Mental illness is a challenge faced by many Aboriginal and Torres Strait Islander families and communities. It can be hard to talk about with your mob and difficult to know how to help a family member who becomes mentally ill.
It is important for anyone receiving involuntary treatment for a mental illness to have their say about decisions that will affect their life. Supporting a family member to attend his/her Mental Health Review Tribunal hearings is a simple and powerful way to do this and start him/her on the road to recovery.
The Tribunal conducts a hearing to decide whether you remain on your treatment order — Involuntary Treatment Order (ITO) or Forensic Order (FO). At the hearing there are usually three Tribunal members, a legal member (presiding member), a psychiatrist member and a community member.
You are invited to attend with an allied person. If you do not have an allied person you can arrange for a support person to come with you. A lawyer can also support you at your hearing. If you do not have a lawyer you can ask an advocate to attend. At least one member of your treating team will also be present.
The hearing is conducted at the hospital or mental health care centre where you are receiving treatment or, where possible, at an Indigenous community venue.
What happens at a hearing?
Hearings are not like a court. A Tribunal panel normally includes a lawyer, a psychiatrist, and another person who is not a lawyer or a doctor. Where possible, the Tribunal will arrange for an Indigenous member to be a part of a panel for Aboriginal and Torres Strait Islander patient reviews.
The Tribunal would like you to be there if possible. You may bring your allied person and/or a lawyer if you have one. If you do not have an allied person or a lawyer you can ask an advocate, or a support person to come with you. The psychiatrist, doctor and/or case manager is at the hearing to give a professional opinion about your illness. You can ask questions of the doctor and the Tribunal, and anyone else present.
If you or someone on your behalf, tell the Tribunal that an interpreter or cultural support person is needed before the hearing, the Tribunal will make arrangements for this at no cost to you.
In most cases, the Tribunal will tell you the decision on the day of the hearing.
How will I know when a hearing is coming up?
The Tribunal will send a letter and a hearing notice to you, your allied person (if you have one), and the mental health service, telling you the date, time and place of your hearing. If you are having your first hearing you and your allied person will also be sent a Tribunal DVD, Deadly Choices, Solid Decisions. The DVD will assist you to understand what is involved in the hearing process.
The treating psychiatrist is asked to write a Clinical Report, and to make sure you have had an opportunity to read the report and understand what is said in the report before the hearing. You may write down your views about your Involuntary Treatment Order or Forensic Order and what is said in the doctor’s report, and send it to the Tribunal or give it to the Tribunal panel at the hearing.
What if I can’t attend the hearing?
If the Tribunal really needs to speak to you, the hearing may be adjourned to another date so that you can attend, or the Tribunal may phone you at home if you agree. If the Tribunal can make a decision without you being there, then the decision will be sent to you by mail within a week after the hearing.
Before the Hearing
You and your allied person will receive a ‘Notice of Hearing’ letter with the date, time and place of the hearing.
Before the hearing you can:
- Ask a lawyer to help in the hearing. A person who is not a lawyer can represent you if the Tribunal agrees.
- Contact the Indigenous Mental Health Worker from the mental health service where you are receiving treatment for assistance and support throughout the hearing process.
- Read the report written about you by your doctor, and any other documents that the Tribunal will consider to make a decision about your case.
- Write your own report about your case to give to the Tribunal. You can ask for a Self Report form from your mental health service or the Tribunal.
During the Hearing
The hearing will be private, confidential and informal and allows time for:
- You, your allied person and lawyer or legal representative to ask questions, give information and discuss their view of the situation.
- The treating doctor to give information to the Tribunal.
- The Tribunal to read and listen to all the information, and make a decision about the case. In most cases, the Tribunal will give their decision on the day of the hearing.
- You and your treating team may be asked to wait outside the hearing room while the panel makes its decision.
A representative of the Attorney-General may attend to represent the community’s view for forensic order reviews.
After the Hearing
You will find out about the Tribunal’s decision by receiving a written decision in the mail.
If you disagree with the decision of the Tribunal an appeal can be made to the Mental Health Court.
You can also request a written Statement of Reasons for the decision from the Tribunal. There are some instances where the Tribunal may not give the reasons.
For more information contact the Registrar of the Mental Health Court.
What is the Tribunal doing to improve services for Aboriginal and Torres Strait Islander people?
The Tribunal is working to:
- produce Indigenous resources to better inform patients about hearings
- conduct hearings at Indigenous community venues
- arrange appropriate cultural support for patients
- include a cultural information page within the Clinical Report
- appoint Indigenous members
- develop the cultural competency of staff and Tribunal members
Conducting hearings at community venues
Wherever possible, the Tribunal holds hearings for Indigenous patients in venues that are appropriate and acceptable to the local Indigenous community.
The Indigenous community venues are located at:
- The Healing Centre, Aboriginal and Torres Strait Islander Community Health Service, Woolloongabba, Brisbane
- Thursday Island
- Wuchopperen Health Service, Cairns
The patient may choose to bring a cultural support person to the hearing. This person may help the patient talk about the cultural issues that impact on the way they view their illness and their attitude towards treatment. The cultural support person for the patient could be a family member, an Indigenous Mental Health Worker, a worker from a non-government organisation, or a member of the community.
If the patient, or someone on his/her behalf, tells the Tribunal before the hearing that an interpreter or cultural support person is needed, the Tribunal will try to make these arrangements.
Cultural Information Page
The Tribunal considers cultural information to be an essential part of any review for an Aboriginal and Torres Strait Islander patient.
The cultural information page allows information relating to the cultural background of the patient to be provided in writing to the Tribunal for consideration when conducting a review.
Cultural information relating to the patients clan group, kinship and family, language and spiritual beliefs are all things that the Tribunal will consider.
Where possible, the Tribunal arranges for an Indigenous Tribunal member to sit on a hearing for an Aboriginal or Torres Strait Islander patient. The role of the member is to undertake a legal, medical or community role and talk with the patient and provide the other panel members with cultural information such as cultural interpretations of mental health and mental illness.
The Tribunal currently has six Indigenous members in Queensland, five who sit as community members and one who sits as a legal member. Patients and Indigenous Mental Health Workers say they are more comfortable when they see an Indigenous member on the panel and are more likely to take part in the hearing.
Developing the cultural competency of staff and members
Tribunal staff and members must be sensitive to the needs of Aboriginal and Torres Strait Islander patients, including having an understanding of the historical and contemporary issues that may impact on the hearing.
The Tribunal has developed a number of resources to assist staff and members to develop their cultural competency including:
- guidelines for members regarding hearing practices with Indigenous patients
- an Indigenous component for the induction program for members
- a multimedia (CD-Rom) learning resource which provides information about Aboriginal and Torres Strait Islander history and culture, social and emotional well-being and the conduct of hearings with Indigenous patients.
Indigenous Liaison Officer
The purpose of this role is to establish links within Indigenous communities to:
- provide information about the Tribunal’s role and function
- encourage Indigenous patients to take part in Tribunal hearings
- ensure the Tribunal meets the needs of Indigenous stakeholders
- provide advice about cultural protocols
- contribute cultural knowledge to the policies and procedures of hearings for Indigenous patients.
The Indigenous Mental Health Worker (IMHW) provides culturally sensitive social, emotional and spiritual well-being support within a primary heath care framework to Aboriginal and Torres Strait Islander people with a mental illness. This includes direct care co-ordination and support to the patient, their families and community.
The IMHW is a member of a mental health multi-disciplinary team which provides co-case management, advice on social and cultural aspects of assessment, treatment and rehabilitation, including social and emotional well-being.
IMHWs at Authorized Mental Health Services can play a key role in the hearing process for Aboriginal and Torres Strait Islander patients by providing culturally appropriate support. They are ideally placed to support the patient before, during and after the hearing by providing education about the Tribunal process, encouraging patient attendance at their hearing and assisting the patient to understand Tribunal decisions.