|Title:||Request For Another Opinion on Psychiatric Treatment , Mental Health Act 1996|
|Document ID:||Operational Directive OD 0250/09|
|Date of issue:||Wednesday, 9 December 2009|
|Status:||NO LONGER APPLICABLE|
|Description:||The process required by psychiatrists for patients requesting a second opinion on psychiatric treatment under the Mental Health Act 1996 .|
|Legal requirements:||Mental Health Act 1996
|Period of effect:||from 28 October 2009 to 28 October 2014|
|Authorised by:||Dr Peter Flett, DIRECTOR GENERAL, DEPARTMENT OF HEALTH, 20-Nov-2009|
|Print version:||View print version|
Request For Another Opinion on Psychiatric Treatment , Mental Health Act 1996
Responsibilities of the Chief Psychiatrist for psychiatric care
The Mental Health Act 1996 states that:
Opinion of another psychiatrist may be requested (s.111)
(a) request that an opinion as to whether the treatment should be given be obtained from a psychiatrist who has not previously considered the matter; or
(b) request the Chief Psychiatrist to arrange for the opinion of a psychiatrist to be obtained as to whether the treatment should be given.
This opinion may be given after the psychiatrist and the patient have been in communication with one another either directly by personal examination or by audio-visual means and without having been in one another’s physical presence (videoconferencing).
An involuntary patient may make this request either to his or her psychiatrist or the Chief Psychiatrist. If it is to the latter the Chief Psychiatrist has delegated his powers of arranging for another opinion to the Head of Service or the psychiatrist acting in that position.
It would be preferable for this other opinion to be obtained from a psychiatrist who is not employed by the mental health service who is providing care and treatment for the involuntary patient. The exception to this principle is when the patient agrees that the other opinion can be provided by another psychiatrist within the same service. This agreement may be preferred because of shorter time frame to obtain that opinion or because of patient choice.
While it is understood that certain mental health services particularly in the rural and remote areas have difficulty in providing another opinion from a psychiatrist from another service it would still be preferable for that principle to be followed. The MHA allows the use of audio-visual means to provide this other opinion.
If another opinion is provided by a psychiatrist who is from within the same service as the treating psychiatrist, it is still a valid opinion.
Other opinion from a Private Psychiatrist
The patient is responsible for any costs that are incurred for an examination by a private psychiatrist.
Recommendations from another opinion
The other opinion may indicate that psychiatric treatment should be modified or discontinued. However, the treating or supervising psychiatrist may decide not to act on any recommendations proposed by the other psychiatrist.
The treating or supervising psychiatrist should note that, having decided not to accept the recommendations of the other psychiatrist, the patient may decide to seek a review by the Mental Health Review Board (MHRB) citing the other opinion as part of the evidence. The MHRB does not have the power to change the treatment but the MHRB may make the patient no longer involuntary or if the patient is on a CTO transfer the responsibility of supervision to another psychiatrist.
If the treating or supervising psychiatrist decides not to modify or discontinue the treatment or for any other reason the patient remains dissatisfied he or she may request that the Chief Psychiatrist take steps as outlined under section 112 (2).
Further remedy when person dissatisfied (s.112)
The responsibility detailed above has been delegated by the Chief Psychiatrist to Heads of Service or a psychiatrist acting in that position.
Dr Peter Flett
This circular last updated: Wednesday, 9 December 2009 at 8:41am