The Tribunal’s primary role is to provide independent review of many different kinds of treatment orders. Our member panels perform reviews of
- Involuntary Treatment Orders (ITO)
- Forensic Orders (FO)
- Forensic Disability Orders (FDO)
- Fitness for Trial (FFT)
- Forensic Information Orders (FIO)
- Confidentiality Orders (CO)
- Electroconvulsive Therapy Applications (ECT)
An order made by a qualified psychiatrist by which a person is required to have mental health treatment either in hospital or in the community. For more information, download “A Guide to Involuntary Treatment Order Reviews”
A Mental Health Court order by which a person deemed not responsible nor fit to stand trial for a criminal offence because of their mental illness becomes an involuntary patient and must receive mental health treatment. For more information, download “A Guide to Forensic Order Reviews”
Under the Mental Health Act 2000 the Tribunal may make an order that a person can have information about a forensic patient including:
- when a review for the patient is going to be carried out
- the Tribunal’s decision at a review to confirm (continue) or revoke (cancel) the forensic order
- if an approval has been given for the patient to move out of Queensland
- if the patient has been transferred from one mental health service to another
- if the patient has been transferred to another state under an interstate agreement
- whether an order or approval has been given for the patient to have some or all of their treatment outside the hospital (limited community treatment)
- the conditions of limited community treatment relevant to the safety of the person applying for the information
- whether an order for limited community treatment has been revoked (cancelled)
- whether the patient is absent from the mental health service without permission
- when the patient has been returned to the mental health service after being absent without permission
- if the patient is no longer a forensic patient, the date the order stopped, and the reason
Who can have a Forensic Information Order?
If you are a direct victim of an offence committed by a forensic patient; or a relative of a direct victim who has died; or the parent or guardian of a direct victim who is a minor, you are an eligible person. This means that you are entitled to have a Forensic Patient Information Order unless the Tribunal believes that giving the information will cause serious harm to the patient’s health, or put the safety of someone else at risk. The Tribunal will need to obtain a report from the patient’s treating doctor to decide this. If you are a young person under the age of 18 years, the Tribunal must decide that it is in your best interests for the order to be made. Additional information may be obtained from you, or your parent or guardian for this purpose. If you are not a direct victim or relative of a direct victim of an offence committed by the forensic patient, the Tribunal must establish that you have sufficient personal interest before making an order. This means the Tribunal must consider:
- whether the patient represents a risk to your safety
- your relationship to the patient
- whether you are likely to come into contact with the patient
- the offence that lead to the patient’s forensic order
How do I get the information?
A person wanting information about a forensic patient must apply to the Tribunal. Download application forms or pick them up from the Tribunal office. An important part of the application is the declaration. When making your application you must give an undertaking that you will not give information to anyone for public use, and you will comply with the conditions of the order. At the same time as making the application, you can nominate a person to receive the information on your behalf while the Forensic Patient Information Order is in place. The nomination form is available from the Queensland Health Victim Support Service. In most cases the Tribunal President will decide the application based on written information without the need for the applicant, or the patient to attend a hearing.
Can the Tribunal refuse my application?
Yes. If the Forensic Patient Information Order will cause serious harm to the patient’s health, or put the safety of someone else at risk the Tribunal must not grant the application. The Tribunal may also refuse an application if it is satisfied that the application is frivolous or vexatious; or if a Forensic Patient Information Order was previously revoked because of misuse of the information, or breach of the conditions. In this case, the applicant would be given an opportunity to make a submission as to why the application should not be refused. If the Tribunal refuses the application, it must give the reasons.
Will the patient know about my application?
Sometimes. The Tribunal has the power to keep the application, or parts of the application confidential from the patient. A Confidentiality Order will be made if the Tribunal is satisfied that it is necessary for the health, or to protect the safety of the applicant or the patient, or the safety of someone else. A Confidentiality Order can stop the patient knowing who has made the application or the fact that an application or order has been made. The Tribunal may need to obtain health information from the applicant to help decide whether a Confidentiality Order should be made. Download “A Guide to Confidentiality Orders” for more information.
How will I know what the decision is?
The Tribunal will issue a decision form which will state what information is to be given under the order. The Tribunal may place conditions on the Forensic Patient Information Order. It is important to understand the conditions, and comply with them. A breach of conditions could lead to cancellation of the order. The Tribunal must give its decision to:
- the Director of Mental Health
- the patient and the patient’s allied person
- the parent or guardian of a patient who is a minor or has legal incapacity
- the administrator of the patient’s treating health service
- the Attorney-General
- the Director-General of Justice
The Director of Mental Health is responsible for notifying the applicant of the decision through the Queensland Health Victim Support Service. Professional staff of the service will explain the decision to you.
Can the order be changed after it is made?
Yes. If you have a Forensic Patient Information Order, you can ask to have the order revoked (cancelled), or the conditions changed. The Tribunal can also decide to change the conditions on the order. Before changing the conditions, the Tribunal must notify those people involved and allow submissions to be put forward regarding the proposed changes. If the changes go ahead, the Tribunal will issue a written decision which will be passed onto you by the Director of Mental Health through the Queensland Health Victim Support Service.
When will the order cease?
The Forensic Patient Information Order will cease if the person for whom the order is made asks the Tribunal President to revoke (cancel) the order; or if the President believes that giving the information will cause serious harm to the patient’s health or put the safety of the patient or someone else at risk.The order will also be revoked if any of the following happen:
- the patient dies
- the person for whom the order is made dies
- the patient stops being a forensic patient or
- the patient is transferred interstate under an interstate agreement
There are other situations that could lead to the order being cancelled. For example:
- the person for whom the order is made or the person’s nominee can not be located
- the person has breached the order by causing the information to be publicly available
- the person has not complied with the conditions of the order
How will I get the information that is allowed under the order?
The Director of Mental Health will receive copies of Tribunal decisions about the forensic patient, and will arrange for the Queensland Health Victim Support Service to give the information to the person for whom the Forensic Patient Information order is made, or their nominee. When a review is coming up for the patient, there will also be the opportunity to make a submission to the Tribunal. If you wish, you can use a Victim and Concerned Person Submission Form. More information is available about making submissions in Submitting Materials to the Tribunal or the brochure “Giving Information to the Tribunal”.
Where can I get more information?
If you are a person applying for a Forensic Patient Information Order, and need help with the application, or with making a submission to the Tribunal, you may contact the Queensland Health Victim Support Service. If you are a patient or carer, you can talk to the hospital or community mental health staff or you can contact the Tribunal.
For more information, download “A Guide to Forensic Information Orders”
Ordinarily an involuntary patient has a right to see any document referred to in a Tribunal proceeding. A Confidentiality Order (CO) restricts the release of certain information to the patient. The Tribunal can only make a CO where it is satisfied that disclosure of the information would:
- cause serious harm to the health of the person or patient; or
- put the safety of someone else at risk.
For more information, download “A Guide to Confidentiality Orders”
Electroconvulsive Therapy (ECT) is a treatment for severe depression, schizophrenia and mania delivered by convulsion produced by passing electric current through the brain.
The following explains the role of the Mental Health Review Tribunal in relation to ECT. The information will assist patients and their carers when ECT is given in an emergency, or an application is made to the Tribunal to give ECT.
Applying for ECT
If you need ECT and you are unable to give informed consent to the treatment, your psychiatrist may apply under the Mental Health Act 2000 to the Tribunal for approval to give you ECT.
The Tribunal will only approve ECT if it is satisfied that you are unable to give informed consent to the treatment, and that ECT is the best treatment for you to have at this time.
The Tribunal will take into account your current illness and whether ECT or other treatments have helped you in the past.
What is informed consent?
For you to be able to give informed consent to ECT you must:
- have been given a full explanation about ECT, including why your doctor thinks you should be given it, what the possible side effects are and what other treatments are available to you
- be able to understand why your doctor wants you to have ECT and be able to make a decision about whether you want to have ECT or not. You must be able to tell your doctor what you have decided about having ECT
- give your consent of your own free will
I am a voluntary patient. Can I refuse to have ECT?
Yes. If you are able to give informed consent you can refuse ECT. You will not need to attend a Tribunal hearing in this case.
If you are a voluntary patient and you are unable to give informed consent you can only be given ECT with the approval of the Tribunal. However, if your doctor knows that you do not want ECT you must not be given the treatment (For example, you may have an Advance Health Directive, or have clearly stated your wishes in another way in the past).
I am an involuntary patient. Can I refuse to have ECT?
Yes. If you are an involuntary patient and you are able to give informed consent you can refuse to have ECT. If you are unable to give informed consent you must not be given ECT without the approval of the Tribunal, unless your doctor thinks it is an emergency situation.
ECT in an emergency situation
If you are an involuntary patient and you don’t have capacity to give informed consent to the treatment your doctor may start giving you ECT. This may only happen if your psychiatrist and the medical superintendent for the health service believe it is necessary to save your life or to prevent you from suffering harm. An emergency certificate authorises the ECT for up to 5 days.
However, your psychiatrist must still apply to the Tribunal for approval for you to have ECT. The Tribunal will have a hearing as soon as possible (usually within a few days) to decide whether you should continue to have ECT or not.
What happens after my doctor has applied to the Tribunal for me to be given ECT?
The Tribunal will decide at a hearing whether or not you should be given ECT. Three members will usually be on the Tribunal panel (a lawyer, a psychiatrist, and one other person with knowledge of mental illness).
You and/or your allied person may attend the hearing to give your views, and you may bring a lawyer or other person to represent you if you wish. Your psychiatrist will also usually be present to give information to the Tribunal.
In most cases, you will be told the Tribunal’s decision at the end of the hearing. If the Tribunal decides to approve for you to have ECT, the Tribunal must also state how many treatments you should have in a particular period of time.
What happens after the hearing?
- You will receive a written decision in the mail
- Within 7 days of receiving the written decision, you can ask for the written reasons for the decision. However there may be some instances where the Tribunal may not give you the reasons.
- If you disagree with the Tribunal’s decision you can appeal to the Mental Health Court.
- More information about appeals is available from: The Registrar, Mental Health Court Phone: (07) 3234 0703