Chapter 4 Section I: Complaints and advocacy services for involuntary patients
This section outlines where you can go if you have any concerns about being an involuntary patient or about the care and treatment you receive as a voluntary or involuntary patient.
If you are an involuntary patient and want to have your involuntary status reviewed, you should contact the Authorised Medical Officer of the hospital where you are being treated and ask them to discharge you. To find out more about this, click here.
If you want legal advice about being an involuntary patient or want a lawyer to represent you at a Mental Health Inquiry held by the Mental Health Review Tribunal or at another type of hearing of the full Mental Health Review Tribunal, you can contact the Mental Health Advocacy Service.
If you have concerns about the quality of your care in hospital, you can contact the Health Care Complaints Commission.
If you have concerns about any issue to do with your treatment and care (except legal issues about your involuntary status) you could contact a Consumer or Patient Advocate within the hospital .
If you have particular concerns about your care and treatment as an involuntary patient or the physical state of the hospital or unit where you are being treated, you can contact the Official Visitor.
If you are an involuntary patient (either an assessable person or an involuntary patient) and want to be discharged, at any time you can ask to speak to the Authorised Medical Officer (who is the Medical Superintendent, or the person delegated by the Medical Superintendent to be the 'Authorised Medical Officer', to discharge you.
You could either argue that you are no longer 'mentally ill' person under the definition in the Mental Health Act 2007 (NSW) or that you could be treated in a less restrictive setting, such as in a private hospital or while living and being cared for by family or friends, or through receiving community care and/or private medical or psychological treatment.
The Authorised Medical Officer has the power to discharge you at any time if they are of the view that you are no longer mentally ill, or that there is other care of a less restrictive kind, consistent with your safe and effective care, reasonably available to you. Despite an order made by the Mental Health Review Tribunal, an involuntary patient can be discharged at any time by hospital medical staff or be made a voluntary patient. The Mental Health Act 2007 (NSW) says that one of these things must happen if you no longer meet the definition of mentally ill or mentally disordered under the Act. Most people don’t remain as involuntary patients for the full length of time set out in the order made by the Mental Health Review Tribunal at the mental health inquiry.
There is an application form to ask for a review of your involuntary status. You can ask any member of the hospital staff for the form. When you have completed the form, ask a staff member to give it to the Authorised Medical Officer. The form for this is called ‘Application by a Patient for Discharge from Hospital’. Click here to download the form.
However, there is nothing in the Mental Health Act 2007 (NSW) or the regulations that stops you from approaching the Authorised Medical Officer directly, and putting your case to him or her verbally. If you want to do this and find that you are not able or allowed to make contact, you could ask a member of your family or a friend to do so. Alternatively, you could approach a legal service or an advocacy service and tell them of your attempts to contact the Authorised Medical Officer.
If the Authorised Medical Officer rejects your application to be discharged, or does nor respond to your request for discharge within three days, you can appeal to the Mental Health Review Tribunal. Legal Aid NSW now provides free representation at hearings of these appeals before the Mental Health Review Tribunal.
The Medical Superintendent of a hospital can and should, like the administrator of any public health facility, receive and deal with complaints and concerns about the general standard of care you get in hospital. It is always best to, if possible, to put such complaints or concerns in writing and keep a copy.
Many hospitals have Patient Representatives or Consumer Advocates. Consumer Advocates are employed by the Area Health Services to provide support and advice to patients and their carers and relatives. Consumer Advocates may also be involved in advocacy in a particular hospital. Consumer Advocates are often well connected to local community services and are able to help patients, their carers and relatives with information on where to get particular types of help and support.
In psychiatric units and hospitals, Consumer Advocates are usually people with lived experience as patients in the mental health system. They can be effective in helping patients raise issues of concern with members of the hospital staff, but they are unlikely to be able to resolve issues such as whether a patient should be discharged, or major concerns about the standard of patient care that challenge decisions of medical staff. However, Consumer Advocates can help you contact bodies such as the Health Care Complaints Commission , and they will often go to Mental Health Review Tribunal hearings with patients. If you do not know who the Consumer Advocate or Patient Representative is in the hospital, ask the nurse unit manager or the hospital social worker.