The Mental Health Act 1996 empowers the Chief Psychiatrist to give direction in respect of clinical care and treatment of mental health patients. Responsibilities of Chief Psychiatrist for Psychiatric Care (s9 Mental Health Act 1996):

1. The Chief Psychiatrist has responsibility for the medical care and welfare of all involuntary patients.
2. In respect of other patients, the Chief Psychiatrist is required to monitor the standards of psychiatric care provided throughout the State.

The Chief Psychiatrist also has responsibility through the Department of Health for consistency of clinical practice within the requirements of the Mental Health Act 1996 . The Department of Health, Operational Circular is the instrument by which the Chief Psychiatrist subsequently directs clinicians and mental health services.

The Chief Psychiatrist monitors the standards of psychiatric care and to do this exercises responsibilities of investigation and reporting under the Mental Health Act 1996 for both Serious Incidents and Unexpected Deaths.

Accordingly Mental Health Services are to report to the Chief Psychiatrist all occurrences of:-

1.0 Unexpected Deaths - The Chief Psychiatrist is to be informed as a matter of first priority, of any Unexpected Death of patients in any mental health service.

2.0 Serious Incidents - The Chief Psychiatrist is to be notified as a matter of first priority, of any Serious Incidents and associated issues that will or are likely to reflect on the standards of mental health care in Western Australia. Notification will include advice as to the potential for media or public implications in any incident or associated issue.

Serious incidents may include, but are not confined to the following examples:

• serious assaults on or by staff, other patients or visitors;
• alleged sexual assault on or by staff, other patients or visitors;
• serious medication error which may require review;
• absconding of any forensic patient;
• absconding of any detained involuntary patient at serious risk of self-harm or harm to others;
• serious misuse or mistake of a function performed under the Act;
• involvement of any government or non-government organisation which is contrary to functions under the Act;
• criminal activity reported at a mental health facility;
• any incident which by its nature or persons involved may receive attention by the media or the wider community.

Notification

Notification of Serious Incidents and Unexpected Death can be made via e-mail or phone call to the Chief Psychiatrist with a cc to the Manager, Office of the Chief Psychiatrist as soon as possible after the incident.

Should all details of the incident not be available at the time of initial priority reporting then subsequent e-mail or phone advice to the Manager, Office of the Chief Psychiatrist is indicated, Contact details are:

Mrs Janet Peacock
Phone: 9222 4462
Fax: 9222 4244
Email: janet.peacock@health.wa.gov.au

Please note that the 'Mental Health Sentinel Event' reporting form that we hoped would be on the website by the end of June 2006 is not available at the present time. We apologise for the information provided in the Autumn 2006 Edition of INFORM which indicated that the form would be available.

The Office of the Chief Psychiatrist is available to advise in the delivery and implementation of the work of this Operational Circular. Telephone Contact:
9222 4462.

Delegations

Medical Treatment s110 Mental Health Act (1996)

Transfer of Responsibility s112 Mental Health Act (1996)

The Health Legislation Administration Act 1984, s9 empowers the Chief Psychiatrist to delegate responsibility for some powers of authority under the Mental Health Act 1996. When delegations are applied a report of the circumstances and action must be made available to the Chief Psychiatrist. Delegations are specific to particular positions which are listed in operational circulars which can be located on the resources and publications page.

Authorised Mental Health Practitioners (AMHPs)

All AMHPs are required to notify the Chief psychiatrist on a six-monthly basis of their activities as an AMHP. AMHPs complete a Notification Form and return it with copies of any Forms 1 and 3 completed to the Office of the Chief Psychiatrist. All AMHPs are notified of this requirement in early July (report on the first 6 months of the year) and January (report on second six months of the year). For further information see AMHP page on this website.

Not Enacting a Form 1

Although the MHA does not consider the option of not acting on a Form 1, the potential for such an occurrence in clinical practice indicates the need for this practice guideline. If during the period between the completion of a Form 1 and a person's receival at an authorised hospital, or other place, there is a change in that person's mental state, and if assessment by a medical or mental health practitioner indicates that, under the principle of least restrictive alternative, a referral is no longer required, then the Form 1 may not be acted on.

This should only be done after discussion with and the agreement of the referrer. If the referrer cannot be contacted then the medical or mental health practitioner may make a decision in line with good practice and make a note of that in the file. On these occasions the Chief Psychiatrist should also be informed by telephone call to staff at the Office of the Chief Psychiatrist or by e-mail to tim.rolfe@health.wa.gov.au. If the referrer believes that the referral should continue despite what the other health practitioner feels then it is up to the referrer to manage the process of transportation to the authorised hospital. The form which is not acted on should remain on the patient's file.