Second psychiatric opinion and process of review by Chief Psychiatrist

Obtaining a second psychiatric opinion

A second psychiatric opinion can be sought to review the treatment of an eligible patient and assess whether the criteria for a treatment order apply to that patient.

Any psychiatrist can provide a second psychiatric opinion.

The Second Psychiatric Opinion Service is an independent service for second opinions.

If any of the recommendations by the second-opinion psychiatrist are not adopted by the Authorised Psychiatrist, an application can be made to the Chief Psychiatrist for a review of the patient’s treatment.

As part of this review, the Chief Psychiatrist may recommend changes to the treatment. They can also direct the authorised psychiatrist to change the eligible patient’s treatment if necessary.

Chief Psychiatrist review of a second psychiatric opinion: the process

• A second-opinion psychiatrist assesses the eligible patient to:
  • provide an opinion about whether the relevant order applies
  • to review the treatment provided under the relevant order
  • to recommend any changes to treatment.
• The second-opinion psychiatrist writes a second psychiatric opinion report containing their recommendations. The report is sent to:
  • the patient
  • a person who sought the second opinion on the patient’s behalf
  • their nominated support person/guardian
  • their carer (if the psychiatrist is satisfied that the second opinion will directly affect the care relationship)
  • their parents (if the patient is under 16)
  • the Department of Families, Fairness and Housing (if the patient is under a relevant child protection order)
  • the Authorised Psychiatrist.
• If the report expresses the opinion that the criteria for the relevant order do not apply, the Authorised Psychiatrist must examine the patient as soon as practicable after receiving a copy of the report. They must determine whether the criteria for the relevant order apply to the patient.
• If the Authorised Psychiatrist determines that the criteria for an order apply, they must give the patient the reasons for their determination. They must also advise the patient they have the right to apply to the Mental Health Tribunal for a determination on whether the criteria apply or for revocation of the order.
• If the second opinion report recommends changes to the patient’s current treatment, the Authorised Psychiatrist must review the patient’s treatment and decide whether to adopt any of the recommendations made in the report.
• If the Authorised Psychiatrist decides to adopt none or only some of the recommendations, they must give the reasons to the patient orally as soon as practicable and in writing within 10 days after the decision is made. They must also advise the patient that they have a right to apply to the Chief Psychiatrist for a review.
• If unsatisfied with the Authorised Psychiatrist’s explanation, the patient or a person at their request can apply to the Chief Psychiatrist to review the treatment.
• If a review is sought, the patient must give the Chief Psychiatrist a copy of the second opinion report and other information the Chief Psychiatrist requests.
• The Chief Psychiatrist will have 10 business days to review the consumer's treatment after receiving an application for review.
• The Chief Psychiatrist may examine the patient, access any health information, consult with the Authorised Psychiatrist and any staff of the mental health services.
• The Chief Psychiatrist will send a letter to the patient and/or any person at the patient’s request informing them of the decision.
• The Chief Psychiatrist will write a letter notifying the Authorised Psychiatrist or the relevant service’s Clinical Director of their decision.