Mental Health Bill 2015
Plain English Summary
Overview
This bill completely replaces Queensland's Mental Health Act 2000 with a new framework for treating people with serious mental illness who cannot consent to their own treatment, and for dealing with people with a mental illness who are charged with serious crimes. It tightens the criteria for involuntary treatment, strengthens patient rights, limits the use of restraint and seclusion, and creates a new role - the chief psychiatrist - to oversee the system.
Who it affects
The bill most directly affects people with serious mental illness (especially those who lack capacity to consent to treatment), their families and carers, and people charged with serious offences whose mental state is in question. It also affects victims of unlawful acts, doctors and other mental health practitioners, police and ambulance officers, and magistrates.
Key changes
- Replaces involuntary treatment orders with 'treatment authorities' that can only be made if the person lacks capacity to consent AND faces imminent serious harm or serious mental or physical deterioration, and only if there is no less restrictive way to treat them
- Creates 'nominated support persons' - a patient can formally appoint one or two people who receive all notices, can access confidential information, and can represent the patient at tribunal hearings
- Requires public mental health services to appoint independent patient rights advisers to help patients and families understand their rights
- Gives patients a right to request a second opinion on their treatment and care
- Requires chief psychiatrist approval before mechanical restraint can be used, caps it at 3 hours per use and 9 hours a day, and requires continuous observation; introduces 'reduction and elimination plans' to phase out restraint and seclusion
- Prohibits psychosurgery, insulin-induced coma therapy and deep sleep therapy, and requires Mental Health Review Tribunal approval before electroconvulsive therapy can be given to people without capacity or to minors
- Creates 'treatment support orders' as a less intensive alternative to forensic orders for people whose role in an offence was minor, and allows the Mental Health Court to set non-revocation periods of up to 10 years for the most serious violent offences like murder and rape
- Gives magistrates express power to dismiss charges or order mental health examinations for people who appear to have been of unsound mind or unfit for trial
- Gives ambulance and police officers clearer powers (under the Public Health Act 2005) to transport people in acute mental distress to hospital for urgent examination, whether the cause is illness, injury, disability or intoxication
- Replaces the Director of Mental Health with an independent chief psychiatrist who makes binding policies, investigates complaints, and protects patient rights
- Requires the tribunal to provide free legal representation at key hearings, including for minors, fitness-for-trial reviews, and electroconvulsive therapy applications
- Improves information and support for victims of unlawful acts by forensic patients, including reasons for community treatment and victim impact statements the tribunal must consider
Bill Story
The journey of this bill through Parliament, including debate and recorded votes.
Referred to Health and Ambulance Services Committee
▸Second Reading18 Feb 2016View Hansard
▸12 members spoke12 support
Supported the government bill as committee chair, highlighting its additional safeguards compared to the private member's bill including provisions on physical restraint, patient rights advisers, advance health directives and the 10-year non-revocation period for forensic orders.
“The vulnerable nature of the people to whom this legislation will apply and the gravity of the powers and orders that it contains was certainly not lost on me.”— 2016-02-18View Hansard
Supported the government bill as Minister for Housing, linking mental health reform to housing policy and criticising the former LNP government's approach to mental health funding, the Barrett Adolescent Centre closure, and social housing evictions of people with mental illness.
“We will not do it the LNP way and evict as soon as possible, driving Queensland's most vulnerable, such as those suffering from mental illness, into homelessness.”— 2016-02-18View Hansard
Supported the government bill as a committee member and former nurse, endorsing the least restrictive approach to treatment, the safeguards around restraint and medication, and the transfer of GPS tracking authority from the Chief Psychiatrist to independent tribunals.
“I have lived through a period when reaching for chemical restraints was common and, as we now know, absolutely the wrong thing to do.”— 2016-02-18View Hansard
Spoke in support of the bill's objectives while urging caution around deep brain stimulation, sharing a constituent's positive experience with DBS for Parkinson's disease but noting media reports linking the procedure to suicide and personality changes.
“Good mental health brings a sense of wellbeing, confidence, self-esteem and it allows us to appreciate other people, our day-to-day lives and our environment.”— 2016-02-18View Hansard
Supported the government bill as a committee member and former paramedic with 25 years' experience, endorsing the new emergency examination authority provisions and the strengthened criteria for mechanical restraint and seclusion.
“It is imperative that politicians, health practitioners, allied health staff from various agencies and community support advocates put patient safety first and foremost.”— 2016-02-18View Hansard
Supported the reform as a medical specialist and former AMA Queensland president, endorsing bipartisan consensus on mental health, supporting clear definitions in the legislation and advocating for GPS tracking with transparent review processes while prioritising community safety.
“If there is to be a conflict between these two competing interests then community safety must be the paramount consideration.”— 2016-02-18View Hansard
Supported the government bill and opposed the LNP bill, citing personal experiences of constituents lost to mental illness and criticising the former LNP government's record of mental health funding cuts.
“That we can recall too many stories like this is the only evidence needed to support legislation like this.”— 2016-02-18View Hansard
Supported the reform, focusing on constituent concerns about ECT and deep brain stimulation on minors, and commending the committee's careful consideration of the safeguards in the bills.
“I would ask that both the government and the opposition continue to pursue this particular matter for those like Mrs Larkman who are concerned.”— 2016-02-18View Hansard
Supported the government bill, focusing on how the bill manages community risks through forensic orders, the role of the Mental Health Court and tribunal, non-revocation periods, and victim notification provisions.
“It does need to be highlighted at the outset that the vast majority of people who are treated involuntarily under mental health legislation are not being involuntarily treated due to the commission of an unlawful act.”— 2016-02-18View Hansard
Supported the government bill's provisions for rural and remote mental health services, and bravely shared his own experience with mental illness, depression and suicidal ideation as a Vietnam veteran, urging others to seek help.
“You have to be prepared to admit that you have a problem. That is the first step and the biggest step.”— 2016-02-18View Hansard
Supported the bill as Minister for Disability Services, noting the forensic disability legislative framework for people with intellectual disability under forensic orders and the new Magistrates Court power to divert people with intellectual disability to appropriate support.
“This important amendment addresses a gap in the law for those people with intellectual disability or mental illness who are involved in the criminal justice system by enabling the court to divert them to the appropriate support and treatment.”— 2016-02-18View Hansard
In reply, defended the government bill's superiority, cited Productivity Commission data showing the former LNP government's record-breaking cuts to mental health spending, and detailed specific provisions absent from the private member's bill.
“In nominal terms, the cut by Lawrence Springborg was the single largest cut to mental health expenditure ever recorded by any state or territory government.”— 2016-02-18View Hansard
▸In Detail18 Feb 2016View Hansard
Government amendments 1-10 (moved en bloc): Technical corrections including omitting the definition of public guardian from clause 13, requiring copies of treatment authorities to be given to nominated support persons, correcting cross-references to forensic order (mental health), and clarifying provisions around treatment support orders and forensic order amendments.
Opposition amendment to insert new clause 214A empowering the Chief Psychiatrist to impose monitoring conditions (including GPS tracking devices) on forensic patients receiving community treatment where there is a material change in circumstances, significant risk of the patient not returning, and significant risk of serious harm. The tribunal would review such decisions within 21 days.
Government amendments 11-26 (moved en bloc): Including provisions requiring public guardian notification when minors are admitted to high-security or adult mental health units, reporting on use of mechanical restraint, seclusion and physical restraint on minors, and various technical corrections to treatment support order provisions, transfer provisions and disclosure provisions.
Government amendments 27-28 (moved en bloc): Adding public guardian definition to dictionary and requiring the public guardian's annual report to include statistics on minor admissions to authorised mental health services and community visitor operations relating to those minors.
Referenced Entities
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Sectors Affected
Classified using AGIFT/ANZSIC Australian government standards