Inpatient Treatment Orders

An inpatient treatment order authorises the detention of a person in a treatment centre. People who are subject to an inpatient treatment order are required to receive psychiatric treatment, even if they do not want to [ss 24, 28, 31] . They must also stay in the treatment centre unless granted leave of absence or permission to leave with treatment centre staff [s 34]. The person can also be required to receive treatment for any other illness whether they agree or do not agree to that treatment [ss 24, 28, 31].

There are three levels of inpatient treatment orders.

Level 1 Inpatient Treatment Order: the maximum period of detention is 7 days [s 21(4)]

This order can be initially made by a psychiatrist, authorised medical practitioner, any medical practitioner or an authorised health professional (nurse, social worker, psychologist or occupational therapist with special mental health training who has been appointed as an authorised health professional) [s 21]. It must be reviewed within 24 hours by a psychiatrist or authorised medical practitioner (not being one who made the original decision to detain) [s 21(5)]. If this cannot be done, then the review must occur as soon as possible [s 21(5)].

A level 1 inpatient treatment order can be revoked by a psychiatrist or authorised medical practitioner at any time during the period of the order [s 21(7)].

required review of a level 1 inpatient treatment order

SACAT must review the circumstances involved in the making of a level 1 inpatient treatment order if the order has been made within 7 days after the expiry or revocation of a previous inpatient treatment order applying to the same person; the review must be conducted as soon as practicable after the making of the level 1 inpatient treatment order [s 79(1)(c)]. Such a review is taken to come within the Tribunal's original jurisdiction [s 79(5)].

Level 2 Inpatient Treatment Order: the maximum period of detention is 42 days [s 25(6)]

This order can be made by a psychiatrist or authorised medical practitioner before the expiry of a level 1 order [s 25].

A level 2 inpatient treatment order can be revoked by a psychiatrist or authorised medical practitioner at any time during the period of the order [s 25(8)].

Level 3 Inpatient Treatment Order: the maximum period of detention is 12 months (6 months for a child) [s 29(5)]

This order can only be made by SACAT upon application usually made by the Director of an Approved Treatment Centre (or his/her nominee) for a person on current level 2 or level 3 orders [s 29].

required review of a level 3 inpatient treatment order

SACAT must review an order of longer than 3 months for a child under 18 years of age within 3 months after the order was made [s 79(1)(d)]. Such a review is taken to come within the Tribunal's original jurisdiction [s 79(5)].

SACAT can on application vary or revoke an order while the order is in force [s 29(6)].

What steps are required when someone is detained?

The person who is the subject of an order of detention and treatment must receive a statement of rights and a copy of the order, or variation or revocation of order. Assistance should be provided for those who have difficulty understanding the information provided including interpreter assistance. When a psychiatrist or an authorised medical practitioner makes, revokes or varies an order, a guardian, medical agent, relative, carer or friend of the detained person should also receive this information unless their whereabouts cannot be located or it is considered not to be in the detained person’s best interests to release this information.

Treatment and Care Plans should be developed for all people on level 2 and level 3 orders in collaboration with the person and their significant others. A detained person can request the involvement of a guardian, medical agent, relative, carer or friend or advocate in significant meetings with treatment centre staff.

Appealing Inpatient Treatment Orders

A legal representation scheme is provided free of charge to all persons who are subject to an order under review or appeal [s 84]. The Legal Services Commission administers the scheme.  Other parties to an appeal will need to make their own arrangements for legal representation.

appealing a level 1 or level 2 inpatient treatment order

All decisions to make level 1 or level 2 inpatient treatment orders can be reviewed by application to SACAT [s 81]. A review may be sought at any time while the order is in place [s 81(2)]. For these reviews, the Tribunal must not be constituted by a medical practitioner sitting alone [s 81(2a)]. Such reviews come within the Tribunal's original jurisdiction [s 81(1a)].

If SACAT reviews a level 1 or 2 inpatient treatment order, the SACAT review decision is then subject to an internal review [s 83A]. The application for internal review must be made within one month of the SACAT decision [s 70(2) South Australian Civil and Administrative Tribunal Act 2013]. For an internal review in this case, the Tribunal must be constituted by 3 members [s 83A(e)(ii) Mental Health Act 2009]. SACAT must give priority to hearing and determining internal reviews of decisions relating to the detention of any person s83A(d)].

SACAT's required review into the circumstances involved in the making of a level 1 inpatient treatment order if the order has been made within 7 days after the expiry or revocation of a previous inpatient treatment order applying to the same person (see above) is subject to an internal review.

appealing a level 3 inpatient treatment order

As level 3 inpatient treatment orders are made by SACAT, any decision to make such an order is subject to an internal review by SACAT [s 83A(b)]. 

SACAT's decision at a required review of a level 3 order of longer than 3 months for a child under 18 years of age within 3 months after the order was made (see above) is subject to an internal review [ss 79(5), 83A(b)].

The application for internal review must be made within one month of the SACAT decision [s 70(2) South Australian Civil and Administrative Tribunal Act 2013]. For an internal review in these cases, the Tribunal must not be constituted by a medical practitioner sitting alone [s 83A(e)(i)].

Appeals to the Supreme Court

Following internal review [s 71(2a) South Australian Civil and Administrative Tribunal Act 2013], a further appeal lies to the Supreme Court [ss 32, 71 South Australian Civil and Administrative Tribunal Act 2013]. The appeal must be made within 14 days after the making of the decision, or after receiving the reasons for the decision, whichever is the later (but the Supreme Court may, if it is satisfied that it is just and reasonable in the circumstances to do so, dispense with the requirement that the appeal should be made within 14 days) [s 83A(g) Mental Health Act 2009].

Inpatient Treatment Orders  :  Last Revised: Fri Apr 24th 2015
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