If you have a mental illness, and need treatment for your health and safety or the safety of others, a doctor may examine you and decide that you must receive treatment under a compulsory treatment order.
Under a compulsory treatment order, a hospital or mental health clinic will give you treatment. You lose some of your rights and freedoms and you may have to stay in a hospital. You can be treated even if you do not agree.
Types of compulsory treatment orders
There are three types of compulsory treatment orders:
- assessment orders – made by a registered medical practitioner or a doctor to allow an authorised psychiatrist to examine you
- temporary treatment orders – made by an authorised psychiatrist for a maximum of 28 days, and
- treatment orders – made by the Mental Health Tribunal. They can only be made if you are already on a temporary treatment order.
A registered medical practitioner or a doctor will make an assessment order if they believe you appear to have a mental illness. You must meet these four criteria for an assessment order:
- you appear to have a mental illness
- you need treatment to prevent serious harm to yourself, serious deterioration in your mental or physical health, or serious harm to another person
- if an order is made, then you can be assessed
- there is no less restrictive means available to assess you including if you can be treated as a voluntary patient.
The order allows an authorised psychiatrist examine you to decide if you have a mental illness and require compulsory treatment under a temporary treatment order.
You can be examined:
- in hospital – an inpatient assessment order allows for 72 hours to transport you to hospital and then 24 hours to be examined when you arrived at the hospital. This can be extended twice (up to a maximum of 48 hours)
- in the community – a community assessment order will only last for a maximum of 24 hours.
Temporary treatment orders
If you are examined by an authorised psychiatrist and they believe you meet all of the treatment criteria, you can be put on a temporary treatment order by that psychiatrist.
Temporary treatment orders last for a maximum of 28 days.
The temporary order can be a:
- community temporary treatment order – this order allows you to live in the community while receiving treatment for a mental illness
- inpatient temporary treatment order – this order says that you must be treated for a mental illness in hospital.
The tribunal will hold a hearing if:
- the authorised psychiatrist applies for a treatment order because they believe you meet the criteria and your:
- temporary treatment order is about to expire (28 days), or
- current treatment order is about to expire
- you apply to have your treatment order revoked (you can do this at any time, by filling in an application form and sending it to the tribunal).
If you wish to apply for your order to be revoked, the sooner you do this, the sooner the revocation hearing will happen.
The tribunal can make a:
- community treatment order – you can live in the community while receiving treatment for mental illness. It lasts for a maximum of 12 months if you are 18 years or older
- inpatient treatment order – you must be in hospital while receiving treatment for a mental illness. It last for a maximum of six months if you are 18 years or older.
- the tribunal can only make an inpatient treatment order if it is satisfied that you cannot be treated in the community..
If you are under 18, both kinds of treatment orders can only last for a maximum of three months.
You must fit the following four criteria before any temporary treatment order or treatment order can be made:
- You have mental illness.
- Because you have mental illness, you need immediate treatment to prevent:
- serious deterioration in your mental or physical health, or
- serious harm to you or to another person.
- You will get immediate treatment if you are on a temporary treatment order or treatment order.
- There are no less restrictive means, reasonably available, for you to get the treatment that is needed.
For an assessment order to be made, you must ‘appear to have mental illness’ rather than the psychiatrist deciding you actually ‘have a mental illness’. Otherwise the criteria are the same.
Review of whether you continue to meet the criteria
If you no longer meet all four criteria, at any time, the psychiatrist must revoke the order. You can ask the psychiatrist to assess you for this.
Second opinion about treatment
You have the right to get a second psychiatric opinion about:
- whether the treatment criteria apply to you
- your treatment and its possible effects on you.
You can ask your treating team to reassess you, or to get a second opinion from a different psychiatrist.
The Mental Health Act 2014 allows you to request a second opinion at any time. Requests for second opinions can also be made by:
- a person you ask to do so on your behalf
- a parent (if you are under 16)
- the Secretary of the Department of Health, if you are on a or guardianship to Secretary order.
You can ask your mental health service to arrange this. It should be free in the public system. You can also ask a private psychiatrist but you may have to pay.
The psychiatrist who provides the second opinion will write a report, which will be given to you and the psychiatrist treating you, as well as any person you have nominated or who requested the second opinion on your behalf.
If you get a different second opinion
A different second opinion won't necessarily mean your treatment changes.
If the psychiatrist providing a second opinion thinks that the criteria for a treatment order do not apply or the treatment should be changed, your treating psychiatrist must reassess you as soon as practicable.
If the treating psychiatrist decides that the criteria for the treatment order do apply, they must give you reasons for their decision.
If you are not happy with the reasons, you can apply to and ask for a review. The Chief Psychiatrist must review the decision within 10 business days. In conducting the review, the Chief Psychiatrist will talk to you, the doctors and look at your file.
The Chief Psychiatrist may direct the treating team to change your treatment.
If you are unhappy about your treatment or being on an order
Publications and resources
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Reviewed 06 May 2022