Compulsory treatment orders

If you have a mental illness, and need treatment for your health and safety or the safety of others, a doctor may examine you. The doctor may 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 even if you don’t want it. Treatment can include medication or injections you must have. You may have to stay in hospital to get your treatment if you cannot get it in the community.

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.

Assessment orders

A mental health practitioner (for example a nurse or social worker at a mental health service) or a doctor can put you on an assessment order if they believe you meet these four compulsory assessment criteria:

• you appear to have a mental illness and
• you appear to need treatment to prevent:
• a serious deterioration in your mental or physical health, or
• serious harm to yourself or someone else
• if an order is made, then you can be assessed
• there is no less restrictive means available to assess you.

The order allows for an authorised psychiatrist to examine you to decide if you have a mental illness and require compulsory tretment under a temporary treatment order.

An order should not be made if the possible harm from it is likely to be more than the harm it is intended to prevent.

You should be given a copy of your 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.

Either order can be extended twice for a maximum of 24 hours each time.

The psychiatrist can revoke (cancel) the order if think you no longer meet the criteria.

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. The psychiatrist can't be the same doctor who made your assessment order.

In deciding whether the criteria apply, the psychiatrist must also consider:

• your views and preferences about treatment
• your reasons and recovery goals.

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.

A psychiatrist can change whether you get treatment in the community or as an inpatient at any time if they think it's the least restrictive option.

Treatment orders

Treatment orders can only be made by the Mental Health Tribunal after a hearing, and only if you meet all of the treatment criteria. The tribunal can also refuse to make, or revoke a treatment order.

The tribunal will hold a hearing if:

• your temporary treatment order is about to expire (that is, within 28 days of the order being made),
• you are on a treatment order which is about to expire and the authorised psychiatrist applies for another treatment order because they believe you meet the compulsory treatment criteria or
• your order is changed by your psychiatrist from a community order to an inpatient order
• you apply for a hearing to cancel (revoke) your temporary treatment order or treatment order

If the tribunal believe the compulsory treatment criteria all apply to you, it can either confirm your order or make a treatment order.

It must also decide if that order should be a community order or inpatient order. A community order means you can live in the community while receiving treatment. An inpatient order means you must stay in hospital to receive treatment. The tribunal can only make an inpatient order if it believes that you cannot be treated in the community.

If the tribunal makes a (new) treatment order it must also decide how long the order should last for. If you are aged 18 or over, your treatment order can last for a maximum of six months. If you are aged under 18, your treatment order can last for a maximum of three months.

Compulsory treatment criteria

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 and Wellbeing Act 2022 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
• your guardian
• a parent (if you are under 16)
• the Secretary of the Department of Health, if you are on a custody 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.

You can also contact the Second Psychiatric Opinion Service.

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 will not automatically change your treatment or cancel the order you are on.

If the psychiatrist providing a second opinion thinks that the criteria for a treatment order do not apply to you, or your treatment should be changed, your treating psychiatrist must reassess you as soon as possible.

If the treating psychiatrist decides that the criteria for the treatment order do apply, they must give you reasons for their decision, in wiriting, with 10 business days of their decision and advise you of your right to seek a review at the Mental Health Tribunal.

If the treating psychiatrist decides not to make any changes to your treatment, they must give you reasons for their decision, in writing, within 10 business days. They must also advise you of your right to apply to Victoria’s Chief Psychiatrist to ask for a review of your treatment.

The Chief Psychiatrist must review the decision within 10 business days. As part of the review, the Chief Psychiatrist will talk to you, the doctors and look at your file.

The Chief Psychiatrist has the power to direct your treating team to change your treatment.

If you are unhappy about your treatment or being on an order

You have the right to make a complaint if you are unhappy about the treatment you are getting from a mental health and wellbeing service provider:

• Mental Health and Wellbeing Commission – Independent complaints services
• Community Visitor – visit mental health services
• Victorian Ombudsman for complaints about government departments.
• Mental Health Tribunal – to ask for a hearing to cancel your temporary treatment order or treatment order.

You can also talk to a lawyer to get legal advice or to a non-legal advocate from Independent Mental Health Advocacy if you have any questions about your rights.

Other support

Find out how you can get other support for mental health and disability.

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