South Australia: Mental Health Act 2009 (SA)

South Australia Mental Health Act 2009 An Act to make provision for the treatment, care and rehabilitation of persons with severe mental illness with the goal of bringing about their recovery as far as is possible; to confer powers to make orders for community treatment, or inpatient treatment, of such persons where required; to provide protections of the freedom and legal rights of persons with mental illness; and for other purposes. Contents Part 1—Preliminary 1 Short title 3 Interpretation 4 Application of Act 5 Medical examinations by audio‑visual conferencing 5A Decision‑making capacity Part 2—Objects and guiding principles 6 Objects 7 Guiding principles Part 3—Voluntary inpatients 8 Voluntary inpatients 9 Voluntary inpatients to be given statement of rights Part 4—Orders for treatment of persons with mental illness Division 1—Level 1 community treatment orders 10 Level 1 community treatment orders 11 Chief Psychiatrist to be notified of level 1 orders or their variation or revocation 12 Copies of level 1 orders, notices and statements of rights to be given to patients etc 13 Treatment of patients to whom level 1 orders apply 14 Chief Psychiatrist to ensure monitoring of compliance with level 1 orders Division 2—Level 2 community treatment orders 16 Level 2 community treatment orders 17 Chief Psychiatrist to be notified of level 2 orders or their variation or revocation 18 Treatment of patients to whom level 2 orders apply 19 Chief Psychiatrist to ensure monitoring of compliance with level 2 orders Part 5—Orders for treatment as inpatient of persons with mental illness Division 1—Non‑compliance with community treatment orders and making of inpatient treatment orders 20 Non-compliance with community treatment orders and making of inpatient treatment orders Division 2—Level 1 inpatient treatment orders 21 Level 1 inpatient treatment orders 22 Chief Psychiatrist to be notified of level 1 orders or their revocation 23 Copies of level 1 orders, notices and statements of rights to be given to patients etc 24 Treatment of patients to whom level 1 orders apply Division 3—Level 2 inpatient treatment orders 25 Level 2 inpatient treatment orders 26 Notices and reports relating to level 2 orders 27 Copies of level 2 orders, notices and statements of rights to be given to patients etc 28 Treatment of patients to whom level 2 orders apply Division 4—Level 3 inpatient treatment orders 29 Level 3 inpatient treatment orders 30 Chief Psychiatrist to be notified of level 3 orders or their variation or revocation 31 Treatment of patients to whom level 3 orders apply Division 5—General 32 Inpatient treatment orders displace community treatment orders 33 Duty of director of treatment centre to comply with inpatient treatment orders 34 Involuntary inpatients not permitted to leave treatment centre or care and control of staff 34A Confinement and other powers relating to involuntary inpatients 35 Transfer of involuntary inpatients 36 Leave of absence of involuntary patients 37 Persons granted leave of absence to be given statement of rights 38 Cancellation of leave of absence Part 6—Treatment and care plans 39 Treatment and care plans for voluntary patients 40 Treatment and care plans for patients to whom community treatment orders apply 41 Treatment and care plans for patients to whom inpatient treatment orders apply Part 7—Regulation of prescribed psychiatric treatments Division A1—Prescribed Psychiatric Treatment Panel 41A Prescribed Psychiatric Treatment Panel 41B Conditions of appointment to Panel 41C Functions of Panel 41D Constitution and proceedings of Panel Division 1—ECT 42 ECT Division 2—Neurosurgery for mental illness 43 Neurosurgery for mental illness Division 3—Other prescribed psychiatric treatments 44 Other prescribed psychiatric treatments Part 8—Further protections for persons with mental illness Division 1—Patients' rights and protections 45 Assistance of interpreters 46 Copies of Tribunal's orders, decisions and statements of rights to be given 47 Patients' right to be supported by guardian etc 48 Patients' right to communicate with others outside treatment centre 48A Prohibition on use of spit hoods 49 Neglect or ill-treatment Division 2—Community visitor scheme 50 Community visitors 51 Community visitors' functions and powers 51A Delegation by Principal Community Visitor 52 Visits to and inspections of treatment centres 52A Visits to and inspection of authorised community mental health facilities 52B Visits and inspections by audiovisual or other electronic means 53 Requests to see community visitors 54 Reports by Principal Community Visitor Part 9—Powers relating to persons who have or appear to have mental illness 54A Issuing of patient assistance requests 55 Issuing of patient transport requests 56 Powers of authorised officers relating to persons who have or appear to have mental illness 57 Powers of police officers relating to persons who have or appear to have mental illness 58 Officers may assist each other 58A Officers to keep records about exercise of powers under Act 59 Roles of various officers 60 Offence to hinder etc officer Part 10—Arrangements between South Australia and other jurisdictions Division 1—Preliminary 61 Interpretation 62 Ministerial agreements 63 Requests or approvals relating to actions involving other jurisdictions 64 Powers of South Australian officers 65 Regulations may modify operation of Part Division 2—Community treatment orders 66 South Australian community treatment orders and treatment in other jurisdictions 67 Powers of interstate officers 68 Interstate community treatment orders and treatment in South Australia 69 Making of South Australian community treatment orders when interstate orders apply Division 3—Transfer to or from South Australian treatment centres 70 Transfer from South Australian treatment centres 71 Transfer to South Australian treatment centres 72 Patient transport requests 73 Powers when patient transport request issued Division 4—Transport to other jurisdictions 74 Transport to other jurisdictions when South Australian inpatient treatment orders apply 75 Transport to other jurisdictions of persons with apparent mental illness 76 Transport to other jurisdictions when interstate inpatient treatment orders apply Division 5—Transport to South Australia 77 Transport to South Australia when South Australian inpatient treatment orders apply 78 Transport to South Australia of persons with apparent mental illness Part 11—Reviews and appeals 79 Reviews of treatment orders and other matters 80 Decisions and reports on reviews of treatment orders 81 Reviews of orders (other than Tribunal orders) 83 Review of directions for transfer of patients to interstate treatment centres 83A Reviews and appeals 84 Representation on reviews or appeals Part 11A—Special provisions relating to Tribunal 85 Tribunal must give notice of proceedings 85A Reasons for decisions 85B Representation of person who is subject of proceedings Part 12—Administration Division 1—Minister and Chief Executive 86 Minister's functions 87 Delegation by Minister 88 Delegation by Chief Executive Division 2—Chief Psychiatrist 89 Chief Psychiatrist 90 Chief Psychiatrist's functions 91 Delegation by Chief Psychiatrist 92 Annual report of Chief Psychiatrist Division 3—Authorised medical practitioners 93 Authorised medical practitioners Division 4—Authorised mental health professionals 94 Authorised mental health professionals 95 Code of practice for authorised mental health professionals Division 5—Treatment centres 96 Approved treatment centres 97 Limited treatment centres 97A Authorised community mental health facilities 100 Delegation by directors of treatment centres Part 13—Miscellaneous 101 Errors in orders etc 102 Offences relating to authorisations and orders 103 Medical practitioners or health professionals not to act in respect of relatives 104 Removing inpatients from treatment centres 106 Confidentiality and disclosure of information 107 Prohibition of publication of reports of proceedings 108 Requirements for notice to Tribunal or Chief Psychiatrist 109 Evidentiary provision 110 Regulations 111 Review of Act Schedule 1—Certain conduct may not indicate mental illness Schedule 2—Transitional provisions 2 Transitional provisions Legislative history The Parliament of South Australia enacts as follows: Part 1—Preliminary 1—Short title This Act may be cited as the Mental Health Act 2009. 3—Interpretation (1) In this Act, unless the contrary intention appears— absent without leave—see subsection (2); advance care directive means an advance care directive given under the Advance Care Directives Act 2013 that is in force; ambulance officer means a person who is— (a) employed as an ambulance officer, or engaged as a volunteer ambulance officer, with an organisation that provides ambulance services; and (b) authorised by the chief executive officer of SA Ambulance Service Inc to exercise the powers conferred by this Act on authorised officers; approved treatment centre means a place determined by the Chief Psychiatrist under Part 12 Division 5 to be an approved treatment centre for the purposes of this Act; authorised community mental health facility means a facility that is determined by the Chief Psychiatrist under Part 12 Division 5 to be an authorised community mental health facility; authorised medical practitioner means a person determined by the Chief Psychiatrist under Part 12 Division 3 to be an authorised medical practitioner for the purposes of this Act; authorised mental health professional means a person determined by the Chief Psychiatrist under Part 12 Division 4 to be an authorised mental health professional for the purposes of this Act; authorised officer means— (a) a mental health clinician; or (b) an ambulance officer; or (c) a person employed as a medical officer or flight nurse by the Royal Flying Doctor Service of Australia (Central Operations) Incorporated or the Royal Flying Doctor Service of Australia (South Eastern Section); or (d) a person, or a person of a class, approved by the Chief Psychiatrist, by notice in the Gazette, for the purposes of this definition; or (e) any other person, or person of a class, prescribed by the regulations for the purposes of this definition; carer—a person is a carer of another if the person provides ongoing care or assistance to the other as a carer within the meaning of the Carers Recognition Act 2005; the term includes a person who was a carer of another before interruption of the provision of care due to the other's illness; Chief Executive means the chief executive of the Department; Chief Psychiatrist means the person appointed to the position of Chief Psychiatrist under Part 12 Division 2; child means a person under 18 years of age; community treatment order means— (a) a level 1 community treatment order; or (b) a level 2 community treatment order; community visitor means— (a) the person appointed to the position of Principal Community Visitor under Part 8 Division 2; or (b) a person appointed to a position of Community Visitor under Part 8 Division 2; consent to treatment means effective consent to the treatment; decision, of the Tribunal, has the same meaning as in the South Australian Civil and Administrative Tribunal Act 2013; Department means the administrative unit of the Public Service that is responsible for assisting a Minister in the administration of this Act; director of a treatment centre means the person for the time being in charge of the mental health services of the centre; domestic partner—a person is a domestic partner of another if the person is a domestic partner of the other within the meaning of the Family Relationships Act 1975, whether declared as such under that Act or not; the term includes a person who was a domestic partner of another before interruption of their shared living arrangements due to the other's illness; ECT means electro-convulsive therapy; guardian—a person is a guardian of another if the person is acting or appointed under any Act or law as the guardian of the other; inpatient in a treatment centre means a person admitted as a patient in a treatment centre; inpatient treatment order means— (a) a level 1 inpatient treatment order; or (b) a level 2 inpatient treatment order; or (c) a level 3 inpatient treatment order; internal review means a review under section 70 of the South Australian Civil and Administrative Tribunal Act 2013; involuntary inpatient means an inpatient who is subject to an inpatient treatment order; leave of absence—see section 36; legal practitioner means a person admitted and enrolled as a practitioner of the Supreme Court of South Australia; level 1 community treatment order—see Part 4 Division 1; level 1 inpatient treatment order—see Part 5 Division 2; level 2 community treatment order—see Part 4 Division 2; level 2 inpatient treatment order—see Part 5 Division 3; level 3 inpatient treatment order—see Part 5 Division 4; limited treatment centre means a place determined by the Chief Psychiatrist under Part 12 Division 5 to be a limited treatment centre for the purposes of this Act; medical agent—a person is a medical agent of another if the person has been appointed under an Act or law to make decisions on behalf of the other about the other's medical treatment; medical examination means examination of a person and the person's mental health by a medical practitioner or authorised mental health professional; medical practitioner means a person registered under the Health Practitioner Regulation National Law to practise in the medical profession (other than as a student); mental health clinician means a person of a class of persons who are engaged in the treatment or care of patients and classified by the Chief Psychiatrist as mental health clinicians for the purposes of this Act; mental illness means any illness or disorder of the mind; see also Schedule 1 (Certain conduct may not indicate mental illness); neurosurgery for mental illness means leucotomy, amygdaloidotomy, hypothalamotomy, temporal lobectomy, cingulectomy, electrode implantation in the brain or any other brain surgery for the relief of mental illness by the elimination or stimulation of apparently normal brain tissues; patient, in relation to the provision of mental health services, includes (where the context so requires) the following: (a) a voluntary inpatient; (b) a person to whom a community treatment order applies; (c) a person to whom an inpatient treatment order applies; (d) a person to whom section 56 applies; (e) a person with a mental illness (within the meaning of this Act) who is liable to a supervision order under Part 8A of the Criminal Law Consolidation Act 1935; patient assistance request means a patient assistance request issued under Part 9; patient transport request means a patient transport request issued under Part 9 or Part 10; prescribed psychiatric treatment means— (a) ECT; or (b) neurosurgery for mental illness; or (c) any other treatment declared by the regulations to be prescribed psychiatric treatment; Prescribed Psychiatric Treatment Panel or Panel means the Prescribed Psychiatric Treatment Panel established under Part 7 Division A1; psychiatrist means a person registered under the Health Practitioner Regulation National Law— (a) to practise in the medical profession; and (b) holding specialist registration as a psychiatrist; Public Advocate means the person holding or acting in the office of Public Advocate under the Guardianship and Administration Act 1993; relative—a person is a relative of another if— (a) the person is related to the other by blood or marriage; or (b) the person is a domestic partner of the other; or (c) the person is of Aboriginal or Torres Strait Islander descent and related to the other according to Aboriginal kinship rules, or Torres Strait Islander kinship rules, as the case may require; restrictive practice, in relation to a patient, includes— (a) the use of physical, mechanical or chemical means to restrain the patient; and (b) seclusion or the confinement of the patient on his or her own in an area from which he or she cannot leave of his or her own volition; senior psychiatrist means a person who has, since qualifying for registration as a specialist in psychiatry, had at least 5 years' experience as a practising psychiatrist; staff of a treatment centre means the director of the centre or any person performing duties involved in the administration or operations of the centre, whether under a contract of employment or some other contractual arrangement; substitute decision‑maker, in respect of a person, means a substitute decision‑maker appointed under an advance care directive given by the person under the Advance Care Directives Act 2013 that is in force; treatment or medical treatment means treatment or procedures administered or carried out by a medical practitioner or other health professional in the course of professional practice, and includes the prescription or supply of drugs; treatment centre means an approved treatment centre or a limited treatment centre; Tribunal means the South Australian Civil and Administrative Tribunal established under the South Australian Civil and Administrative Tribunal Act 2013; voluntary community patient means a person receiving treatment, care and rehabilitation services for a mental illness in an authorised community mental health facility; voluntary inpatient means an inpatient who is not subject to an inpatient treatment order. (2) For the purposes of this Act, a patient will be taken to be absent without leave if— (a) an inpatient treatment order applies to the patient; and (b) the patient— (i) has not been taken into, or remained in, the care and control of treatment centre staff or an authorised officer or police officer after the making of the order and before admission to a treatment centre; or (ii) has left a treatment centre in which he or she was an involuntary inpatient, or the care and control of treatment centre staff, without leave of absence under Part 5 Division 5; or (iii) has been granted leave of absence from a treatment centre under Part 5 Division 5 but has not returned to the centre, or been taken into the care and control of treatment centre staff or an authorised officer or police officer, by the expiry of the leave or after cancellation of the leave. (3) For the purposes of this Act, a form that has been approved by the Chief Psychiatrist must— (a) be published on the Department's website; and (b) be used for the purposes specified in the form; and (c) contain the information required by, and be presented and completed in accordance with, any instruction contained in the form; and (d) be lodged in the manner and form required by the Chief Psychiatrist. 4—Application of Act (1) This Act applies to children in the same way as to persons of full age, subject to the following: (a) a right conferred on a person under this Act may, if the person is a child under 16 years of age, be exercised by a parent or guardian of the child on behalf of the child; (b) an obligation under this Act to give a document to a person is, if the person is a child under 16 years of age, to be treated as an obligation to give the document to a parent or guardian of the child, and operates to the exclusion of any further obligation under this Act to send or give the document to a guardian, medical agent, relative, carer or friend; (c) an obligation under this Act to give information to a person (including information about the person's illness, any order that applies to the person, his or her legal rights, the treatment and other services that are to be provided or offered to the person and what alternatives are available) is, if the person is a child under 16 years of age, to be treated as an obligation to give the information to a parent or guardian of the child. (2) Subsection (1) does not affect the operation of a provision of this Act that expressly relates to a child or children. (3) Subject to an express provision of this Act or of any other Act, this Act is in addition to and does not derogate from— (a) the Advance Care Directives Act 2013; and (b) the Consent to Medical Treatment and Palliative Care Act 1995; and (c) the Guardianship and Administration Act 1993. 5—Medical examinations by audio‑visual conferencing (1) A reference in this Act to medical examination or examination of a person by a medical practitioner or authorised mental health professional includes, if it is not practicable in the circumstances for a medical practitioner or authorised mental health professional to carry out an examination of the person in the person's physical presence, a reference to an examination of the person by the medical practitioner or authorised mental health professional by means of audio‑visual conferencing. (2) In this section— audio‑visual conferencing means any system of two‑way communication linking different places so that a person speaking at any 1 of the places can be seen and heard at the other. 5A—Decision‑making capacity (1) A person is, in the absence of evidence or a law of the State to the contrary, to be presumed to have full decision‑making capacity in respect of decisions about his or her health care, residential and accommodation arrangements and personal affairs. (2) For the purposes of this Act, a person will be taken to have impaired decision‑making capacity in respect of a particular decision if— (a) the person is not capable of— (i) understanding any information that may be relevant to the decision (including information relating to the consequences of making a particular decision); or (ii) retaining such information; or (iii) using such information in the course of making the decision; or (iv) communicating his or her decision in any manner; or (b) in the case of a person who has given an advance care directive—the person has satisfied any requirement in the advance care directive that sets out when the person is to be considered to have impaired decision‑making capacity (however described) in respect of a decision of the relevant kind. (3) For the purposes of this Act— (a) a person will not be taken to be incapable of understanding information merely because the person is not able to understand matters of a technical or trivial nature; and (b) a person will not be taken to be incapable of retaining information merely because the person can only retain the information for a limited time; and (c) a person may fluctuate between having impaired decision‑making capacity and full decision‑making capacity; and (d) a person's decision‑making capacity will not be taken to be impaired merely because a decision made by the person results, or may result, in an adverse outcome for the person. Part 2—Objects and guiding principles 6—Objects The objects of this Act are— (a) to ensure that persons with severe mental illness— (i) receive a comprehensive range of services of the highest standard for their treatment, care and rehabilitation with the goal of bringing about their recovery as far as is possible; and (ii) retain their freedom, rights, dignity and self‑respect as far as is consistent with their protection, the protection of the public and the proper delivery of the services; and (b) for that purpose, to confer appropriately limited powers to make orders for community treatment, or inpatient treatment, of such persons where required. 7—Guiding principles (1) The Minister, the Tribunal, the Chief Psychiatrist, health professionals and other persons and bodies involved in the administration of this Act are to be guided by the following principles in the performance of their functions: (a) mental health services should be designed to bring about the best therapeutic outcomes for patients, and, as far as possible, their recovery and participation in community life; (ab) mental health services should meet the highest levels of quality and safety; (ac) mental health services should (subject to this Act or any other Act) be provided in accordance with international treaties and agreements to which Australia is a signatory; (b) mental health services should be provided on a voluntary basis as far as possible, and otherwise in the least restrictive way and in the least restrictive environment that is consistent with their efficacy and public safety, and at places as near as practicable to where the patients, or their families or other carers or supporters, reside; (c) mental health services should be governed by comprehensive treatment and care plans that are developed in a multi‑disciplinary framework in consultation with the patients (including children) and their family or other carers or supporters; (ca) mental health services should take into account— (i) the different developmental stages of infants, children, young persons, adults and older persons; and (ii) the gender or gender identity, or the sexuality or sexual identity or orientation, of persons; and (iii) the particular needs of persons with disability; and (iv) in the case of persons of Aboriginal or Torres Strait Islander descent—the persons' traditional beliefs and practices and, when practicable and appropriate, involve collaboration with health workers and traditional healers from their communities; and (v) the cultural and linguistic backgrounds of persons; and (vi) the background, circumstances and particular needs of persons who have experienced torture or trauma; (d) there should be regular medical examination of every patient's mental and physical health and regular medical review of any order applying to the patient; (e) children and young persons should be cared for and treated separately from other patients as necessary to enable the care and treatment to be tailored to their different developmental stages; (f) the rights, welfare and safety of the children and other dependants of patients should always be considered and protected as far as possible; (g) medication should be used only for therapeutic purposes or safety reasons and not as a punishment or for the convenience of others; (h) restrictive practices should be used only as a last resort for safety reasons and not as a punishment or for the convenience of others; (i) patients (together with their family or other carers or supporters) should be provided with comprehensive information about their illnesses, any orders that apply to them, their legal rights, the treatments and other services that are to be provided or offered to them and what alternatives are available; (j) information should be provided in a way that ensures as far as practicable that it can be understood by those to whom it is provided. (2) In this section— mental health services means all services involved in the treatment, care and rehabilitation of persons with severe mental illness, including the making and carrying out of orders under this Act and services to assist the recovery of patients after the termination of the orders or the completion of treatment; patient includes a voluntary community patient. Part 3—Voluntary inpatients 8—Voluntary inpatients (1) A person may be admitted as a voluntary inpatient in a treatment centre at his or her own request. (2) A person admitted as a voluntary inpatient in a treatment centre may leave the centre at any time unless an inpatient treatment order then applies to the person. 9—Voluntary inpatients to be given statement of rights (1) The director of a treatment centre must ensure that a voluntary inpatient in the centre is given, as soon as practicable after admission, a statement in writing in the form approved by the Chief Psychiatrist (a statement of rights)— (a) informing the patient of his or her legal rights; and (b) containing any other information prescribed by the regulations. (2) If a patient is unable to read or otherwise comprehend the statement of rights, the director must ensure that any steps that are practicable in the circumstances are taken to convey the information contained in the statement to the patient. (3) Subject to subsection (4), the director must cause a copy of the statement of rights to be sent or given to a guardian, medical agent, relative, carer or friend of the patient as soon as practicable. (4) The following provisions apply for the purposes of subsection (3): (a) the person to be sent or given a copy of the statement of rights must be— (i) a guardian, medical agent, relative, carer or friend of the patient nominated by the patient for the purpose; or (ii) if that is not practicable or appropriate—a guardian, medical agent, relative, carer or friend of the patient who appears to have or be assuming responsibility for the care of the patient; or (iii) if that is not practicable or appropriate—any other guardian, medical agent, relative, carer or friend of the patient to whom it is practicable and appropriate to send or give a copy of the statement; (b) the director is not required to send or give a copy of the statement to a person whose whereabouts are not known to or readily ascertainable by the director; (c) it is not appropriate for the director to send or give a copy of the statement to a particular person if the director has reason to believe that it would be contrary to the patient's best interests to do so. Part 4—Orders for treatment of persons with mental illness Division 1—Level 1 community treatment orders 10—Level 1 community treatment orders (1) A medical practitioner or authorised mental health professional may make an order for the treatment of a person (a level 1 community treatment order) if it appears to the medical practitioner or authorised mental health professional, after examining the person, that— (a) the person has a mental illness; and (b) because of the mental illness, the person requires treatment for the person's own protection from harm (whether physical or mental, and including harm involved in the continuation or deterioration of the person's condition) or for the protection of others from harm; and (c) the person has impaired decision‑making capacity relating to appropriate treatment of the person's mental illness; and (d) there is no less restrictive means than a community treatment order of ensuring appropriate treatment of the person's illness. (2) In considering whether there is no less restrictive means than a community treatment order of ensuring appropriate treatment of the person's illness, consideration must be given, amongst other things, to the prospects of the person receiving all treatment of the illness necessary for the protection of the person and others on a voluntary basis. (3) A level 1 community treatment order must be made in writing in the form approved by the Chief Psychiatrist. (4) A level 1 community treatment order, unless earlier revoked, expires at a time fixed in the order which must be 2 pm on a business day not later than 42 days after the day on which it is made. (5) On the making of a level 1 community treatment order, the following provisions apply: (a) the patient must be examined by a psychiatrist or authorised medical practitioner, who must, if the order was made by a psychiatrist or authorised medical practitioner, be a different psychiatrist or authorised medical practitioner from whomever made the order; (b) the examination must occur within 24 hours of the making of the order; (c) if it is not practicable for the examination to occur within that period, it must occur as soon as practicable thereafter; (d) after completion of the examination, the psychiatrist or authorised medical practitioner may confirm the level 1 community treatment order if satisfied that the grounds referred to in subsection (1) exist for the making of a level 1 community treatment order, but otherwise must revoke the order. (6) A medical practitioner or authorised mental health professional may form an opinion about a person under subsection (1) or (5) based on his or her own observations and any other available evidence that he or she considers reliable and relevant (which may include evidence about matters occurring outside the State). (7) A psychiatrist or authorised medical practitioner who has examined a patient to whom a level 1 community treatment order applies may vary or revoke the order at any time. Note— A psychiatrist or authorised medical practitioner who revokes a level 1 community treatment order may, in substitution, make a level 1 inpatient treatment order under Part 5 Division 2. (8) Confirmation, variation or revocation of a level 1 community treatment order must be effected by notice in the form approved by the Chief Psychiatrist. 11—Chief Psychiatrist to be notified of level 1 orders or their variation or revocation (1) A psychiatrist or authorised medical practitioner making, confirming, varying or revoking a level 1 community treatment order must ensure that the Chief Psychiatrist is sent or given, within 1 business day, a notice in the form approved by the Chief Psychiatrist. (3) The Chief Psychiatrist must, within 1 business day, by written notice sent or given to the psychiatrist or authorised medical practitioner, acknowledge receipt by the Chief Psychiatrist of a notice under subsection (1). 12—Copies of level 1 orders, notices and statements of rights to be given to patients etc (1) A medical practitioner or authorised mental health professional making a level 1 community treatment order must ensure that the patient is given, as soon as practicable, a copy of the order. (2) A medical practitioner or authorised mental health professional making a level 1 community treatment order must ensure that the patient is given, as soon as practicable, a statement in writing in the form approved by the Chief Psychiatrist (a statement of rights)— (a) informing the patient of his or her legal rights; and (b) containing any other information prescribed by the regulations. (3) If a patient is unable to read or otherwise comprehend the statement of rights, the medical practitioner or authorised mental health professional must ensure that any steps that are practicable in the circumstances are taken to convey the information contained in the statement to the patient. (4) Subject to subsection (6), a psychiatrist or authorised medical practitioner making or confirming a level 1 community treatment order must cause a copy of the order and statement of rights to be sent or given to a guardian, medical agent, relative, carer or friend of the patient as soon as practicable. (5) If a level 1 community treatment order is varied or revoked, the psychiatrist or authorised medical practitioner varying or revoking the order must— (a) ensure that the patient is given, as soon as practicable, a copy of the notice of variation or revocation of the order; and (b) subject to subsection (6), cause a copy of the notice of variation or revocation to be sent or given to a guardian, medical agent, relative, carer or friend of the patient as soon as practicable. (6) The following provisions apply for the purposes of subsections (4) and (5)(b): (a) the person to be sent or given a copy of the order and statement of rights, or notice of variation or revocation, must be— (i) a guardian, medical agent, relative, carer or friend of the patient nominated by the patient for the purpose; or (ii) if that is not practicable or appropriate—a guardian, medical agent, relative, carer or friend of the patient who appears to have or be assuming responsibility for the care of the patient; or (iii) if that is not practicable or appropriate—any other guardian, medical agent, relative, carer or friend of the patient to whom it is practicable and appropriate to send or give the copy of the order and statement, or notice of variation or revocation; (b) the psychiatrist or authorised medical practitioner is not required to send or give a copy of the order and statement, or notice of variation or revocation, to a person whose whereabouts are not known to or readily ascertainable by the psychiatrist or authorised medical practitioner; (c) it is not appropriate for the psychiatrist or authorised medical practitioner to send or give a copy of the order and statement, or notice of variation or revocation, to a particular person if the psychiatrist or authorised medical practitioner has reason to believe that it would be contrary to the patient's best interests to do so. 13—Treatment of patients to whom level 1 orders apply (1) Subject to subsection (2), a patient to whom a level 1 community treatment order applies may be given treatment for his or her mental illness of a kind authorised by a psychiatrist or authorised medical practitioner who has examined the patient. (2) Authorisation is not required under subsection (1) for treatment if a medical practitioner considers that— (a) the nature of the patient's mental illness is such that the treatment is urgently needed for the patient's well‑being; and (b) in the circumstances it is not practicable to obtain that authorisation. (3) The treatment may be given despite the absence or refusal of consent to the treatment. (4) This section does not apply to prescribed psychiatric treatment, or to prescribed treatment within the meaning of the Guardianship and Administration Act 1993. 14—Chief Psychiatrist to ensure monitoring of compliance with level 1 orders The Chief Psychiatrist must, after receiving notice of the making of a level 1 community treatment order, ensure that there is a mental health clinician who has ongoing responsibility for monitoring and reporting to the Chief Psychiatrist on the patient's compliance with the order. Division 2—Level 2 community treatment orders 16—Level 2 community treatment orders (1) If the Tribunal is satisfied that— (a) a person has a mental illness; and (b) because of the mental illness, the person requires treatment for the person's own protection from harm (whether physical or mental, and including harm involved in the continuation or deterioration of the person's condition) or for the protection of others from harm; and (c) the person has impaired decision‑making capacity relating to appropriate treatment of the person's mental illness; and (d) there is no less restrictive means than a community treatment order of ensuring appropriate treatment of the person's illness, the Tribunal may make an order for the treatment of the person (a level 2 community treatment order). (2) In considering whether there is no less restrictive means than a community treatment order of ensuring appropriate treatment of the person's illness, consideration must be given, amongst other things, to the prospects of the person receiving all treatment of the illness necessary for the protection of the person and others on a voluntary basis. (3) A level 2 community treatment order may be made in respect of a person— (a) on an application to the Tribunal for the Tribunal's decision as to whether it should make a community treatment order in respect of the person (whether or not a level 1 community treatment order has been made in respect of the person); or (c) on an application to the Tribunal under Part 5 Division 4 for the revocation of a level 3 inpatient treatment order that applies to the person. (4) An application may be made to the Tribunal for the Tribunal's decision as to whether it should make a community treatment order in respect of a person by— (a) the Public Advocate; or (b) a medical practitioner; or (c) a mental health clinician; or (d) a guardian, medical agent, relative, carer or friend of the person; or (e) any other person who satisfies the Tribunal that he or she has a proper interest in the welfare of the patient. (4a) A level 1 community treatment order applying in relation to a person is taken to be revoked on the making of a level 2 community treatment order in relation to the person. (5) A level 2 community treatment order, unless earlier revoked, expires at a time fixed in the order which must be— (a) in the case of an order relating to a child—2 pm on a business day not later than 6 calendar months after the day on which it is made; or (b) in any other case—2 pm on a business day not later than 12 calendar months after the day on which it is made. (6) A registrar of the Tribunal must, not less than 2 months before the expiry of a level 2 community treatment order that has a period of operation of more than 6 months, send to the applicant (if any) for the order, the Public Advocate and to any other person who it appears to the registrar may have a proper interest in the welfare of the patient a written reminder of the date of expiry of the order. (7) The Tribunal may, on application, by order, vary or revoke a level 2 community treatment order at any time. (8) An application for variation or revocation of a level 2 community treatment order may be made by— (a) the patient; or (b) the Public Advocate; or (c) a medical practitioner; or (d) a mental health clinician; or (e) a guardian, medical agent, relative, carer or friend of the patient; or (f) any other person who satisfies the Tribunal that he or she has a proper interest in the welfare of the patient. 17—Chief Psychiatrist to be notified of level 2 orders or their variation or revocation A registrar of the Tribunal must ensure that the Chief Psychiatrist is notified, within 1 business day, of the making, variation or revocation of a level 2 community treatment order by the Tribunal. 18—Treatment of patients to whom level 2 orders apply (1) Subject to subsection (2), a patient to whom a level 2 community treatment order applies may be given treatment for his or her mental illness of a kind authorised by a psychiatrist or authorised medical practitioner who has examined the patient. (2) Authorisation is not required under subsection (1) for treatment if a medical practitioner considers that— (a) the nature of the patient's mental illness is such that the treatment is urgently needed for the patient's well‑being; and (b) in the circumstances it is not practicable to obtain that authorisation. (3) Treatment may be given under this section despite the absence or refusal of consent to the treatment. (4) This section does not apply to prescribed psychiatric treatment, or to prescribed treatment within the meaning of the Guardianship and Administration Act 1993. Note— Under Part 6, the treatment and care of a patient to whom a level 2 community treatment order applies is to be governed by a treatment and care plan. 19—Chief Psychiatrist to ensure monitoring of compliance with level 2 orders The Chief Psychiatrist must ensure that for each patient to whom a level 2 community treatment order applies there is a mental health clinician who has ongoing responsibility for monitoring and reporting to the Chief Psychiatrist on the patient's compliance with the order. Part 5—Orders for treatment as inpatient of persons with mental illness Division 1—Non‑compliance with community treatment orders and making of inpatient treatment orders 20—Non-compliance with community treatment orders and making of inpatient treatment orders (1) A person's refusal or failure to comply with a community treatment order is a relevant consideration in deciding whether an inpatient treatment order should be made in respect of the person under this Part. (2) However, nothing in this Act prevents the making of an inpatient treatment order under this Part in respect of a person without a prior community treatment order having been made in respect of the person if an inpatient treatment order is required in the particular circumstances. Division 2—Level 1 inpatient treatment orders 21—Level 1 inpatient treatment orders (1) A medical practitioner or authorised mental health professional may make an order that a person receive treatment as an inpatient in a treatment centre (a level 1 inpatient treatment order) if it appears to the medical practitioner or authorised mental health professional, after examining the person, that— (a) the person has a mental illness; and (b) because of the mental illness, the person requires treatment for the person's own protection from harm (whether physical or mental, and including harm involved in the continuation or deterioration of the person's condition) or for the protection of others from harm; and (ba) the person has impaired decision‑making capacity relating to appropriate treatment of the person's mental illness; and (c) there is no less restrictive means than an inpatient treatment order of ensuring appropriate treatment of the person's illness. (2) In considering whether there is no less restrictive means than an inpatient treatment order of ensuring appropriate treatment of the person's illness, consideration must be given, amongst other things, to the prospects of the person receiving all treatment of the illness necessary for the protection of the person and others on a voluntary basis or in compliance with a community treatment order. (3) A level 1 inpatient treatment order must be made in writing in the form approved by the Chief Psychiatrist. (4) A level 1 inpatient treatment order, unless earlier revoked, expires at a time fixed in the order which must be 2 pm on a business day not later than 7 days after the day on which it is made. (5) On the making of a level 1 inpatient treatment order, the following provisions apply: (a) the patient must be examined by a psychiatrist or authorised medical practitioner, who must, if the order was made by a psychiatrist or authorised medical practitioner, be a different psychiatrist or authorised medical practitioner; (b) the examination must occur within 24 hours of the making of the order; (c) if it is not practicable for the examination to occur within that period, it must occur as soon as practicable thereafter; (d) after completion of the examination, the psychiatrist or authorised medical practitioner may confirm the level 1 inpatient treatment order if satisfied that the grounds referred to in subsection (1) exist for the making of a level 1 inpatient treatment order, but otherwise must revoke the order. (6) A medical practitioner or authorised mental health professional may form an opinion about a person under subsection (1) or (5) based on his or her own observations and any other available evidence that he or she considers reliable and relevant (which may include evidence about matters occurring outside the State). (7) A psychiatrist or authorised medical practitioner who has examined a patient to whom a level 1 inpatient treatment order applies may revoke the order at any time. Note— A psychiatrist or authorised medical practitioner who revokes a level 1 inpatient treatment order may, in substitution, make a level 1 community treatment order under Part 4 Division 1. (8) Confirmation or revocation of a level 1 inpatient treatment order must be effected by notice in the form approved by the Chief Psychiatrist. 22—Chief Psychiatrist to be notified of level 1 orders or their revocation (1) A psychiatrist or authorised medical practitioner making, confirming or revoking a level 1 inpatient treatment order must ensure that the Chief Psychiatrist is sent or given, within 1 business day, a notice in the form approved by the Chief Psychiatrist. (2) If the order is made within 7 days after the expiry or revocation of a previous inpatient treatment order applying to the same person, the Chief Psychiatrist must ensure that the Tribunal is given a copy of the notice referred to in subsection (1) within 1 business day of the making of the order. (3) The Chief Psychiatrist must, within 1 business day, by written notice sent or given to the psychiatrist or authorised medical practitioner, acknowledge receipt by the Chief Psychiatrist of a notice under subsection (1). 23—Copies of level 1 orders, notices and statements of rights to be given to patients etc (1) A medical practitioner or authorised mental health professional making a level 1 inpatient treatment order must ensure that the patient is given, as soon as practicable, a copy of the order. (2) A medical practitioner or authorised mental health professional making a level 1 inpatient treatment order must ensure that the patient is given, as soon as practicable, a statement in writing in the form approved by the Chief Psychiatrist (a statement of rights)— (a) informing the patient of his or her legal rights; and (b) containing any other information prescribed by the regulations. (3) If a patient is unable to read or otherwise comprehend the statement of rights, the medical practitioner or authorised mental health professional must ensure that any steps that are practicable in the circumstances are taken to convey the information contained in the statement to the patient. (4) Subject to subsection (6), the director of a treatment centre in which a patient is first admitted as an inpatient under a level 1 inpatient treatment order must cause a copy of the order and statement of rights to be sent or given to a guardian, medical agent, relative, carer or friend of the patient as soon as practicable. (5) If a level 1 inpatient treatment order is revoked, the director of the treatment centre in which the patient is admitted as an inpatient must— (a) ensure that the patient is given, as soon as practicable, a copy of the notice of revocation of the order; and (b) subject to subsection (6), cause a copy of the notice of revocation to be sent or given to a guardian, medical agent, relative, carer or friend of the patient as soon as practicable. (6) The following provisions apply for the purposes of subsections (4) and (5)(b): (a) the person to be sent or given a copy of the order and statement of rights, or notice of revocation, must be— (i) a guardian, medical agent, relative, carer or friend of the patient nominated by the patient for the purpose; or (ii) if that is not practicable or appropriate—a guardian, medical agent, relative, carer or friend of the patient who appears to have or be assuming responsibility for the care of the patient; or (iii) if that is not practicable or appropriate—any other guardian, medical agent, relative, carer or friend of the patient to whom it is practicable and appropriate to send or give the copy of the order and statement, or notice of revocation; (b) the director is not required to send or give a copy of the order and statement, or notice of revocation, to a person whose whereabouts are not known to or readily ascertainable by the director; (c) it is not appropriate for the director to send or give a copy of the order and statement, or notice of revocation, to a particular person if the director has reason to believe that it would be contrary to the patient's best interests to do so. 24—Treatment of patients to whom level 1 orders apply (1) A patient to whom a level 1 inpatient treatment order applies may be given treatment for his or her mental illness, or for any other illness that may be causing or contributing to the mental illness, of a kind authorised by a medical practitioner who has examined the patient. (2) The treatment may be given despite the absence or refusal of consent to the treatment. (3) Nothing prevents the treatment of a patient to whom a level 1 inpatient treatment order applies before confirmation of the order under this Part. (4) This section does not apply to prescribed psychiatric treatment, or to prescribed treatment within the meaning of the Guardianship and Administration Act 1993. (5) If a medical practitioner authorises treatment of a patient to whom a level 1 inpatient treatment order applies that is treatment of a kind prescribed by the regulations, the medical practitioner must ensure that the Chief Psychiatrist is sent or given, within 1 business day, a notice in the form approved by the Chief Psychiatrist. Division 3—Level 2 inpatient treatment orders 25—Level 2 inpatient treatment orders (1) If a level 1 inpatient treatment order has been made or confirmed by a psychiatrist or authorised medical practitioner under Division 2, a psychiatrist or authorised medical practitioner may, after further examination of the patient carried out before the order expires, make a further order for the treatment of the patient as an inpatient in an approved treatment centre (a level 2 inpatient treatment order). (2) A psychiatrist or authorised medical practitioner may make a level 2 inpatient treatment order if satisfied that— (a) the person has a mental illness; and (b) because of the mental illness, the person requires treatment for the person's own protection from harm (whether physical or mental, and including harm involved in the continuation or deterioration of the person's condition) or for the protection of others from harm; and (ba) the person has impaired decision‑making capacity relating to appropriate treatment of the person's mental illness; and (c) there is no less restrictive means than an inpatient treatment order of ensuring appropriate treatment of the person's illness. (3) In considering whether there is no less restrictive means than an inpatient treatment order of ensuring appropriate treatment of the person's illness, consideration must be given, amongst other things, to the prospects of the person receiving all treatment of the illness necessary for the protection of the person and others on a voluntary basis or in compliance with a community treatment order. (4) A psychiatrist or authorised medical practitioner may form an opinion about a person under subsection (2) based on his or her own observations and any other available evidence that he or she considers reliable and relevant (which may include evidence about matters occurring outside the State). (5) A level 2 inpatient treatment order must be made in writing in the form approved by the Chief Psychiatrist. (6) Subject to subsection (7), a level 2 inpatient treatment order, unless earlier revoked, expires at a time fixed in the order which must be 2 pm on a business day not later than 42 days after the day on which it is made. (7) A level 2 inpatient treatment order may, once only, be extended by a psychiatrist or authorised medical practitioner (other than the psychiatrist or authorised medical practitioner who made the order) who has examined the patient to whom the order applies and, in that case, the order, unless earlier revoked, will expire at a time fixed in the extended order (which must be 2 pm on a business day not later than 42 days from the day on which the order would, had it not been extended, have expired). (8) A psychiatrist or authorised medical practitioner who has examined a patient to whom a level 2 inpatient treatment order applies may revoke the order at any time. Note— A psychiatrist or authorised medical practitioner who revokes a level 2 inpatient treatment order may, in substitution, make a level 1 community treatment order under Part 4 Division 1. (9) Revocation of a level 2 inpatient treatment order must be effected by notice in the form approved by the Chief Psychiatrist. 26—Notices and reports relating to level 2 orders (1) A psychiatrist or authorised medical practitioner making or revoking a level 2 inpatient treatment order must ensure that the Chief Psychiatrist is sent or given, within 1 business day, a notice in the form approved by the Chief Psychiatrist. (2) If the order extends an inpatient treatment order, the Chief Psychiatrist must ensure that the Tribunal is given a copy of the notice referred to in subsection (1) within 1 business day of the making of the order. (3) The Chief Psychiatrist must, within 1 business day, by written notice sent or given to the psychiatrist or authorised medical practitioner, acknowledge receipt by the Chief Psychiatrist of a notice under subsection (1). (4) A psychiatrist or authorised medical practitioner making a level 2 inpatient treatment order must, as soon as practicable, provide to the director of the approved treatment centre in which the patient is or is to be an involuntary inpatient a written report of the results of his or her examination of the patient and of the reasons for making the order. (5) On receiving a report under subsection (4), the director must forward a copy of the report to the Chief Psychiatrist. 27—Copies of level 2 orders, notices and statements of rights to be given to patients etc (1) A psychiatrist or authorised medical practitioner making a level 2 inpatient treatment order must ensure that the patient is given, as soon as practicable, a copy of the order. (2) A psychiatrist or authorised medical practitioner making a level 2 inpatient treatment order must ensure that the patient is given, as soon as practicable, a statement in writing in the form approved by the Chief Psychiatrist (a statement of rights)— (a) informing the patient of his or her legal rights; and (b) containing any other information prescribed by the regulations. (3) If a patient is unable to read or otherwise comprehend the statement of rights, the psychiatrist or authorised medical practitioner must ensure that any steps that are practicable in the circumstances are taken to convey the information contained in the statement to the patient. (4) Subject to subsection (6), the director of a treatment centre in which a patient is first admitted as an inpatient under a level 2 inpatient treatment order must cause a copy of the order and statement of rights to be sent or given to a guardian, medical agent, relative, carer or friend of the patient as soon as practicable. (5) If a level 2 inpatient treatment order is revoked, the director of the treatment centre in which the patient is admitted as an inpatient must— (a) ensure that the patient is given, as soon as practicable, a copy of the notice of revocation of the order; and (b) subject to subsection (6), cause a copy of the notice of revocation to be sent or given to a guardian, medical agent, relative, carer or friend of the patient as soon as practicable. (6) The following provisions apply for the purposes of subsections (4) and (5)(b): (a) the person to be sent or given a copy of the order and statement of rights, or notice of revocation must be— (i) a guardian, medical agent, relative, carer or friend of the patient nominated by the patient for the purpose; or (ii) if that is not practicable or appropriate—a guardian, medical agent, relative, carer or friend of the patient who appears to have or be assuming responsibility for the care of the patient; or (iii) if that is not practicable or appropriate—any other guardian, medical agent, relative, carer or friend of the patient to whom it is practicable and appropriate to send or give the copy of the order and statement, or notice of revocation; (b) the director is not required to send or give a copy of the order and statement, or notice of revocation, to a person whose whereabouts are not known to or readily ascertainable by the director; (c) it is not appropriate for the director to send or give a copy of the order and statement, or notice of revocation, to a particular person if the director has reason to believe that it would be contrary to the patient's best interests to do so. 28—Treatment of patients to whom level 2 orders apply (1) A patient to whom a level 2 inpatient treatment order applies may be given treatment for his or her mental illness, or for any other illness that may be causing or contributing to the mental illness, of a kind authorised by a medical practitioner who has examined the patient. (2) The treatment may be given despite the absence or refusal of consent to the treatment. (3) This section does not apply to prescribed psychiatric treatment, or to prescribed treatment within the meaning of the Guardianship and Administration Act 1993. (4) If a medical practitioner authorises treatment of a patient to whom a level 2 inpatient treatment order applies that is treatment of a kind prescribed by the regulations, the medical practitioner must ensure that the Chief Psychiatrist is sent or given, within 1 business day, a notice in the form approved by the Chief Psychiatrist. Note— Under Part 6, the treatment and care of a patient to whom a level 2 inpatient treatment order applies is to be governed by a treatment and care plan. Division 4—Level 3 inpatient treatment orders 29—Level 3 inpatient treatment orders (1) If the Tribunal is satisfied that— (a) a person has a mental illness; and (b) because of the mental illness, the person requires treatment for the person's own protection from harm (whether physical or mental, and including harm involved in the continuation or deterioration of the person's condition) or for the protection of others from harm; and (ba) the person has impaired decision‑making capacity relating to appropriate treatment of the person's mental illness; and (c) there is no less restrictive means than an inpatient treatment order of ensuring appropriate treatment of the person's illness, the Tribunal may make an order that the person receive treatment as an inpatient in an approved treatment centre (a level 3 inpatient treatment order). (2) In considering whether there is no less restrictive means than an inpatient treatment order of ensuring appropriate treatment of the person's illness, consideration must be given, amongst other things, to the prospects of the person receiving all treatment of the illness necessary for the protection of the person and others on a voluntary basis or in compliance with a community treatment order. (3) A level 3 inpatient treatment order may be made, on application, in respect of a person to whom a level 1, level 2 or level 3 inpatient treatment order applies. (4) An application may be made for the Tribunal to make a level 3 inpatient treatment order in respect of a person by the Public Advocate, the director of an approved treatment centre or an employee in an approved treatment centre authorised by the director of the centre for the purpose. (4a) A level 1 or 2 inpatient treatment order applying in relation to a person is taken to be revoked on the making of a level 3 inpatient treatment order in relation to the person. (5) A level 3 inpatient treatment order, unless earlier revoked, expires at a time fixed in the order which must be— (a) in the case of an order relating to a child—2 pm on a business day not later than 6 calendar months after the day on which it is made; or (b) in any other case—2 pm on a business day not later than 12 calendar months after the day on which it is made. (6) The Tribunal may, on application, by order, vary or revoke a level 3 inpatient treatment order at any time. (7) An application for variation or revocation of a level 3 inpatient treatment order may be made by— (a) the patient; or (b) the Public Advocate; or (c) a medical practitioner; or (d) a mental health clinician; or (e) a guardian, medical agent, relative, carer or friend of the patient; or (f) any other person who satisfies the Tribunal that he or she has a proper interest in the welfare of the patient. Note— If the Tribunal revokes a level 3 inpatient treatment order, it may, in substitution, make a level 2 community treatment order under Part 4 Division 2. 30—Chief Psychiatrist to be notified of level 3 orders or their variation or revocation A registrar of the Tribunal must ensure that the Chief Psychiatrist is notified, within 1 business day, of the making, variation or revocation of a level 3 inpatient treatment order by the Tribunal. 31—Treatment of patients to whom level 3 orders apply (1) A patient to whom a level 3 inpatient treatment order applies may be given treatment for his or her mental illness, or for any other illness that may be causing or contributing to the mental illness, of a kind authorised by a medical practitioner who has examined the patient. (2) Treatment may be given under this section despite the absence or refusal of consent to the treatment. (3) This section does not apply to prescribed psychiatric treatment, or to prescribed treatment within the meaning of the Guardianship and Administration Act 1993. (4) If a medical practitioner authorises treatment of a patient to whom a level 3 inpatient treatment order applies that is treatment of a kind prescribed by the regulations, the medical practitioner must ensure that the Chief Psychiatrist is sent or given, within 1 business day, a notice in the form approved by the Chief Psychiatrist. Note— Under Part 6, the treatment and care of a patient to whom a level 2 or level 3 inpatient treatment order applies is to be governed by a treatment and care plan. Divi