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Legislative Assembly for the ACT: 2004 Week 05 Hansard (Friday, 14 May 2004) . . Page.. 1944 ..

Over the last five years it has become apparent that, while these community care orders have been of benefit to most of the people who have required this involuntary support, a small number of people with mental dysfunctions require closer supervision and support than the Mental Health (Treatment and Care) Act 1994 currently allows. Currently, the act does not allow for people who are suffering from a mental dysfunction and who are assessed to be at high risk of harm to themselves or other people, to be detained in treatment or care facilities until the risk is lessened. The amendments aim to clarify the legal requirements for community care orders and provide the Care Coordinator with the ability to coordinate the most appropriate care in the most appropriate environment.

Currently, the Mental Health Tribunal may order a person to reside in a community care facility. However there is legal opinion that the word “reside” has to be understood in its ordinary meaning and does not mean that the person is to be detained at the facility. This bill clarifies the intention. The word “reside” is no longer used and the tribunal may order that a person must live at a stated place or may order that a person be detained at a stated facility.

The amendments provide two clear pathways within the act—a pathway for psychiatric treatment orders and a pathway for community care orders. This acknowledges that the act not only is a legal document, but also is used on a daily basis by human service workers and should also be expressed clearly to facilitate understanding and utilisation of the act. The section related to the functions of the Care Coordinator has been expanded to clarify this role. This includes the requirement for the Care Coordinator to coordinate the provision of appropriate treatment, care and support, the provision of appropriately trained staff and the provision of suitable residential facilities for persons on community care orders.

The amendments clarify and strengthen the orders that the Mental Health Tribunal can make to enable persons subject to community care orders to be appropriately cared and treated for. This includes the power to detain a person in a stated community care facility and to authorise the involuntary use of medication for the amelioration of mental dysfunction as prescribed by the treating doctor. Once ordered to be detained in a community care facility, the person may be secluded or restrained if the Care Coordinator or delegate is satisfied that it is the only means in the circumstances of preventing the person from causing harm to themselves or other people.

The amendments require the Care Coordinator to inform the Community Advocate in writing within 24 hours of the involuntary administration of medication, or seclusion or restraint of a person subject to a community care order. The event and the reason will be recorded in the person’s record and a register of such involuntary administration of medication, seclusion or restraint will be kept. This will provide three pathways of reporting and recording such incidents, with the Community Advocate monitoring directly these events on behalf of the government and the community more broadly.

It should be noted that the amendments to the Mental Health (Treatment and Care) Act are important for the appropriate care and support of a very small number of people with a mental dysfunction who require involuntary orders to protect their safety or that of the wider community. There were six community care orders made in 2002-03, of which three were repeat orders from 2001-02. There were also three community care restriction

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