Mental Health Review Tribunal – NSW

Mental Health Review Tribunal – NSW

Medical Health Review Tribunal

The Mental Health Review Tribunal specialises in mental health issues within NSW. The tribunal has exclusive jurisdiction and a wide range of powers to deal with the care and treatment of people with mental illness.

Find out more about the Mental Health Review Tribunal, its objectives, jurisdiction and proceedings.

Let’s take a closer look.

What is the Mental Health Review Tribunal?

The mental health review tribunal is a specialist body which is constituted under the Mental Health Act. It is located in New South Wales and deals with the care and treatment of people with mental illness. The dedicated tribunal covers an exclusive and broad jurisdiction for civil and forensic hearings to aid in treating and caring for people with mental illness.

The MHRT plays a critical role in balancing the rights of those with a mental illness. Their role is significant, given that people with mental health disorders can be vulnerable to abuse and violation of their rights. The tribunal seeks to improve accessibility to justice for clients of the mental health system.

The tribunal consists of:

  • A president
  • Two full-time deputy presidents
  • Several part time deputy presidents (some are former judges and magistrates)
  • A registrar
  • Over 140 part-time members

The Governor of New South Wales appoints tribunal members for a year. They are chosen because of their mental health experience, suitable qualifications or experience with mental health issues.

A tribunal panel generally consists of three members; a lawyer, a psychiatrist and a qualified member, and several panels are held daily.

What are the Objectives of the Tribunal?

The tribunal has several objectives, and its legislated role seeks to align with the objectives stated in the Mental Health Act 2007. It says that people with a mental illness in NSW are subject to review by the MHRT for their continued or initial involuntary treatment in mental health facilities across the state. Other duties of the tribunal include the following;

  • To provide care and treatment, promote recovery of mentally ill or disordered persons
  • To help facilitate care and treatment through community care facilities
  • To facilitate the provision of hospital care on a voluntary or involuntary basis
  • Give the mentally ill or disorders persons accessibility to appropriate care, and provide treatment for their protection whilst protecting their civil rights
  • Help facilitate the individuals and their carers to be involved in decisions regarding their appropriate care and treatment

What Jurisdiction does the MHRT Have?

The mental health review tribunal can make legal decisions and judgements on behalf of mentally ill persons.

The legislation contained in the Mental Health Act 2007 and Mental Health Forensic Provisions Act 1990 enables the review tribunal to determine cases and has jurisdiction concerning the following in a civil hearing;

  • Conduct mental health enquiries and make the decision authorising the involuntary detention of a person in a mental health facility.
  • Review voluntary and involuntary patients regularly.
  • Hear appeals against a medical officer’s refusal to discharge an involuntary patient.
  • Vary, make, revoke and hear appeals regarding a community treatment order.
  • Determine whether voluntary patients have consented to electroconvulsive therapy ECT and approve the use for involuntary patients.
  • Approve special medical treatment, such as sterilisation.
  • Approve surgery on a patient in a mental health facility.
  • Make and revoke orders regarding a person’s financial affairs when a person is unable to make competent decisions because of mental illness.

The tribunal will also conduct hearings for forensic patients, who are often hospitalised at the of the hearing; in these circumstances, the MHRT hearings may be held remotely.

In the forensic division, the mental health review tribunal will determine the following;

  • When a person has been charged with a criminal offence, the tribunal will determine whether a person is fit or unfit to be tried.
  • Reviews cases of forensic patients found not criminally responsible because of mental health.
  • Review cases of patients who have received a limiting term to establish their mental health order status.
  • Review patients transferred from prison to hospital because of a mental illness.
  • Review, make, revoke and vary community treatment orders. A community treatment order authorises compulsory care and treatment, including regular medication and support services.

Following the hearing, the MHRT will send a “statement of reasons” to the court, specifying their determination. Decisions made by the mental health review tribunal are almost always in direct response to an application made by a mental health facility or psychiatrist of an involuntary patient in the community or a hospital.

There may be several hearings for a person, as there will generally be a review within 12 months to determine whether the person has become fit since the last hearing. A recent study has shown that only 15% of the clients remained in the system for more than four years.

What are the Patient’s Rights?

The principles for care and treatment of people with a mental illness are defined in the Mental Health Act 2007; it states the following:

  • People should receive the best possible care in the least restrictive environment, and be provided with timely and high quality treatment.
  • The care provided should assist the person in working and participating in the community.
  • Medication should only be given for therapeutic or diagnostic needs, and the person should be provided with information about treatment and the effects.
  • Restrictions to the patient’s liberties should be kept to a minimum, and any special needs such as religious, sexual or cultural should be recognised.
  • Every effort should be made to obtain consent for treatment and to involve them in their treatment plans.
  • They should be informed of their legal rights, and the information should be provided in a language they can understand.

Where are the Tribunal Hearings Held?

Depending on the patient’s location, there are several locations for the tribunal hearings in New South Wales. A tribunal hearing can be held in any of the following locations;

  • Hospitals
  • Community health centre
  • Video or telephone conference
  • Secure facilities around NSW
  • MHRT building in Gladesville

Who Attends the Hearings?

It is common for the following people to attend a hearing;

  • The Deputy President
  • Psychiatrist
  • Lawyer (usually chairs the hearing)
  • A suitably qualified member
  • The person’s lawyer
  • The client/patient
  • The person’s case manager
  • The person’s social worker
  • Support person (family member or friend)
  • One observer

A recent study by the Law and justice foundation in NSW showed low levels of attendance by support persons and legal representatives at the hearings. They suggested strategies to improve attendance and participation that may improve their clients’ therapeutic outcomes.

Are the Tribunal Proceedings Open to the Public?

There is a tremendous public interest in the tribunal’s proceedings for various reasons, including the power it can have to change people’s lives, their health and liberties. They must balance the patient’s rights to treatment, care and protection and the safety of the community and the general public. The MHRT provides complete transparency and options for the general public to attend a hearing, but the person’s name, witnesses and people mentioned in the proceedings will not be published.

Summary

The Mental Health Review Tribunal seeks to improve access to justice for clients of the mental health system. The MHRT has the power to make legal decisions and judgements on behalf of their clients. The tribunal seeks to improve access to justice for clients of the mental health system. The dedicated tribunal covers an exclusive and wide jurisdiction for civil and forensic hearings to aid in treating and caring for people with mental illness.

The tribunal can; Approve surgery or special medical treatment on a person in a community care facility, conduct mental health enquiries and make the decision authorising the involuntary detention of a person in mental health facilities and make and revoke orders regarding a person’s financial affairs when a person is unable to make competent decisions because of mental illness.

The MHRT plays a vital role in balancing the rights of those with a mental illness. Their role is critical, given that people with mental health disorders can be vulnerable to abuse and violation of their rights.

FAQs

What is the Mental Health Review Tribunal?

The specialist tribunal covers an exclusive and broad jurisdiction for civil and forensic hearings to aid in treating and caring for people with a mental illness.

The MHRT plays a critical role in balancing the rights of those suffering a mental illness. Their role is crucial, given that people with mental health disorders can be vulnerable to abuse and violation of their rights. The tribunal seeks to improve access to justice for clients of the mental health system. The mental health review tribunal has the power to make legal decisions and judgements on behalf of their clients with matters including;

  • Conduct mental health enquiries and make the decision authorising the continued involuntary detention of a person in a mental health facility
  • Approve surgery or special medical treatment on a patient in a mental health facility
  • Make and revoke orders regarding a person’s financial affairs when a person cannot make competent decisions because of mental illness.
  • Establish whether voluntary patients have consented to electroconvulsive therapy ECT and approve the use for involuntary patients

What are the Patient Rights in the Mental Health Act?

The Act states that people with a mental illness should receive the best possible care and be provided timely and high quality treatment. The care provided should assist the person to work and participate in the community. Medication should only be given for therapeutic or diagnostic needs, and the person should be provided with information about treatment and its effects. Restrictions to the patient’s liberties should be kept to a minimum, and any special needs, such as religious, sexual or cultural, should be recognised. Every effort should be made to obtain consent for treatment and to involve them in their treatment plans. They should be informed of their legal rights, and the information should be provided in a language they can understand.

What is a Mental Health Inquiry?

The tribunal conducts a mental health inquiry in person at the community care facility or via video conference. Any person who has been detained in the facility for a week or more will have a mental health inquiry to determine whether the person should continue to be detained or can be discharged. The tribunal will develop an appropriate community treatment or discharge plan.

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