Pathways to involuntary admission - getting the person to hospital

In the Southern Highlands, there are typically four ways that a person with a mental illness can be taken to a hospital for treatment, generally, as an involuntary patient. The NSW Mental Health Act 2007 specifies detention on certificate of a medical practitioner; detention on certificate of an Accredited Person; detention on certificate by Police service personnel; and detention on certificate by Ambulance service personnel. Detention on certificate: A person may be taken to, and detained, in a declared mental health facility on the certificate of a medical practitioner, accredited person, police officer and ambulance officer where: the medical practitioner or other duly authorised person has personally examined or observed the person immediately or shortly before completing the certificate, and the medical practitioner or other duly authorised person has formed the opinion that the person is either a "mentally ill", or a "mentally disordered" person, and the medical practitioner or other duly authorised person is satisfied that involuntary admission and detention is necessary (and that there are no other appropriate means available for dealing with the person), and the medical practitioner or other duly authorised person is not a near relative of the person. The certificate completed by the medical practitioner or other duly authorised person: must be in the form set out in Part 1 of the Schedule 2 is valid for five days for a "mentally ill" person, and for 1 day for a "mentally disordered" person. Request for police assistance: A medical practitioner or other duly authorised person who has completed a Schedule under Section 19 of the Mental Health ACT 2007, may enlist the assistance of the police in taking the person to a declared mental health facility where: they believe such assistance is required, and there is no other means reasonably available. In such circumstances the medical practitioner or other duly authorised person must complete Part 2 of the Schedule 2. The police must assist as soon as is practicable. Only the police may use force to take the person to a declared mental health facility.Detention on the request of a relative or friend. In the previous Mental Health Act 1990 a person may be detained on the written request, of a relative or friend, to the medical superintendent of the declared mental health facility. This section of the Act was only to be used in remote areas where distance and the urgency of the situation made it impractical for the person to be seen by a medical practitioner or other duly authorised person. It was (and still is) rarely applicable. Detention by the police: The police may apprehend someone and take them to a declared mental health facility where:the person appears to be mentally disturbed, and the police have reasonable grounds for believing that the person is committing or has recently committed an offence, and it would be beneficial if that person were to be admitted to a hospital rather than being dealt with under the criminal law; or the person has recently attempted or is at risk of killing themselves or attempting to cause serious bodily injury to themselves. Police do not need a warrant in these circumstances. They may apprehend a person in any place, either public or private. Detention on order of the court: This occurs where a magistrate is of the opinion that the person appearing before them is a mentally ill person who requires assessment at a declared mental health facility. The person may be taken to, and detained, in a declared mental health facility in accordance with an order made under Section 33 of the Mental Health (Criminal Procedures) Act 1990.Detention following order for medical examination or observationIf a magistrate is satisfied that:a person may be "mentally ill" or "mentally disordered", and the person could not be personally examined due to physical inaccessibility, then the magistrate may make an order authorising:- a medical practitioner to visit and personally examine or observe the person- a police officer to accompany and assist the medical practitioner - the use of reasonable force to enable the examination or observation to be carried out. Where this section is used the medical practitioner may complete a Schedule 2.The Bowral Mental Health Service now has a total of 5 Accredited Persons trained by the NSW Institute of Psychiatry and authorised by the Minister and by the Director-General of NSW Health. The Bowral Mental Health Service has also been responsible for almost all of the Schedule 2s written for persons with a mental illness or mental disorder, and the team has been responsible for most of the transfers (in health service vehicles) of the detained persons from the Wingecarribee to the declared mental health facilities at Campbelltown Hospital.