Key messages

  • The Mental Health Act 2014 (Act) seeks to minimise the use and duration of compulsory treatment.
  • An Assessment order is the first step in compulsory mental health treatment.
  • An Assessment order authorises the compulsory assessment of a person to determine whether the person needs compulsory mental health treatment.

The Mental Health Act 2014 (Act) seeks to minimise the use and duration of compulsory treatment by specifying strict criteria for making a person subject to an Assessment order, a Temporary treatment order or Treatment order.

An Assessment order is the first step in compulsory mental health treatment.

An Assessment order authorises the compulsory assessment of a person to determine whether the person needs compulsory mental health treatment.

Assessment order

An Assessment order is the first step to initiating compulsory mental health treatment.

A registered medical practitioner or a mental health practitioner may make an Assessment order if they have examined the person and are satisfied that the criteria for an Assessment order apply to the person.

Purpose of an Assessment order

An Assessment order enables an authorised psychiatrist to examine the person without the person’s consent to determine whether they have mental illness and need compulsory mental health treatment.

An Assessment order enables a person subject to that Order to be taken to and detained in a designated mental health service for assessment if necessary.

Making an Assessment order

Before a registered medical practitioner or mental health practitioner makes an Assessment order they must to the extent reasonable in the circumstances:

  • inform the person that he or she will be examined by the practitioner
  • explain the purpose of this examination to the person.

The registered medical practitioner or mental health practitioner must examine the person before making an Assessment order.

The practitioner must be satisfied that all the criteria for an Assessment order apply to the person before making an Assessment order.

Criteria for an Assessment order

The criteria for an Assessment order are:

  • the person appears to have mental illness
  • because the person appears to have mental illness, the person appears to need immediate treatment to prevent:
    • serious deterioration in the person’s mental or physical health
    • serious harm to the person or to another person
  • if the person is made subject to an Assessment order, the person can be assessed
  • there is no less restrictive means reasonably available to enable the person to be assessed.

In determining whether the criteria apply the registered medical practitioner or mental health practitioner may consider information communicated to the practitioner by a person other than the person being assessed.

A registered medical practitioner or mental health practitioner may only make an Assessment order within 24 hours of examining the person.

Setting of an Assessment order

The practitioner making the Assessment order must determine whether the assessment of the person can occur in the community or whether the person needs to be taken to a designated mental health service.

An Assessment order must specify whether the assessment is to be undertaken:

  • in a designated mental health service (an Inpatient Assessment order)
  • in the community (a Community Assessment order).

A registered medical practitioner or mental health practitioner may only make a person subject to an Inpatient Assessment order if the practitioner is satisfied that the assessment of the person cannot occur in the community.

Contents of an Assessment order

An Assessment order must state whether the Assessment order is a Community Assessment order or an Inpatient Assessment order.

An Assessment order must also state the date and time that the person was examined, the date and time the Assessment order was made, and advice about duration of the Assessment order.

Duration of an Assessment order

An Assessment order comes into force when the Assessment order is made.

An authorised psychiatrist must assess a person subject to an Assessment order as soon as practicable and within 24 hours:

  • of the person subject to an Inpatient Assessment order being received at a designated mental health service or
  • of the making of a Community Assessment order.

A person subject to an Inpatient Assessment order must be taken to and received at a designated mental health service within 72 hours of the making of an Inpatient Assessment order or the Order will expire.

If the authorised psychiatrist is unable to determine whether the treatment criteria apply to the person within 24 hours of commencing the assessment, the authorised psychiatrist may extend the duration of the Assessment order.

An Assessment order may be extended for a period up to 24 hours from the time the extension was granted. An Assessment order may be extended twice before it finally expires.

The authorised psychiatrist must examine the person before extending the duration of the Assessment order for up to 24 hours.

Information requirements for Assessment orders

A registered medical practitioner or mental health practitioner who makes an Assessment order must:

  • notify the authorised psychiatrist of the relevant designated mental health service that the Assessment order is made, and
  • give the authorised psychiatrist a copy of the Assessment order.

The practitioner must also, to the extent reasonable in the circumstances:

  • inform the person who is subject to the Assessment order that he or she is subject to an Assessment order
  • give the person a copy of the Order and a copy of the relevant statement of rights
  • explain the purpose and effect of the Order to the person.

As soon as practicable after being notified that the Assessment order has been made, the authorised psychiatrist must ensure that reasonable steps are taken:

  • to inform the following persons in relation to the person subject to the Assessment order that the Assessment order has been made:
    • the nominated person
    • guardian
    • a carer, if the authorised psychiatrist is satisfied that assessing the person will directly affect the carer and the care relationship
    • a parent, if the person is under the age of 16 years
    • the Secretary to the Department of Human Services if the person is the subject of custody to the Secretary order or a guardianship to Secretary order
  • give these persons a copy of the Assessment order and the relevant statement of rights.

Variation of an Assessment order

The setting of an Assessment order can be varied (between inpatient and community and community and inpatient) before the authorised psychiatrist completes his or her assessment of the person.

The variation may be made by a registered medical practitioner or a mental health practitioner. The variation does not need to be made by the same registered medical practitioner or mental health practitioner who made the Assessment order.

A variation from a Community Assessment order to an Inpatient Assessment order may only be made if the medical practitioner or mental health practitioner is satisfied that the assessment of the person cannot occur in the community.

Where a Community Assessment order is varied to an Inpatient Assessment order, the person subject to the Assessment order must be taken to the designated mental health service as soon as practicable after the Assessment order is varied.

If a Community Assessment order is varied to an Inpatient Assessment order it does not vary the duration of the Community Assessment order. This means that the transport of a person to a designated mental health service and the assessment must be within the remainder of the 24 hour duration of the Community Assessment order.

Where an Assessment order is varied, the registered medical practitioner or mental health practitioner who makes the variation must:

  • notify the authorised psychiatrist of the relevant designated mental health service that the Assessment order has been varied
  • give the authorised psychiatrist a copy of the varied Assessment order, and
  • ensure that reasonable steps are taken:
    • to inform the person who is subject to the Assessment order that the order has been varied
    • give the person a copy of the varied Assessment order and copy of the relevant statement of rights
    • explain the purpose and effect of the variation to the person.
  • As soon as practicable after being notified of the variation of the Assessment order, the authorised psychiatrist must ensure that reasonable steps are taken to inform the following persons in relation to the person subject to the Assessment order that the Assessment order has been varied:
    • the nominated person
    • a guardian
    • a carer, if the authorised psychiatrist is satisfied that assessing the person will directly affect the carer and the care relationship
    • a parent, if the person is under the age of 16 years
    • the Secretary to the Department of Human Services if the person is the subject of custody to the Secretary order or a guardianship to Secretary order
  • give these persons a copy of the Assessment order and the relevant statement of rights.

Assessment by the authorised psychiatrist

An authorised psychiatrist must examine a person subject to an Assessment order as soon as practicable after:

  • the Assessment order is made, for a Community Assessment order
  • the person is received at the designated mental health service, for an Inpatient Assessment order.

The authorised psychiatrist must, to the extent reasonable in the circumstances, explain the purpose of the examination to the person being assessed before starting each examination during the course of the assessment.

The authorised psychiatrist must determine whether the treatment criteria apply to the person subject to the Assessment order before the Assessment order expires.

Revocation or expiry of an Assessment order

An authorised psychiatrist must immediately revoke an Assessment order if, after assessing the person subject to the Assessment order, the authorised psychiatrist is satisfied that the treatment criteria do not apply to the person.

An Inpatient assessment order expires:

  • if a person is not received at a designated mental health service within 72 hours of the making of the Inpatient Assessment order
  • 24 hours after the person is received at the designated mental health service unless the Assessment order is extended by the authorised psychiatrist
  • at the end of the relevant period of extension of the Inpatient Assessment order if the duration of the Assessment order is extended by the authorised psychiatrist
  • if the person is made subject to a Temporary treatment order.

A Community assessment order expires:

  • 24 hours after the Assessment order has been made
  • at the end of the relevant period of extension of the Community assessment order
  • if the person is made subject to a Temporary treatment order.

As soon as practicable after the Assessment order is revoked or expires, the authorised psychiatrist must ensure that reasonable steps are taken to:

  • inform the person that they are no longer subject to an Assessment order
  • explain the effect of the revocation or expiry of the Assessment order to the person
  • inform the following persons that the Assessment order has been revoked or has expired:
    • the nominated person
    • a guardian
    • a carer, if the authorised psychiatrist is satisfied that assessing the person will directly affect the carer and the care relationship
    • a parent, if the person is under the age of 16 years
    • the Secretary to the Department of Human Services if the person is the subject of custody to the Secretary order or a guardianship to Secretary order.

Providing treatment during an Assessment order

A patient subject to an Assessment order may only be given treatment for their apparent mental illness if:

  • they give informed consent to the treatment or
  • where the treatment is required as a matter of urgency to prevent serious deterioration in their mental or physical health or serious harm to the person or another person.

This means that a clinician must seek the informed consent of the person before administering treatment (see informed consent). The clinician must presume that the person has capacity to give informed consent to treatment before making a treatment decision for the person (see presumption of capacity).

A clinician may administer treatment to a person without their informed consent where treatment is urgently required.

Indications of urgency include circumstances where the person is suffering significant distress or where their health or mental health is seriously deteriorating or where a delay in treatment would result in serious harm to the person.