This chapter explains:
When a person experiences mental illness they usually get to make their own decisions about their treatment. The Mental Health (Compulsory Assessment and Treatment) Act 1992 covers situations when it is considered a person needs treatment for their mental illness, but they do not agree to this.
If a person becomes a patient under the Mental Health Act:
Note: The responsible clinician should, wherever practicable, seek to obtain the patient’s consent to any treatment even when the treatment is authorised under the Mental Health Act without the patient’s consent.
The Mental Health Act:
The Mental Health Act defines mental disorder as:
Note: This definition is important because it is used to decide whether a person has a mental illness that could require them to be treated without their consent.
These words are legal terms used to describe specific symptoms.
Delusions include holding false beliefs, for example, a person believing that they are related to royalty when they are not.
A person becomes a proposed patient when an application is made to have them assessed under the Mental Health Act.
If, after a person has been assessed, the psychiatrist believes they have a mental disorder and requires them to undergo patient assessment, they become a patient under the Mental Health Act. Patient also includes a person who is subject to compulsory treatment order and special patients.
Special patients are those who can be detained in a hospital by an order made under the Criminal Procedure (Mentally Impaired Persons) Act 2003, the Criminal Procedure Act 2011, the Air Forces Discipline Act 1971 or the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003.
If a person’s assessment says that there are reasonable grounds for believing they have a mental disorder, they will be assigned a responsible clinician. This person is usually a psychiatrist and is responsible for a patient’s treatment while they are under the Mental Health Act.
This is a friend or family or whānau member who is, or appears to be, most directly concerned with a patient’s care. If a patient is not well enough to nominate someone or there is some disagreement about who their principal caregiver should be, then the Director of Area Mental Health Services (see the description below) should decide. Not everyone has a principal caregiver. If a patient does have a principal caregiver, the principal caregiver will be sent information about the patient’s legal status and treatment.
Directors of Area Mental Health Services (DAMHS) are appointed by District Health Boards and are responsible for the Mental Health Act in their area. If someone believes a person has a mental disorder they can apply to the DAMHS to have that person assessed (see “Compulsory assessment process” in this chapter). The DAMHS or a duly authorised officer (see the description below) will then arrange an assessment examination. DAMHS are also responsible for assigning responsible clinicians (see the description above).
Duly authorised officers (DAOs) are health professionals with special responsibilities under the Mental Health Act. For example, DAOs can:
District inspectors are lawyers with special responsibilities for safeguarding the rights of people under the Mental Health Act. For example, district inspectors must:
District inspectors also have a more general oversight role for mental health services. They visit and inspect psychiatric hospitals and services and can inquire into how they are managed and any aspect of patient care and treatment.