Community care order
There may be times when people become unwell due to their mental disorder and have no decision-making capacity, or refuse help.
This can be a risk to you or the community and in this situation, you may be placed under a community care order.
A mental disorder is a condition that interferes with your perceptual interpretation, comprehension, reasoning, learning, judgement, memory, motivation, or emotion. Common causes of a mental disorder include dementia, intellectual disability, acquired brain injury and other degenerative neurological conditions.
A mental disorder can significantly affect your ability to function in day-to-day life.
Understanding a community care order
A community care order (CCO) is a type of mental health order made by the ACT Civil and Administrative Tribunal (ACAT), that means you have been identified as requiring treatment and care for your mental disorder.
It is made to enable you to receive the assessment, treatment, care or support you need, when you don’t have the ability to seek it yourself or are refusing to do so. This means treatment, care or support can be given without your consent.
Making an order
An order will only be made if, based on an assessment if:
- you have a mental disorder and you do not have decision-making capacity and refuse treatment, care, or support
- you have decision-making capacity, but refuse treatment, care, or support, and because of the mental disorder you are doing or are likely to do serious harm to yourself or someone else,
A CCO can be made if your physical or mental health is getting worse, or is likely to get worse, to the extent that it outweighs your right to give consent and:
- if treatment, care, and support are likely to reduce the harm or stop it from getting worse
- if treatment, care, and support cannot be given in a way that involves less restriction on your freedom of choice and movement
- and if a psychiatric treatment order should not be made instead.
Application process
The care coordinator, or their delegate, can apply to the tribunal for an order. The application includes a copy of the proposed treatment plan.
The proposed treatment plan will include information about what treatment, care or support is recommended, why and how it will help. Before applying for an order, the care coordinator will take all reasonable steps to consult and consider views expressed by you, your guardian, carer, nominated person if appointed and any other relevant service providers as required.
After an application is made
After receiving an application, ACAT will hold a hearing to decide whether an order should be made. The tribunal will give you at least 3 days written notice of the hearing. The hearing is a formal meeting, and you will be invited to attend. The tribunal encourages this as your views and wishes are important. You can bring a support person or people with you and have a lawyer if you want to.
The tribunal is provided with information from your treating team. Your views and those of your carer, guardian or nominated person can be put forward, both verbally and in writing.
Hearings are held in private, which means that only people who you want to be present will be able to attend. Hearings may be in person or via video or audio conference.
What consultation takes place
If an order has been made for you, the care coordinator or their delegate will consult with you. There are a range of things you can discuss, such as:
- what treatment, care or support, counselling, training, therapeutic or rehabilitation program they are considering and why
- where and when the treatment, care or support will take place
- treatment, care or support that has worked for you in the past
- type of treatment, care or support you do or do not want and why
- if you also have a restriction order, whether you must stay in an approved mental health facility for treatment.
While your opinions and views will always be considered, your treatment, may need to accommodate your clinical needs. Your doctor may also talk to:
- your parents, or the people who have parental responsibility if you are a child
- your guardian if you have one
- your nominated person if you have one
- the person who holds power of attorney for you if you have one
- your carer if you have on
- your health attorney if you have one
- the Corrections Director General if you are a detainee, on bail or parole
- the Children and Young People’s Director General, if you are a child who is a detainee or on bail.
The care coordinator or their delegate will give a copy of your treatment plan to you and:
- your parents, or the people who have parental responsibility if you are a child
- ACAT
- the Public Advocate
- your nominated person if you have one
- your guardian if you have one
- the person who holds power of attorney for you if you have one
- and your health attorney if you have one.
After the order is made
If an order has been made for you, the care coordinator is responsible for coordinating your treatment, care, and support. The order may state:
- that you are to be given treatment, care, or support
- that you may be given medication for your mental disorder as prescribed by a doctor
- that you are to participate in counselling, training or a therapeutic or rehabilitation program
- and that limits may be imposed on communication with others.
These decisions will be made within 5 working days of the order being made. The details of your treatment will be outlined in your treatment plan. This plan will say where you will receive treatment, care, and support.
Before you are given any treatment, care, or support, it will be clearly explained to you.
Duration of an order
Under the Act any compulsory treatment must be for the shortest time possible. An order can be made for any period up to 6 months, but it is frequently shorter.
The CCO will be reviewed before it expires. It can also be reviewed sooner if your treating team believe the order is no longer needed or if you ask for a review. A hearing needs to be held if you, your representative or the tribunal initiated the review. The tribunal will review the order within 72 hours. This will usually occur without holding a hearing.
When ACAT review an order, it can:
- confirm the order as it stands
- change the order
- cancel the order
- make additional orders
- or make an assessment order, requiring you to undergo a mental health assessment to decide what further treatment, care and support is needed.
Limits on communication
As part of your order, limits can be placed on who you are able to communicate with. The limitation must be consistent with the order, necessary and reasonable and must not reduce the effectiveness of your treatment, care, or support.
You will be told the reasons for the limitation, what the limitations are and how long they will be in place. This is a maximum of 7 days at a time.
Taking leave during an order
If you are on an order with a restriction order, and you are required to stay at an approved mental health facility. You cannot leave, but have the right to apply for leave. This is an amount of time able to be spent outside the facility that has been agreed between you and your treating team. It is designed to enhance recovery and help you return to your usual life in the community.
Your treatment plan should state whether you are entitled to leave and if not, why. If leave is requested, the specific type, length and other conditions of leave are decided on a case-by-case basis.
The care coordinator or your treating doctor can also cancel your leave. If leave is cancelled, you will be invited to return to the facility voluntarily. If you do not then a mental health officer, doctor, authorised ambulance officer or police officer can apprehend you and take you to a relevant facility.
Restriction orders
A restriction order is a type of mental health order that can be added to a community care order for a maximum of 3 months. This order can tell you where you must live or where you must stay. It can also state any people you must not see or talk to, places you must not go and/or things you must not do.
ACAT is responsible for reviewing applications and can make a restriction order if:
- the order is needed to keep you, someone else, or the public safe
- and treatment, care, and support cannot be given in a way that involves less restriction of your freedom of choice and movement.