What must happen before a treatment authority is made in Queensland

Step 1: an examination

A doctor or authorised mental health practitioner examines the person to decide whether to make a recommendation for assessment (s 31). Ideally this happens with the person's agreement. If not, it needs an examination authority, which the Mental Health Review Tribunal issues as a last resort, or an emergency examination authority made by police or ambulance officers under the Public Health Act 2005.

Step 2: a recommendation for assessment

The examiner can make a recommendation for assessment only if they are satisfied the treatment criteria may apply and there appears to be no less restrictive way to treat the person (s 39). It must be made within 7 days after the examination, in the approved form, and it stays in force for 7 days (s 41). The person must be told about it and what it means (s 40).

Step 3: assessment by a different authorised doctor

An authorised doctor who did not make the recommendation assesses the person, unless they are a rural and remote doctor and no one else is reasonably available (s 43). The doctor must take reasonable steps to check for a less restrictive way, such as searching the health record for an advance health directive, guardian or attorney. The person can be detained for up to 24 hours for the assessment, extendable to a maximum of 72 hours (s 45). If the doctor decides not to make an authority, they must explain this to the person (s 47).

Step 4: the tests the doctor applies

All three treatment criteria in section 12 must apply: the person has a mental illness, does not have capacity to consent to be treated for it, and without involuntary treatment is likely to suffer imminent serious harm, harm others, or seriously deteriorate. Capacity is defined in section 14, and a person can have capacity and still refuse.

Section 13 then asks whether there is a less restrictive way, such as consent from a parent of a minor, an advance health directive, a guardian, an attorney or a statutory health attorney. If none exists, the doctor may make the authority (s 49). Its category must be community unless the person's needs or safety, or the safety of others, cannot reasonably be met that way (s 51). If an advance health directive is overridden, the reasons must be explained and recorded (s 54).

After the authority is made

If a psychiatrist made the authority, the service must give the person a copy and notify the Tribunal in writing within 7 days (s 55). If another doctor made it, an authorised psychiatrist must review it within 3 days, or 7 days in some rural and remote cases (s 56), and the Tribunal is notified if it is confirmed (s 58). The Tribunal reviews the authority within 28 days of it being made. Families and support workers can contact the service's independent patient rights adviser, and the person can seek legal advice or apply for a Tribunal review at any time.