrist or the chief psychiatrist may apply for you
                    to be detained in the mental health service for a period of up
                    to 3 months.
                    The Secretary to the Department of Human Services will
                    arrange for a committee of 3 psychiatrists to make a
                    decision about the application. The chief psychiatrist will
                    be a member of the committee and there will be 2 other
                    independent psychiatrists.
                    Each member of the committee will examine you to decide
                    whether you should continue to be detained and treated or
                    not. The committee must make its decision within 7 days of
                    the application being made; if it does not you will be
                    discharged from being a continuing treatment involuntary
                    patient.
                    If the committee believes that all of the criteria for
                    continuing treatment apply to you, the committee will
                    consent to your continuing detention and treatment for a
                    period of up to 3 months. At the end of that time, your
                    psychiatrist or the chief psychiatrist may apply to have your
                    detention extended for another period of up to 3 months.
                    There is no limit to the number of times an order can be
                    extended.
                    If the committee does not believe that all of the criteria for
                    continuing treatment apply to you, your psychiatrist must
                    discharge you and you will be free to leave. You can then
                    discuss continuing treatment on a voluntary basis with your
                    case manager or psychiatrist.




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            TREATMENT
            Your psychiatrist will prepare a treatment plan that is
            designed to meet your specific needs. You have the right to
            be involved in planning your treatment and the psychiatrist
            will consider your preferences and concerns. However, if
            your psychiatrist believes a particular psychiatric treatment
            is necessary, that treatment can be given to you, even if you
            refuse. If this happens, your psychiatrist will explain why
            the treatment is necessary. Your psychiatrist or another
            member of the treating team will discuss your treatment plan
            with you, and give you a copy.
            Your psychiatrist and other members of the treating team
            will regularly discuss with you your diagnosis, medication,
            methods of treatment, alternative treatments and available
            services. They will review and update your treatment plan
            on a regular basis.
            You may have a friend or advocate with you when you are
            discussing your treatment with your psychiatrist.
            Family members and other caregivers can provide valuable
            support and care to you while you are receiving treatment
            for your illness. Generally, they will only be given
            information about your treatment and care if you agree.
            However, if a guardian, family member or your primary
            carer needs information to care for you, a member of the
            treating team can give them the information, even if you
            don't agree.
            Second opinions
            It is your right to get a second opinion about your
            psychiatric condition and treatment. Your case manager or
            psychiatrist can arrange this from within the mental health
            service, or they can help you choose your own psychiatrist.
            If you choose a private psychiatrist you may have to pay a
            fee. You can discuss the second opinion with your treating
            psychiatrist. However, your treating psychiatrist is
            responsible for making the final decision about the treatment
            you receive.




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                    Access to information
                    It is your right under Freedom of Information (FOI) laws to
                    request access to documents about your personal
                    information that are held by the mental health service.
                    If you wish to access the information, you can ask a member
                    of the treating team or the mental health service's FOI
                    officer to help you make an FOI application.
                    Organisations that may be able to help you with an FOI
                    application are described at the end of this statement.
                    Leave of Absence
                    You may be allowed to leave the mental health service for a
                    short time (for example, a few hours, overnight or a
                    weekend) to visit family or friends or for some other
                    purpose. If you would like to have leave, you should talk to
                    a member of the treating team. Your psychiatrist will make
                    the final decision about a request for leave.
                    Seclusion and Restraint
                    Seclusion
                    Seclusion is when a person is kept alone in a room where
                    the doors and windows are locked from the outside.
                    This only happens if it is necessary to protect the person or
                    others from an immediate or imminent risk to their health or
                    safety or to prevent the person from absconding. It is only
                    used when other ways of ensuring safety have failed.
                    Mechanical Restraint
                    Mechanical restraint is the use of a device, such as a harness
                    or straps, to restrict a person's freedom to move about.
                    Restraint may be used to enable a person to be medically
                    treated, to prevent the person from injuring themselves or
                    others or to prevent the person from continuing to destroy
                    property.
                    Approval and Monitoring of Seclusion and Mechanical
                    Restraint
                    Seclusion and restraint may be approved by your
                    psychiatrist or, in an emergency, authorised by the senior
                    nurse on duty. They can only be used for as long as the
                    above reasons apply.




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            If you are put in a seclusion room or are restrained, staff
            must give you appropriate bedding, clothing, food and drink
            when you want them. They must also provide you with
            adequate toilet arrangements, including the opportunity to
            wash.
            A nurse must review your physical and mental condition at
            least every 15 minutes. A doctor must also examine you at
            least every 4 hours, unless your psychiatrist thinks less
            frequent examinations are appropriate. If you are being
            restrained you must be monitored continuously.
            Letters and telephone calls
            You can contact people by letter or telephone. Your mail
            will not be opened.
            Transfer
            You may be transferred to a different mental health service
            if your psychiatrist believes that you would benefit from the
            transfer or if it is necessary for your treatment. If you do not
            want to be transferred, you should talk to your psychiatrist
            or you can appeal to the Mental Health Review Board.
            If you are transferred before the appeal is heard, the Board
            will decide whether you should be returned to the original
            service when it hears the appeal.
            Discharge from continuing treatment involuntary
            patient status
            If the chief psychiatrist believes that any of the criteria for
            continuing treatment no longer apply to you, you must be
            discharged from being a continuing treatment involuntary
            patient and you will be free to leave. However, if both you
            and your psychiatrist think that you would benefit from
            further treatment at the mental health service, you can ask to
            be allowed to stay in the service on a voluntary basis.
            If at any time you want to be discharged from being a
            continuing treatment involuntary patient, you should talk to
            your psychiatrist or other members of the treating team, or
            you can appeal to the Mental Health Review Board.
            Whether or not you appeal, the Board will automatically
            review you within 2 weeks of the committee consenting to
            you becoming a continuing treatment involuntary patient
            and then at least every 12 months until you are discharged.
            Your psychiatrist will also regularly review you to see if you
            should be discharged.




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                    APPEAL AND REVIEW: THE MENTAL HEALTH
                    REVIEW BOARD
                    This section of the statement contains information about
                    your rights and entitlements to appeal and review by the
                    Mental Health Review Board.
                    The functions of the Board
                    The Mental Health Review Board is an independent tribunal
                    that—
                        • hears appeals from continuing treatment involuntary
                          patients who want to be discharged;
                        • reviews all continuing treatment involuntary patients
                          within 14 days of the committee's consent to
                          continuing involuntary treatment, to decide if they
                          can be discharged;
                        • reviews all continuing treatment involuntary patients
                          at least every 12 months to decide if they can be
                          discharged;
                        • hears appeals from patients who do not want to be
                          transferred to a different mental health service.
                    At each appeal or review, the Board will also review your
                    treatment plan.
                    Appeals to the Board
                    It is your right to appeal to the Mental Health Review Board
                    at any time. If you want to appeal, ask a member of the
                    treating team for an Appeal Form, fill it in and ask the team
                    member to send it to the Board. If no appeal form is
                    available, you can write a letter or email to the Board that
                    sets out your name, the name of the mental health service
                    and what you want to appeal about. The Board must hear
                    your appeal without delay. If you need help to fill in the
                    form or with anything else, you should ask a member of the
                    treating team, a friend, a family member, a lawyer or a
                    community visitor to help you.
                    The Board's contact details
                    To fax, mail or email an appeal to the Board, or to find out
                    further information, use the contact details below—
                    Executive Officer
                    Mental Health Review Board
                    [insert appropriate contact details]



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            Preparing for the Board hearing
            The Board will send you a notice advising the date, time and
            place at which your review or appeal will be heard.
            Your psychiatrist and case manager will also be notified of
            the hearing. It is your right to attend the hearing unless the
            Board decides that this would be bad for your health.
            You are encouraged to attend and present your case.
            You can have someone attend to offer support or speak for
            you, for example, an advocate, a lawyer, a private doctor, a
            friend or a family member. If you are unable to attend the
            hearing, you should tell the Board as soon as possible.
            The Board will also notify the Public Advocate about the
            hearing. The Public Advocate may be able to offer you
            advice and assistance and can be contacted on [insert
            telephone number].
            Before the hearing, read the documents that will be given to
            the Board for your hearing (see below) and think about what
            you are going to say to the Board. You may also want to
            give the Board written information. Your family and friends
            or someone you respect may wish to write letters or come to
            the hearing in support of your appeal or review.
            If you have special needs, such as an interpreter, you should
            discuss these with a member of the treating team or contact
            the Board. The Board will arrange for an interpreter if
            necessary.
            Organisations that may be able to help you with your appeal
            or review are described at the end of this statement.
            Access to documents for the hearing
            You or your representative will be given the opportunity to
            read any documents to be given to the Board for your
            hearing, including your clinical file and your psychiatrist's
            report to the Board, at least 24 hours before the hearing.
            However, your psychiatrist may apply to the Board to
            prevent you from seeing a document or part of a document if
            it is believed that—
                • seeing the document will cause serious harm to your
                  health or the health or safety of another person; or
                • the information in a document was given in
                  confidence; or is personal information about another
                  person.




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                    If an application is made to prevent you seeing a document
                    or part of a document, a member of the treating team will
                    tell you about this and explain the process. The Board will
                    make the final decision whether you see the whole
                    document or part of the document or none of the document.
                    If the Board decides you should not see a document or part
                    of any document, it may allow your representative to see it
                    instead.
                    The Board hearing
                    Hearings will be held at the mental health service.
                    Your hearing will usually be heard by 3 Board
                    members—a lawyer, a psychiatrist and a community
                    member. If the hearing is the annual review of you being a
                    continuing treatment involuntary patient, it may be
                    conducted by one person—a lawyer, a psychiatrist or a
                    community member of the Board.
                    The hearing will be informal and private, unless the Board
                    decides that it is in your best interests or the public interest
                    for the hearing to be open. Your doctor and other members
                    of the treating team will give information to the Board.
                    You and your representative will be able to ask questions
                    and explain your side of the case, for example, why you
                    believe you should not be a continuing treatment
                    involuntary patient.
                    If you are too ill to attend the hearing, the Board may visit
                    you in your ward.
                    The Board's decision on appeal or review of continuing
                    treatment involuntary patient status
                    The Board must decide whether all the criteria for being a
                    continuing treatment involuntary patient still apply to you
                    and whether your continued detention is still necessary.
                    Discharge from continuing treatment involuntary patient
                    status
                    If the Board is satisfied that any of the criteria for being a
                    continuing treatment involuntary patient no longer apply to
                    you and your continued detention is not necessary, you will
                    be discharged. You will be free to leave the mental health
                    service. However, if both you and your psychiatrist think
                    you would benefit from further treatment at the mental
                    health service, you can ask to be allowed to stay on a
                    voluntary basis.




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            Continuation of continuing treatment involuntary patient
            status
            If the Board doesn't discharge you, you will continue to
            receive treatment as a continuing treatment involuntary
            patient.
            The Board will also review your treatment plan to decide
            whether the proper procedures have been followed in
            making the plan, for example, were your wishes taken into
            account and did the psychiatrist consider alternative
            treatments? The Board must be satisfied that the plan can be
            implemented by the mental health service.
            At the end of the hearing, the Board will tell you its decision
            and the reasons for it. You will be given a written copy of
            the decision. If you want written reasons for the decision,
            you must request these in writing from the Board within
            28 days and the Board must provide you with a statement of
            reasons within 14 days of your request. You can appeal
            again to the Board at any time.
            Review of the Board's decision
            If you disagree with the Board's decision you can apply to
            the Victorian Civil and Administrative Tribunal (VCAT) for
            a review of the Board's decision. VCAT is an independent
            tribunal with the power to confirm or overturn the decision
            of the Board.
            Applications must be made in writing within 28 days of
            receiving the Board's decision or, if you requested a
            statement of reasons from the Board, within 28 days of
            receiving that statement, to—
            Victorian Civil and Administrative Tribunal
            [insert appropriate contact details]
            COMPLAINTS
            You should be treated with dignity and respect and be
            protected from abuse when you receive treatment and care
            from the mental health service. If you are unhappy about
            any part of your treatment or care, you can complain.
            A good place to start is with your case manager, primary
            nurse or another member of the treating team, the
            complaints liaison officer or consumer consultant in the
            hospital or the Director of Psychiatry at the mental health
            service.
            You can also complain directly to the Health Services
            Commissioner or to the Chief Psychiatrist.



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                    If you need help with your complaint, you can ask someone
                    you trust to assist you. This might be a member of the
                    treating team, a friend, a family member, a lawyer or a
                    community visitor.
                    IMPORTANT CONTACTS
                    The organisations you can contact for assistance and more
                    information are described below. The service will provide
                    you with their contact details.
                        • The Mental Health Review Board is an
                          independent tribunal that hears appeals from
                          continuing treatment involuntary patients,
                          involuntary patients, hospital order patients and
                          security patients who want to be discharged from
                          their involuntary treatment status. It also
                          automatically reviews these patients.
                        • 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. They also investigate
                          complaints and report on their inquiries and
                          investigations.
                        • The Mental Health Legal Centre is an independent
                          legal service which specialises in mental health legal
                          issues. It may be able to arrange representation for
                          you at Mental Health Review Board hearings or
                          about other legal matters.
                        • Victoria Legal Aid provides free legal advice about
                          a range of issues. It may also provide legal
                          assistance if you cannot afford a private solicitor and
                          may be able to assist with legal representation at
                          Mental Health Review Board hearings.
                        • The Public Advocate assists, advises and advocates
                          for people with serious complaints about mental
                          health and disability services and treatment.
                        • 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.




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                • 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. The Commissioner can help
                  patients access their health information.
                • The Ombudsman investigates complaints about
                  government departments.
            You can also ask your case manager or any member of the
            treating team about other local organisations and support
            groups which may be able to help you.
                             _______________".
   11. New Schedules 12 and 13 inserted
            After Schedule 11 to the Principal Regulations
            insert—

                                 'SCHEDULE 12

                                                        Regulation 7(f)

                 STATEMENT OF LEGAL RIGHTS AND
             ENTITLEMENTS AND OTHER INFORMATION—
            ASSESSMENT ORDERS; DIAGNOSIS, ASSESSMENT
                     AND TREATMENT ORDERS

                             Mental Health Act 1986
                         Mental Health Regulations 1998

            IN SUMMARY
            When you are on an assessment order, or a diagnosis,
            assessment and treatment order, you—
                • will have a treatment plan and can be involved in
                  planning your treatment;
                • have a right to obtain a second opinion from a
                  psychiatrist about your treatment;
                • have a right to appeal to the Mental Health Review
                  Board against being on the order;
                • have a right to obtain legal advice and have a lawyer
                  represent you;




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                        • can talk to and have a friend or family member
                          represent you;
                        • can complain about your treatment.
                    You can ask a member of the treating team, a friend, a
                    family member, a lawyer, an advocate or a community
                    visitor to help you do these things.
                    ABOUT THIS STATEMENT
                    This statement provides information about being on an
                    assessment order or a diagnosis, assessment and treatment
                    order and your legal rights and entitlements under the
                    Mental Health Act 1986.
                    The information must be explained in a language or way
                    that you can understand. This statement may be translated
                    into other languages. You can ask a member of the treating
                    team if it is available in your preferred language. Copies of
                    the Mental Health Act 1986 are available at the mental
                    health service.
                    A member of the treating team will talk to you about this
                    information and answer your questions.
                    If at any time you have questions about this information or
                    your rights, ask someone to explain. You can ask a member
                    of the treating team, a friend, a family member, a lawyer, an
                    advocate or a community visitor.
                    ASSESSMENT ORDERS—DIAGNOSIS,
                    ASSESSMENT AND TREATMENT ORDERS
                    "Assessment orders" and "diagnosis, assessment and
                    treatment orders" are made by a court under the Sentencing
                    Act 1991. If a person with a mental illness is found guilty
                    of an offence, the court may decide that the person should
                    first be assessed and treated in a mental health service under
                    one of these orders before it gives the person a sentence or
                    makes another order.




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            You have been admitted to a mental health service as an
            involuntary patient under the following court order.
            A member of the treating team will tell you which order
            applies to you and will tick the correct box—
                         An assessment order
                         The court ordered that you be assessed in a
                         mental health service for up to 72 hours
                         before being returned to court.
                         A diagnosis, assessment and treatment order
                         The court ordered that you be diagnosed,
                         assessed and treated in a mental health
                         service for up to 3 months before being
                         returned to court.
            The court made the order after deciding that all of the
            following three criteria for assessment and treatment apply
            to you—
                • you appear to be mentally ill and require treatment
                  for your illness;
                • the treatment you need can be obtained in a mental
                  health service;
                • because of your mental illness, you need to be
                  admitted and detained in the mental health service
                  for treatment as an involuntary patient for your
                  health or safety (whether to prevent a deterioration
                  in your physical or mental condition or otherwise) or
                  for the protection of members of the public.
            Once you are admitted on an assessment order or diagnosis,
            assessment and treatment order, you must remain in the
            mental health service and receive treatment for mental
            illness.
            TREATMENT
            Your psychiatrist will prepare a treatment plan that is
            designed to meet your specific needs. You have the right to
            be involved in planning your treatment and the psychiatrist
            will consider your preferences and concerns. However, if
            your psychiatrist believes a particular psychiatric treatment
            is necessary, that treatment can be given to you, even if you
            refuse. If this happens, your psychiatrist will explain why
            the treatment is necessary. Your psychiatrist or another
            member of the treating team will discuss your treatment plan
            with you and give you a copy.



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                    Your psychiatrist and other members of the treating team
                    will regularly discuss with you your diagnosis, medication,
                    methods of treatment, alternative treatments and available
                    services. They will review and update your treatment plan
                    on a regular basis.
                    You may have a friend or advocate with you when you are
                    discussing your treatment with your psychiatrist.
                    Family members and other caregivers can provide valuable
                    support and care to you while you are receiving treatment
                    for your illness. Generally, they will only be given
                    information about your treatment and care if you agree.
                    However, if a guardian, family member or your primary
                    carer needs information to care for you, a member of the
                    treating team can give them the information, even if you
                    don't agree.
                    Second opinions
                    It is your right to get a second opinion about your
                    psychiatric condition and treatment. Your case manager or
                    psychiatrist can arrange this from within the mental health
                    service, or they can help you choose your own psychiatrist.
                    If you choose a private psychiatrist you may have to pay a
                    fee. You can discuss the second opinion with your treating
                    psychiatrist. However, your treating psychiatrist is
                    responsible for making the final decision about the treatment
                    you receive.
                    Access to information
                    It is your right under Freedom of Information (FOI) laws to
                    request access to documents about your personal
                    information that are held by the mental health service.
                    If you wish to access the information, you can ask a member
                    of the treating team or the mental health service's FOI
                    officer to help you make an FOI application.
                    Organisations that may be able to help you with an FOI
                    application are described at the end of this statement.
                    Leave of Absence
                    You may be allowed to leave the mental health service for a
                    short time (for example, a few hours, overnight or a
                    weekend) to visit family or friends or for some other
                    purpose. If you would like to have leave, you should talk to
                    a member of the treating team. Your psychiatrist will make
                    the final decision about a request for leave.




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            Seclusion and Restraint
            Seclusion
            Seclusion is when a person is kept alone in a room where
            the doors and windows are locked from the outside. This
            only happens if it is necessary to protect the person or others
            from an immediate or imminent risk to their health or safety
            or to prevent the person from absconding. It is only used
            when other ways of ensuring safety have failed.
            Mechanical Restraint
            Mechanical restraint is the use of a device, such as a harness
            or straps, to restrict a person's freedom to move about.
            Restraint may be used to enable a person to be medically
            treated, to prevent the person from injuring themselves or
            others or to prevent the person from continuing to destroy
            property.
            Approval and Monitoring of Seclusion and Mechanical
            Restraint
            Seclusion and restraint may be approved by your
            psychiatrist or, in an emergency, authorised by the senior
            nurse on duty. They can only be used for as long as the
            above reasons apply.
            If you are put in a seclusion room or are restrained, staff
            must give you appropriate bedding, clothing, food and drink
            when you want them. They must also provide you with
            adequate toilet arrangements, including the opportunity to
            wash.
            A nurse must review your physical and mental condition at
            least every 15 minutes. A doctor must also examine you at
            least every 4 hours, unless your psychiatrist thinks less
            frequent examinations are appropriate. If you are being
            restrained you must be monitored continuously.
            Letters and telephone calls
            You can contact people by letter or telephone. Your mail
            will not be opened.




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                    Transfer
                    You may be transferred to a different mental health service
                    if your psychiatrist believes that you would benefit from the
                    transfer or if it is necessary for your treatment. If you do not
                    want to be transferred, you should talk to your psychiatrist
                    or you can appeal to the Mental Health Review Board.
                    If you are transferred before the appeal is heard, the Board
                    will decide whether you should be returned to the original
                    service when it hears the appeal.
                    Discharge from involuntary patient status
                    You will be discharged and returned to the court for
                    sentencing or another order at the end of the time specified
                    in the assessment order, or diagnosis, assessment and
                    treatment order.
                    If the chief psychiatrist or the Mental Health Review Board
                    or the court (following an application by your psychiatrist)
                    believes that any of the three criteria for assessment and
                    treatment no longer apply to you and your continued
                    detention as an involuntary patient is no longer necessary,
                    you must be discharged and returned to the court for
                    sentencing or another order. If at any time you want to be
                    discharged from being an involuntary patient, you should
                    talk to your psychiatrist or other members of the treating
                    team, or you can appeal to the Mental Health Review Board.
                    Whether or not you appeal, the Board will automatically
                    review you within 8 weeks of you becoming an involuntary
                    patient and then at least every 12 months if you continue as
                    an involuntary patient. Your psychiatrist will also regularly
                    review you to see if you should be discharged.
                    APPEAL AND REVIEW: THE MENTAL HEALTH
                    REVIEW BOARD
                    This section of the statement contains information about
                    your rights and entitlements to appeal and review by the
                    Mental Health Review Board.
                    The Functions of the Board
                    The Mental Health Review Board is an independent tribunal
                    that—
                        • hears appeals from involuntary patients who want to
                          be discharged;
                        • reviews all involuntary patients within 8 weeks of
                          being placed on an order to decide if they can be
                          discharged;



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                • reviews all involuntary patients at least every
                  12 months to decide if they can be discharged;
                • hears appeals from patients who do not want to be
                  transferred to a different mental health service.
            At each appeal or review, the Board will also review your
            treatment plan.
            Appeals to the Board
            It is your right to appeal to the Mental Health Review Board
            at any time. If you want to appeal, ask a member of the
            treating team for an Appeal Form, fill it in and ask the team
            member to send it to the Board. If no appeal form is
            available, you can write a letter or email to the Board that
            sets out your name, the name of the mental health service
            and what you want to appeal about. The Board must hear
            your appeal without delay. If you need help to fill in the
            form or with anything else, you should ask a member of the
            treating team, a friend, a family member, a lawyer or a
            community visitor to help you.
            The Board's contact details
            To fax, mail or email an appeal to the Board, or to find out
            further information, use the contact details below—
            Executive Officer
            Mental Health Review Board
            [insert appropriate contact details]
            Preparing for the Board hearing
            The Board will send you a notice advising the date, time and
            place at which your review or appeal will be heard.
            Your psychiatrist and case manager will also be notified of
            the hearing. It is your right to attend the hearing unless the
            Board decides that this would be bad for your health.
            You are encouraged to attend and present your case.
            You can have someone attend to offer support or speak for
            you, for example, an advocate, a lawyer, a private doctor, a
            friend or a family member. If you are unable to attend the
            hearing, you should tell the Board as soon as possible.




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                    Before the hearing, read the documents that will be given to
                    the Board for your hearing (see below) and think about what
                    you are going to say to the Board. You may also want to
                    give the Board written information. Your family and friends
                    or someone you respect may wish to write letters or come to
                    the hearing in support of your appeal or review.
                    If you have special needs, such as an interpreter, you should
                    discuss these with a member of the treating team or contact
                    the Board. The Board will arrange for an interpreter if
                    necessary.
                    Organisations that may be able to help you with your appeal
                    or review are described at the end of this statement.
                    Access to documents for the hearing
                    You or your representative will be given the opportunity to
                    read any documents to be given to the Board for your
                    hearing, including your clinical file and your psychiatrist's
                    report to the Board, at least 24 hours before the hearing.
                    However, your psychiatrist may apply to the Board to
                    prevent you from seeing a document or part of a document if
                    it is believed that—
                        • seeing the document will cause serious harm to your
                          health or the health or safety of another person; or
                        • the information in a document was given in
                          confidence; or is personal information about another
                          person.
                    If an application is made to prevent you seeing a document
                    or part of a document a member of the treating team will tell
                    you about this and explain the process. The Board will
                    make the final decision whether you see the whole
                    document or part of the document or none of the document.
                    If the Board decides you should not see a document or part
                    of any document, it may allow your representative to see it
                    instead.
                    The Board hearing
                    Hearings will be held at the mental health service.
                    Your hearing will usually be heard by 3 Board members—
                    a lawyer, a psychiatrist and a community member. If the
                    hearing is the annual review of you being an involuntary
                    patient, it may be conducted by one person—a lawyer, a
                    psychiatrist or a community member of the Board.




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            The hearing will be informal and private, unless the Board
            decides that it is in your best interests or the public interest
            for the hearing to be open. Your doctor and other members
            of the treating team will give information to the Board. You
            and your representative will be able to ask questions and
            explain your side of the case, for example, why you believe
            you should not be on an involuntary treatment order.
            If you are too ill to attend the hearing, the Board may visit
            you in your ward.
            The Board's decision on appeal or review of involuntary
            status
            The Board must decide whether all the 3 criteria for
            assessment and treatment still apply to you and whether
            your continued detention in the mental health service as an
            involuntary patient is still necessary.
            Discharge from involuntary status
            If the Board decides that your continued detention is not
            necessary, the Board must discharge you from your order
            and you will be returned to the court to receive a sentence or
            other order.
            Continuation of involuntary status
            If the Board decides that your continued detention is
            necessary, the Board will confirm your order and you must
            stay at the mental health service.
            The Board will also review your treatment plan to decide
            whether the proper procedures have been followed in
            making the plan, for example, were your wishes taken into
            account and did the psychiatrist consider alternative
            treatments? The Board must be satisfied that the plan can be
            implemented by the mental health service.
            At the end of the hearing, the Board will tell you its decision
            and the reasons for it. You will be given a written copy of
            the decision. If you want written reasons for the decision,
            you must request these in writing from the Board within
            28 days and the Board must provide you with a statement of
            reasons within 14 days of your request. You can appeal
            again to the Board at any time.




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                    Review of the Board's decision
                    If you disagree with the Board's decision you can apply to
                    the Victorian Civil and Administrative Tribunal (VCAT) for
                    a review of the Board's decision. VCAT is an independent
                    tribunal with the power to confirm or overturn the decision
                    of the Board.
                    Applications must be made in writing within 28 days of
                    receiving the Board's decision or, if you requested a
                    statement of reasons from the Board, within 28 days of
                    receiving that statement, to—
                    Victorian Civil and Administrative Tribunal
                    [insert appropriate contact details]
                    COMPLAINTS
                    You should be treated with dignity and respect and be
                    protected from abuse when you receive treatment and care
                    from the mental health service. If you are unhappy about
                    any part of your treatment or care, you can complain.
                    A good place to start is with your case manager, primary
                    nurse or another member of the treating team, the
                    complaints liaison officer or consumer consultant in the
                    hospital or the Director of Psychiatry at the mental health
                    service.
                    You can also complain directly to the Health Services
                    Commissioner or to the Chief Psychiatrist.
                    If you need help with your complaint, you can ask someone
                    you trust to assist you. This might be a member of the
                    treating team, a friend, a family member, a lawyer or a
                    community visitor.
                    IMPORTANT CONTACTS
                    The organisations you can contact for assistance and more
                    information are described below. The service will provide
                    you with their contact details.
                        • The Mental Health Review Board is an
                          independent tribunal that hears appeals from
                          involuntary patients, hospital order patients and
                          security patients who want to be discharged from
                          their involuntary treatment status. It also
                          automatically reviews these patients.




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               • 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. They also investigate
                 complaints and report on their inquiries and
                 investigations.
               • The Mental Health Legal Centre is an independent
                 legal service which specialises in mental health legal
                 issues. It may be able to arrange representation for
                 you at Mental Health Review Board hearings or
                 about other legal matters.
               • Victoria Legal Aid provides free legal advice about
                 a range of issues. It may also provide legal
                 assistance if you cannot afford a private solicitor and
                 may be able to assist with legal representation at
                 Mental Health Review Board hearings.
               • The Public Advocate assists, advises and advocates
                 for people with serious complaints about mental
                 health and disability services and treatment.
               • 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.
               • 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. The Commissioner can help
                 patients access their health information.
               • The Ombudsman investigates complaints about
                 government departments.
               You can also ask your case manager or any member of
               the treating team about other local organisations and
               support groups which may be able to help you.
                                _______________




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                                          SCHEDULE 13

                                                                 Regulation 7(g)

                         STATEMENT OF LEGAL RIGHTS AND
                     ENTITLEMENTS AND OTHER INFORMATION—
                      FORENSIC PATIENT (REMAND AND INTERIM
                               DISPOSITION ORDERS)

                                     Mental Health Act 1986
                                  Mental Health Regulations 1998

                    IN SUMMARY
                    When you are a forensic patient you—
                        • will have a treatment plan and can be involved in
                          planning your treatment;
                        • have a right to obtain a second opinion from a
                          psychiatrist about your treatment;
                        • have a right to obtain legal advice and have a lawyer
                          represent you;
                        • can talk to and have a friend or family member
                          represent you;
                        • can complain about your treatment.
                    You can ask a member of the treating team, a friend, a
                    family member, a lawyer, an advocate or a community
                    visitor to help you do these things.
                    ABOUT THIS STATEMENT
                    This statement provides information about being a forensic
                    patient on a remand order or an interim disposition order,
                    and your legal rights and entitlements under the Mental
                    Health Act 1986.
                    The statement also provides information about rights and
                    entitlements some forensic patients have under the Crimes
                    (Mental Impairment and Unfitness to be Tried) Act
                    1997.
                    A member of the treating team will talk to you about this
                    information and answer your questions.




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            The information must be explained in a language or way
            that you can understand. This statement may be translated
            into other languages. You can ask a member of the treating
            team if it is available in your preferred language.
            Copies of the Mental Health Act 1986 and the Crimes
            (Mental Impairment and Unfitness to be Tried) Act 1997
            are available at the mental health service.
            If at any time you have questions about this information or
            your rights, ask someone to explain. You can ask a member
            of the treating team, a friend, a family member, a lawyer, an
            advocate or a community visitor.
            FORENSIC PATIENTS
            You have been admitted to a mental health service as a
            forensic patient so you can receive treatment for a mental
            disorder.
            There are several ways you may have been admitted as a
            forensic patient. A member of the treating team will tell you
            which of the following applies to you and tick the correct
            box—
                         A remand order
                         A court has remanded you in custody, for the
                         time specified in the order, to await further
                         court proceedings.
                         An interim disposition order made by the
                         Magistrates' Court
                         The Magistrates' Court placed you on an
                         interim disposition order because you left a
                         mental health facility in another state without
                         permission or you did not comply with a
                         supervision order in another state, and you
                         came to Victoria.
                         An interim disposition order made by the
                         Victorian Minister
                         You were transferred to Victoria and placed
                         on an interim disposition order by the
                         Victorian Minister.




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                    TREATMENT
                    Your psychiatrist will prepare a treatment plan that is
                    designed to meet your specific needs. You have the right to
                    be involved in planning your treatment and the psychiatrist
                    will consider your preferences and concerns. However, if
                    your psychiatrist believes a particular psychiatric treatment
                    is necessary, that treatment can be given to you, even if you
                    refuse. If this happens, your psychiatrist will explain why
                    the treatment is necessary. Your psychiatrist or another
                    member of the treating team will discuss your treatment plan
                    with you and give you a copy.
                    Your psychiatrist and other members of the treating team
                    will regularly discuss with you your diagnosis, medication,
                    methods of treatment, alternative treatments and available
                    services. They will review and update your treatment plan
                    on a regular basis.
                    You can have a friend or advocate with you when you are
                    discussing your treatment with your psychiatrist.
                    Family members and other caregivers can provide valuable
                    support and care to you while you are receiving treatment
                    for your illness. Generally, they will only be given
                    information about your treatment and care if you agree.
                    However, if a guardian, family member or your primary
                    carer needs information to care for you, a member of the
                    treating team can give them the information, even if you
                    don't agree.
                    Second opinions
                    It is your right to get a second opinion about your
                    psychiatric condition and treatment. Your case coordinator
                    or psychiatrist can arrange this from within the mental
                    health service, or they can help you choose your own
                    psychiatrist. If you choose a private psychiatrist you may
                    have to pay a fee. You can discuss the second opinion with
                    your treating psychiatrist. However, your treating
                    psychiatrist is responsible for making the final decision
                    about the treatment you receive.




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            Access to information
            It is your right under Freedom of Information (FOI) laws to
            request access to documents about your personal
            information that are held by the mental health service.
            If you wish to access the information, you can ask a member
            of the treating team or the mental health service's FOI
            officer to help you make an FOI application.
            Organisations that may be able to help you with an FOI
            application are described at the end of this statement.
            Seclusion and Restraint
            Seclusion
            Seclusion is when a person is kept alone in a room where
            the doors and windows are locked from the outside.
            This only happens if it is necessary to protect the person or
            others from an immediate or imminent risk to their health or
            safety or to prevent the person from absconding. It is only
            used when other ways of ensuring safety have failed.
            Mechanical Restraint
            Mechanical restraint is the use of a device, such as a harness
            or straps, to restrict a person's freedom to move about.
            Restraint may be used to enable a person to be medically
            treated, to prevent the person from injuring themselves or
            others or to prevent the person from continuing to destroy
            property.
            Approval and Monitoring of Seclusion and Mechanical
            Restraint
            Seclusion and restraint may be approved by your
            psychiatrist or, in an emergency, authorised by the senior
            nurse on duty. They can only be used for as long as the
            above reasons apply.
            If you are put in a seclusion room or are restrained, staff
            must give you appropriate bedding, clothing, food and drink
            when you want them. They must also provide you with
            adequate toilet arrangements, including the opportunity to
            wash.
            A nurse must review your physical and mental condition at
            least every 15 minutes. A doctor must also examine you at
            least every 4 hours, unless your psychiatrist thinks less
            frequent examinations are appropriate. If you are being
            restrained you must be monitored continuously.




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                    Security Conditions
                    While you are in the mental health service, your psychiatrist
                    may apply any security conditions that are considered
                    necessary, for example limiting your phone calls or opening
                    your mail. Security conditions are applied to ensure your
                    health or safety, or for the protection of members of the
                    public.
                    Letters and telephone calls
                    You can contact people by letter or telephone, unless your
                    psychiatrist has applied a security condition to you.
                    Transfer
                    You may be transferred to a different mental health service
                    if the chief psychiatrist believes that you would benefit from
                    the transfer or if it is necessary for your treatment. If you do
                    not want to be transferred, you should talk to your
                    psychiatrist or you can appeal to the Forensic Leave Panel
                    (see below).
                    LEAVE
                    Leave of absence allows forensic patients on interim
                    disposition orders to leave the mental health service for a
                    variety of purposes. Leave is always subject to security
                    conditions and time limits.
                    There are three types of short-term leave available to
                    forensic patients on interim disposition orders: special leave
                    of absence, on-ground leave and limited off-ground leave.
                    Special leave
                    Your psychiatrist can grant special leave of absence.
                    Special leave of absence is for specific purposes, such as
                    medical treatment, court appearances, or special events
                    (such as funerals). Special leave cannot exceed 24 hours, or
                    seven days in the case of medical treatment.
                    You or someone on your behalf can apply to your
                    psychiatrist stating the special circumstances for which you
                    need special leave. If your psychiatrist is satisfied there are
                    special circumstances and the safety of members of the
                    public will not be seriously endangered, the special leave
                    must be granted. If your psychiatrist refuses to grant you
                    special leave, you can appeal to the Forensic Leave Panel.




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            On-ground leave and limited off-ground leave
            To obtain on-ground leave or limited off-ground leave, you
            must make an application to the Forensic Leave Panel.
            On-ground leave allows forensic patients on interim
            disposition orders to leave the mental health service, but the
            leave is limited to a defined area around the mental health
            service known as the surrounds.
            Limited off-ground leave allows forensic patients on interim
            disposition orders to go beyond the surrounds of the mental
            health service. Generally, limited off-ground leave is only
            permitted during the day between the hours of 6.00 a.m.
            and 9.00 p.m. It can be granted outside these hours, but
            only for a maximum of three days in any seven-day period.
            Leave can be granted for a period of up to six months.
            At the end of this time, an application can be made to the
            Forensic Leave Panel to have the leave renewed.
            The purpose of on-ground leave and limited off-ground
            leave is to help with the treatment and rehabilitation of
            forensic patients.
            Forensic Leave Panel
            The Forensic Leave Panel is an independent tribunal that
            hears—
                • applications for on-ground and limited off-ground
                  leave from forensic patients;
                • appeals from forensic patients who have been
                  refused special leave of absence by their
                  psychiatrist;
                • appeals from forensic patients who do not want to be
                  transferred to a different mental health service.
            Applications to the Forensic Leave Panel
            If you would like on-ground leave or limited off-ground
            leave, you should talk to the treating team. They will be
            able to give you advice and discuss your choices. If your
            treating team believes you are ready for leave, they will
            update your treatment plan and prepare a leave plan. It is
            important the treating team is involved because the Forensic
            Leave Panel will want to know whether they support your
            application and how it relates to your treatment plan and
            your leave plan.




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                    To apply for on-ground leave or limited off-ground leave or
                    to appeal against the refusal of special leave or against a
                    transfer, ask a member of your treating team for the correct
                    form, fill it in and ask the team member to send it to the
                    Panel. If no forms are available, you can write a letter to the
                    Panel setting out your name, the name of the mental health
                    service and the type of leave you want. The application or
                    letter should be mailed or faxed to—
                    Executive Officer
                    Forensic Leave Panel
                    [insert appropriate contact details]
                    If you need help to fill in the form or help with anything
                    else, you should ask a member of the treating team, a friend,
                    a family member, a lawyer or a community visitor to help
                    you.
                    Preparing for the Panel hearing
                    The Panel will arrange for you to be given a notice advising
                    the date, time and place at which your application or appeal
                    will be heard. It is your right to attend the hearing and
                    present your case, and you are encouraged to do so. You
                    can have someone attend to offer support or speak for you,
                    for example, an advocate, a lawyer, a friend or a family
                    member. If you are unable to attend the hearing, you should
                    tell the Panel as soon as possible.
                    Before the hearing, read the documents that will be given to
                    the Panel for the hearing (see below) and think about what
                    you are going to say to the Panel. You might also want to
                    give the Panel written information. Your family and friends
                    or someone you respect might wish to write letters or come
                    to the hearing in support of your application.
                    If you have special needs, such as the need for an
                    interpreter, you should discuss these with a member of the
                    treating team or contact the Panel. The Panel will arrange
                    for an interpreter if necessary.
                    Organisations that might be able to help you with your
                    application or appeal are described at the end of this
                    statement.




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            Access to documents for the hearing
            You or your representative will be given the opportunity to
            read any documents to be given to the Panel for your
            hearing at least 24 hours before the hearing. These will
            include your clinical file, your psychiatrist's report, a profile
            about you and your leave plan. However, an application can
            be made to the Panel to prevent you from seeing a document
            or part of a document if it is believed that—
                • seeing the document will cause serious harm to your
                  health or the health or safety of another person; or
                • the information in a document was given in
                  confidence; or is personal information about another
                  person.
            If an application is made to prevent you seeing a document
            or part of a document, a member of the treating team will
            tell you about this and explain the process. The Panel will
            make the final decision about whether you see the whole
            document or part of the document or none of the document.
            If the Panel decides you should not see a document or part
            of any document, it might allow your representative to see it
            instead.
            The Panel hearing
            Your hearing will be held at the mental health service.
            The Panel members are a judge, a community member, the
            chief psychiatrist and a medical practitioner.
            The hearing will be informal and private, unless the Panel
            decides it is in your best interests or the public interest for
            the hearing to be open. The Panel is not bound by strict
            rules of practice, such as those in a court, and can inform
            itself in any way it thinks fit. Your psychiatrist and other
            members of the treating team will give information to the
            Panel. You and your representative will be able to ask
            questions and explain your side of the case; for example,
            why you believe you should be given leave of absence.
            The Panel's reasons for the decision
            Approval of leave
            If the Panel is satisfied the proposed leave will help your
            rehabilitation and your safety or the safety of members of
            the public will not be seriously endangered, it might grant
            your leave. It will place conditions on the leave; for
            example, that members of staff escort you at all times.
            You and your representative will be given a copy of the



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                    order, which will list the type of leave granted and the
                    conditions of the leave.
                    Leave can be granted for a period of up to six months.
                    At the end of this time, you can apply to the Panel to have
                    the leave renewed. You can also apply at any time to have
                    the conditions of the leave varied if your circumstances have
                    significantly changed, for example, if a new rehabilitation
                    program has become available.
                    Refusal of leave
                    If the Panel refuses your application for leave, you should
                    talk to your case coordinator or another member of the
                    treating team and discuss the reasons. They might be able to
                    help you make another application that is more likely to be
                    granted. While you remain a forensic patient you can apply
                    for leave to the Panel at any time. Your psychiatrist and
                    other members of the treating team will also regularly
                    review your progress to see whether to make a new
                    application for leave.
                    Special leave
                    If you have appealed to the Panel because your psychiatrist
                    has refused you special leave, the Panel might grant the
                    special leave if it believes there are special circumstances
                    and the safety of members of the public will not be seriously
                    endangered.
                    Transfer
                    If you have appealed to the Panel against a transfer to
                    another mental health service, the Panel will decide whether
                    you should be transferred or not. If you are transferred
                    before the appeal is heard, the Panel will decide whether you
                    should be returned to the original service when it hears the
                    appeal.
                    Reasons for the decision
                    At the end of the hearing, the Panel will tell you its decision
                    and the reasons for it. You will be given a written copy of
                    the order. If you want written reasons for the Panel's
                    decision, you must request them in writing from the Panel.
                    The Panel must provide you with a statement of reasons
                    within 14 days of your request.




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            Suspension of leave
            If at any time the chief psychiatrist believes your safety or
            the safety of members of the public will be seriously
            endangered, your leave or part of your leave can be
            suspended. You will be told if your leave is suspended.
            If you are not already in the mental health service, you must
            return there. You will be given written notification of the
            suspension from the chief psychiatrist. If you do not return,
            police or other prescribed people can apprehend you at any
            time.
            Extended leave
            Extended leave allows forensic patients on custodial
            supervision orders to leave the mental health service and
            live in the community for periods of up to 12 months.
            Some forensic patients on interim disposition orders made
            by the Minister might also be granted extended leave by the
            Minister. The Minister will apply conditions to the
            extended leave; for example the place where you will live,
            and where and how often you should receive treatment.
            A grant of extended leave is one of the orders a court can
            make if it converts your interim disposition order to a
            custodial supervision order (see "Ending the Order" below).
            For more information about extended leave, you can ask a
            member of the treating team for a copy of the statement of
            rights for forensic patients on custodial supervision orders.
            ENDING THE ORDER
            Remand orders and interim disposition orders are generally
            only intended to last for short periods of time. This section
            of the statement explains how these orders finish and has
            information about your rights and entitlements under the
            Crimes (Mental Impairment and Unfitness to be Tried)
            Act 1997.
            Remand orders
            If you are on a remand order, you will be returned to the
            court at the end of the time specified in the court order.




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                    Interim disposition order made by the Magistrates'
                    Court
                    If you are on an interim disposition order made by the
                    Magistrates' Court, the Secretary to the Department of
                    Human Services must apply to the Supreme Court for a
                    review of that order within 7 days after the order is made.
                    At the review, the court may—
                        • make a custodial supervision order. You must
                          then remain in the mental health service as a forensic
                          patient. If this happens, you will be given a new
                          statement explaining your rights and entitlements as
                          a forensic patient. The court might also grant you
                          extended leave if it is satisfied that granting you
                          leave will not seriously endanger your safety or the
                          safety of members of the public;
                        • make a non-custodial supervision order. You will
                          be able to live in the community subject to
                          conditions decided by the court;
                        • order you to be taken back to the state you came
                          from;
                        • release you unconditionally to live in the
                          community.
                    It is your right to attend any court hearing and to have a
                    lawyer represent you. Organisations that might be able to
                    give you advice and help with legal representation are
                    described at the end of this statement.
                    Interim disposition order made by the Victorian
                    Minister
                    If you are on an interim disposition order made by the
                    Victorian Minister, the Secretary to the Department of
                    Human Services must apply to the Supreme Court for a
                    review of that order within 6 months after your transfer.
                    At the review, the court may—
                        • make a custodial supervision order. You must
                          then remain in the mental health service as a forensic
                          patient. If this happens, you will be given a new
                          statement explaining your rights and entitlements as
                          a forensic patient. The court might also grant you
                          extended leave if it is satisfied that granting you
                          leave will not seriously endanger your safety or the
                          safety of members of the public;



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                • make a non-custodial supervision order. You will
                  be able to live in the community subject to
                  conditions decided by the court;
                • release you unconditionally to live in the
                  community.
            COMPLAINTS
            You should be treated with dignity and respect and be
            protected from abuse when you receive treatment and care
            from the mental health service. If you are unhappy about
            any part of your treatment or care, you have a right to
            complain. A good place to start is with your case
            coordinator, primary nurse or another member of the
            treating team, the complaints liaison officer or consumer
            consultant in the hospital or the Clinical Director of the
            mental health service.
            You can also complain directly to the Health Services
            Commissioner or to the Chief Psychiatrist.
            If you need help with your complaint, you can ask someone
            you trust to assist you. This might be a member of the
            treating team, a friend, a family member, a lawyer or a
            community visitor.
            IMPORTANT CONTACTS
            The organisations you can contact for assistance and more
            information are described below. The service will provide
            you with their contact details.
                • The Forensic Leave Panel is an independent Panel.
                  Its main function is to hear applications for leave of
                  absence by forensic patients.
                • 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. They also investigate
                  complaints and report on their inquiries and
                  investigations.




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                        • The Mental Health Legal Centre is an independent
                          legal service which specialises in mental health legal
                          issues. It may be able to arrange representation for
                          you at Forensic Leave Panel or Court hearings or
                          about other legal matters.
                        • Victoria Legal Aid provides free legal advice about
                          a range of issues. It may also provide legal
                          assistance if you cannot afford a private solicitor and
                          may be able to assist with legal representation at
                          Forensic Leave Panel or Court hearings.
                        • The Public Advocate assists, advises and advocates
                          for people with serious complaints about mental
                          health and disability services and treatment.
                        • 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.
                        • 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. The Commissioner can help
                          patients access their health information.
                        • The Ombudsman investigates complaints about
                          government departments.
                    You can also ask your case coordinator or any member of
                    the treating team about other local organisations and support
                    groups which may be able to help you.
                                         _______________'.




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   12. New Schedule 15 substituted
            For Schedule 15 to the Principal Regulations
            substitute—

                                 "SCHEDULE 15

                                                          Regulation 8(b)

                 STATEMENT OF LEGAL RIGHTS AND
             ENTITLEMENTS AND OTHER INFORMATION—
                        PSYCHOSURGERY

                             Mental Health Act 1986

                         Mental Health Regulations 1998

            IN SUMMARY
            If your psychiatrist or neurosurgeon recommends that you
            have psychosurgery you—
              •   will be provided with information about
                  psychosurgery and can ask questions about it;
              •   have a right to refuse psychosurgery;
              •   have a right to obtain medical and legal advice;
              •   have a right to obtain a second opinion from a
                  psychiatrist about psychosurgery;
              •   have a right to have a friend, family member or
                  lawyer represent you;
              •   have a right to withdraw your consent at any time
                  before psychosurgery is performed;
              •   can complain about your treatment.
            You can ask a member of the treating team, a friend, a
            family member, a lawyer, an advocate or a community
            visitor to help you do these things.
            ABOUT THIS STATEMENT
            This statement has been given to you because your
            psychiatrist has recommended that you would benefit from
            psychosurgery. It provides information about the treatment
            and your legal rights and entitlements under the Mental
            Health Act 1986.



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                    Copies of the Mental Health Act 1986 are available at the
                    mental health service.
                    Your psychiatrist or a member of the treating team will talk
                    to you about this information and your rights and
                    entitlements and answer your questions.
                    This information must be explained in a language or way
                    that you can understand. This statement may be translated
                    into other languages. You can ask a member of your
                    treating team if it is available in your preferred language.
                    If at any time you have questions about this information or
                    your rights, ask someone to explain. You can ask a member
                    of the treating team, a friend, a family member, a lawyer, an
                    advocate or a community visitor.
                    You can also get information from the Psychosurgery
                    Review Board at—
                    [insert appropriate contact details]
                    PSYCHOSURGERY: YOUR RIGHTS AND
                    ENTITLEMENTS
                    Psychosurgery is an operation on the brain and may be used
                    to treat people with severe mental disorders that have not
                    responded to other treatments. Examples of the disorders
                    are major depression, obsessive-compulsive disorder and
                    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 or neurosurgeon will talk to you about
                    psychosurgery and explain how it works and how it can help
                    your illness. The psychiatrist or neurosurgeon will discuss
                    possible side effects and alternative treatments, ask your
                    views and answer any questions you might have.
                    When you are discussing psychosurgery with your
                    psychiatrist or neurosurgeon, you can have a friend, a family
                    member, a lawyer or an advocate with you for support. It is
                    your right to have that person represent you before you
                    consent to psychosurgery.



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            Advice and second opinions
            It is your right to get legal and medical advice. It is also
            your right to get a second opinion about whether you need
            psychosurgery. Your case manager or psychiatrist can
            arrange this from within the mental health service or they
            can help you choose your own psychiatrist. If you choose a
            private psychiatrist you may have to pay a fee.
            Consenting to psychosurgery
            You will only be considered for psychosurgery if you can
            give informed consent to the treatment.
            You have the right to refuse psychosurgery.
            Informed consent
            Informed consent is when you agree to have psychosurgery
            after you have been told—
              •   what psychosurgery involves; and
              •   the benefits, discomforts and risks of psychosurgery;
                  and
              •   any beneficial alternative treatments; and
              •   the answers to any questions you have about
                  psychosurgery and you have understood the answers;
                  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, family member, lawyer or an
            advocate, or one of the organisations described at the end of
            this statement.
            If you agree to have psychosurgery, you will be asked to
            sign a form to say you have given informed consent.
            Your psychiatrist will then apply to the Psychosurgery
            Review Board to obtain its consent. The Psychosurgery
            Review Board will make the final decision.




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                    Withdrawing consent to psychosurgery
                    If you agree to have psychosurgery, but then change your
                    mind, it is your right to withdraw your consent at any time
                    and the psychosurgery will not proceed. If you want to
                    withdraw your consent, you should talk to your psychiatrist
                    or neurosurgeon. Remember that you can have a friend, a
                    family member, a lawyer or an advocate with you for
                    support or to represent you.
                    PSYCHOSURGERY REVIEW BOARD
                    The Psychosurgery Review Board is an independent tribunal
                    that decides 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.
                    Preparing for the hearing
                    The Psychosurgery Review Board will send you a notice
                    advising the date, time and place of the hearing, at least
                    10 days before the hearing. Your advocate or representative
                    (if you have one) and your primary carer will also be
                    notified.
                    It is your right to attend the hearing and present your case,
                    and you are encouraged to do so. It is also your right to
                    have a friend, a family member, a lawyer or an advocate
                    represent you at the hearing.
                    If you are unable to attend the hearing, you should tell the
                    Board as soon as possible.
                    You or your representative will be given copies of the
                    application and all supporting documents before the hearing.
                    You should read the documents and think about what you
                    are going to say to the Board. You may also want to give
                    the Board written information. Your family and friends or
                    someone you respect may wish to write letters or come to
                    the hearing in support of the application.




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            If you have special needs, such as an interpreter, you should
            discuss these with a member of the treating team or contact
            the Board. The Board will arrange an interpreter if
            necessary.
            Organisations that may be able to help you with the
            application are described at the end of this statement.
            The Board hearing
            The hearing will be held by either 4 or 5 Board members—
            a lawyer, 1 or 2 psychiatrists, a neurosurgeon and a nominee
            of the Victorian Council for Civil Liberties.
            The hearing will be informal and private, unless the Board
            decides that it is in your best interest or in the public interest
            for the hearing to be open.
            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
            information. The neurosurgeon may be present if it is
            considered necessary by the Board.
            The Board's decision
            When the Psychosurgery Review Board has heard the
            evidence, it will make its decision.
            The Board must decide whether—
              •   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, service or clinic where the proposed
                  psychosurgery would be performed is an appropriate
                  place;
              •   all other reasonable treatments have already been tried
                  without sufficient and lasting benefit.




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                    The Board consents to psychosurgery
                    If the Board is satisfied about the above matters, it will
                    consent to you having psychosurgery and will specify—
                      •   the name of the neurosurgeon authorised to perform
                          the psychosurgery;
                      •   the nature of the psychosurgery to be performed;
                      •   the hospital, service or clinic where the psychosurgery
                          is to be performed;
                      •   the time within which the psychosurgery is to be
                          performed.
                    You and your representative will be given a written copy of
                    the Board's consent.
                    The Board refuses consent to psychosurgery
                    If the Board is not satisfied about the above matters, it must
                    refuse to give its consent and you cannot have
                    psychosurgery.
                    You will be advised of the refusal and the reasons in
                    writing.
                    Reports about the psychosurgery
                    If you have psychosurgery, your neurosurgeon must provide
                    a report about the treatment to the Board within 3 months.
                    Your psychiatrist must also provide reports on your progress
                    within 3 months after the treatment and then within
                    12 months.
                    The Board will continue to review your progress on a
                    regular basis, unless you object to this regular review.
                    If you do not want the Board to review your progress, you
                    should discuss this with a member of the treating team or
                    contact the Board.
                    COMPLAINTS
                    You should be treated with dignity and respect and be
                    protected from abuse when you receive treatment and care
                    from the mental health service. If you are unhappy about
                    any part of your treatment or care, you can complain.
                    A good place to start is with your case manager, primary
                    nurse or another member of the treating team, the
                    complaints liaison officer or consumer consultant in the
                    hospital, or the Director of Psychiatry at the mental health
                    service.




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            You can also complain directly to the Health Services
            Commissioner or to the Chief Psychiatrist.
            If you need help with your complaint, you can ask someone
            you trust to assist you. This might be a member of the
            treating team, a friend, a family member, a lawyer or a
            community visitor.
            IMPORTANT CONTACTS
            The organisations you can contact for assistance and more
            information are described below. The service will provide
            you with their contact details.
              •   The Psychosurgery Review Board is an independent
                  tribunal that decides whether psychosurgery should be
                  performed on any person in the state of Victoria.
              •   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. They also investigate
                  complaints and report on their inquiries and
                  investigations.
              •   The Mental Health Legal Centre is an independent
                  legal service which specialises in mental health legal
                  issues. It may be able to arrange representation for
                  you at Psychosurgery Review Board hearings or about
                  other legal matters.
              •   Victoria Legal Aid provides free legal advice about a
                  range of issues. It may also provide legal assistance if
                  you cannot afford a private solicitor and may be able
                  to assist with legal representation at Psychosurgery
                  Review Board hearings.
              •   The Public Advocate assists, advises and advocates
                  for people with serious complaints about mental
                  health and disability services and treatment.
              •   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.




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                      •   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.
                          The Commissioner can help patients access their
                          health information.
                      •   The Ombudsman investigates complaints about
                          government departments.
                      •   The Mental Health Review Board is an independent
                          tribunal that hears appeals from involuntary patients,
                          hospital order patients and security patients who want
                          to be discharged from their involuntary treatment
                          status. It also automatically reviews these patients.
                    You can also ask your case manager or any member of the
                    treating team about other local organisations and support
                    groups which may be able to help you.
                                     _______________".
                            ═══════════════




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    Mental Health (Forms and Patient's Rights) Regulations 2006
                                                                      Endnotes
                             S.R. No. 39/2006

                                 ENDNOTES


1
    Reg. 3: S.R. No. 120/1998. Reprint No. 1 as at 7 December 2004.
     Reprinted to S.R. No. 157/2004 and subsequently amended by
     S.R. Nos 111/2005 and 127/2005.




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