The Law Handbook 2024

824 Section 8: Disability, mental illness and the law as soon as practicable and in writing within 10 days) and advise the patient they can make an application to the chief psychiatrist for a review of the patient’s treatment if they are dissatisfied with the decision of the authorised psychiatrist. The chief psychiatrist must review the treatment within 10 days of receiving the application. The chief psychiatrist can direct the authorised psychiatrist to change the treatment plan and must notify the patient, authorised psychiatrist and relevant others of this decision as soon as practicable in writing. Advance statement of preferences An advance statement of preferences (pt 2.5 MHWA) is a written document in which a person states their preferences about treatment, care and support if they became unwell and needed compulsory mental health assessment or treatment. A designated mental health service must take all reasonable steps to find out whether a person has an advance statement of preferences and ensure that all reasonable efforts are made to give effect to it. The reasonable steps that should be taken will depend on the circumstances but may, for example, include: • checking the person’s file to see if there is a record of an advance statement of preferences being made; • asking the patient, their nominated support person, or their family, carer or other supporter if the person has made an advance statement of preferences; • asking anyone who has referred the patient and has ongoing involvement in their care, such as a private psychiatrist or GP. An advance statement of preferences may include any preferences relating to treatment, care and support. This may include information about: • treatment the person prefers or finds effective; • treatments they’ve received in the past which they find ineffective; • their views about medication and electro­ convulsive treatment; • support preferences to assist them to communicate and participate in decision-making; • preferences about who may be provided with their health information; • provide an opinion about whether the treatment criteria for a CTO apply; • review any treatment provided by the authorised psychiatrist; and • recommend any changes to that treatment. Any psychiatrist can provide a second psychiatric opinion. This may not be a free service. The Second Psychiatric Opinion Service (SPOS) is a free and independent service available to consumers. A Second Psychiatric Opinion Report must be prepared by the second psychiatrist outlining their opinion on whether the treatment criteria apply, the treatment provided and any recommended changes to the treatment that are deemed appropriate. The authorised psychiatrist will: • consult with the patient about their views and preferences for treatment, beneficial alternative treatments and their reasons for these views including any recovery outcomes they seek; • review an advance statement of preferences; • consult with nominated support persons, guardians, carers (in some circumstances), parents of children under the age of 16 and the DFFH Secretary if parental responsibility is awarded to them for a child. If this Second Psychiatric Opinion Report provides an opinion that the treatment criteria do not apply, the authorised psychiatrist must examine the patient as soon as possible after receiving the report and determine whether the criteria apply. If the authorised psychiatrist deems the criteria apply, they must give the patient their reasons for determining this and advise them they can apply to the Mental Health Tribunal for review. This must be done orally as soon as practicable after the determination and in writing within 10 days after the determination is made. This second psychiatric opinion does not automatically override any treatment order or treatment plan. If the Second Psychiatric Opinion Report recommends changes to the patient’s treatment, the authorised psychiatrist must review the patient’s treatment and decide whether to adopt all, some, or none of the recommendations in the report. If none or only some of the recommendations by the second-opinion psychiatrist are not adopted by the authorised psychiatrist, the authorised psychiatrist must give reasons to the patient (orally