Important terms used in the Mental Health Act

There are a range of important terms and definitions in the treatment of mental health conditions. They are outlined in the Mental Health Act (2015).

Term	Definition
Absconding	A person leaves an approved mental health or community care facility at which they are being treated under a mental health order without permission.
ACT Civil and Administrative Tribunal (ACAT)	An independent entity which has the legal authority to make decisions about whether to allow involuntary treatment, care, and support under the Mental Health Act 2015. ACAT usually includes a lawyer, psychiatrist, and a community member.
Aboriginal liaison officer (ALO)	Aboriginal and Torres Strait Islander Liaison Officers (ALOs) are available to Aboriginal and Torres Strait Islander peoples from the ACT that are accessing or needing to access mental health, justice health, or alcohol and drug services within Canberra Health Services. ALOs work closely with health professionals within these services, as well as staff in community organisations.
Advance agreement (AA)	A written document stating a person’s preferences and consent for future mental health treatment, care or support. The AA can be used if the person loses decision-making capacity. A person may make an AA when they have decision-making capacity.
Advance consent direction (ACD)	A written document made by a person, stating their consent or nonconsent to receiving treatment, care or support, or specific medications and procedures if, in the future, they become unwell and do not have decision-making capacity. A person may make an ACD when they have decision-making capacity
Affected person	Someone who has suffered harm because of a crime committed, or alleged to have been committed, by a person on, or who could be on, a forensic mental health order. An affected person may require some support or protection and may also be entitled to information and assistance as a victim of crime under the Victims of Crime Act 1994.
Affected person's register	A register, kept by ACAT, of persons affected by an offence committed or alleged to have been committed by a forensic patient.
Apprehension	The legal holding and transportation of a person to an approved mental health facility by a police officer, authorised ambulance officer, doctor, or mental health officer if certain criteria are met.
Approved community care facility	A place approved by the Minister for Mental Health under s. 261 of the Act. This is a facility that a person may be taken to, if they are detained under emergency detention, on a mental health order requiring inpatient treatment, care and support or have contravened a Psychiatric Treatment Order. In the ACT this includes Canberra Hospital, Gawanggal and Dhulwa mental health units, Calvary Hospital, except for the emergency department, and the Adult mental health rehabilitation unit. Under Canberra Health Service policy, the Emergency Department is the only approved mental health facility where a person can be taken following an Emergency Apprehension.
Approved mental health facility	A place approved by the Minister for Mental Health for the treatment, care or support, rehabilitation, or accommodation of people with a mental illness or mental disorder. In the ACT this includes Canberra Hospital, Brian Gawanggal Mental Health Unit, Dhulwa mental health unit, Calvary Public Hospital Bruce, excluding the emergency department, and the University of Canberra Hospital, excluding correctional patients or people brought in under an apprehension.
Assessment order	An order that enables the assessment of the person with the possible mental illness or mental disorder. An Assessment Order must: state the nature of the assessment to be conducted state the approved mental health facility where the assessment is to be conducted direct the person to be assessed to attend the facility and, if necessary, stay the facility until the assessment is conducted.
Attorney	A person appointed under the Powers of Attorney Act 2006. You can give someone power of attorney to make decisions for you when you do not have capacity to make those decisions yourself.
Authorised ambulance paramedic	A member of the ambulance service who can undertake apprehensions and transport a person to an approved mental health facility for assessment and treatment, if they believe the person: has a mental illness/disorder has attempted or is likely to cause serious harm to themselves or others needs to be examined by a doctor immediately,and does not agree to this. Or if the person: has a removal order in place and requires transporting to an approved mental health facility has had their leave revoked and the person requires transport to an approve mental health or community care facility has contravened their mental health order.
Authorised officer under Section 243	An authorised ambulance paramedic, a doctor, a mental health officer or a police officer who, in relation to an interstate patient in the ACT, can exercise any function given to a person under a corresponding law or under an interstate involuntary treatment order. This may include: apprehension of the person in breach of interstate mental health order or forensic mental health order the interstate transfer of a person on an emergency order, a mental health order or forensic mental health order.
Carer	A person who provides personal care, support, or assistance to you. According to the Act, people can be carers if they are a partner, parent, child, relative, guardian of the person, or if they live with a person who experiences mental illnesses or disorders. However, a person is not automatically a carer simply because they hold such a position.
Care coordinator	A public servant appointed by the Minister and who has the training experience and personal qualities necessary to exercise the care coordinator’s functions. The care coordinator is responsible for coordinating the treatment, care or support for a person living with a mental disorder who is subject to a community care order. The care coordinator may delegate some of their responsibilities who is subject to a community care or forensic community care order.
Chief Psychiatrist	A senior psychiatrist who has been appointed by the Minister for Mental Health and who is employed by the ACT Health Directorate.
Child	A person under 12 years old under the Children and Young People Act 2008.
Child and adolescent psychiatrist	A psychiatrist who is a member of the Faculty of Child and Adolescent Psychiatry of the Royal Australian and New Zealand College of Psychiatry or a similarly accredited body.
Children and Young People’s Director-General	A person appointed under the Children and Young People Act 2008. A delegate of the Children and Young People’s Director-General must be consulted in matters relating to a young person with a mental illness or mental disorder.
Community care order (CCO)	An order made by ACAT that authorises the involuntary treatment, care and support of someone with mental disorder. A community care order can be made for up to 6 months, either as an inpatient or in the community. It may also authorise certain restrictions to ensure that treatment care and support can be safely delivered.
Community corrections order	An order made by a court where a person is serving a custodial sentence or is on a corrections order in the community. They may be either voluntary or involuntary, that is on emergency detention or a mental health order.
Comprehensive examination conducted under section 86 of the Act	An in-depth examination, which includes both psychiatric and physical systems. The examination must be undertaken by a doctor who did not conduct the initial examination of the person under section 84 of the Act. Ideally, this should be a consultant psychiatrist. If a consultant psychiatrist is not available to conduct the examination face to face, either a psychiatry registrar, or another doctor, in consultation with a consultant psychiatrist, may conduct the examination.
Confinement	Any restriction of movement or liberty of a person that does not include seclusion, according to the Australian Institute of Health and Welfare Data Dictionary.
Contravention of a mental health order	Occurs where a person on a mental health order, forensic mental health order, community care order, forensic community care order or restriction order has failed to comply with all the conditions of the order.
Correctional patient	A person serving a custodial sentence who requires treatment, care or support in an approved mental health facility and consents to receiving the treatment, care or support.
Corrections Director- General	A person appointed under the Corrections Management Act 2007. A delegate of the Correction Services Director-General must be consulted in matters relating to a person with a mental illness or mental disorder, when the person is a detainee, a person released on parole or licence, or a person serving a community-based sentence for who must be consulted.
Decision-making capacity	When you can make decisions for yourself about treatment, care, and support, for your mental illness or mental disorder, with help if needed. A person is considered to have decision making capacity to make a decision in relation to their treatment, care or support for a mental disorder or mental illness if they can, with reasonable assistance if needed: understand when a decision needs to be made about their treatment, care and support understand the facts of the decision understand the main choices available to them in relation to the decision weigh up the consequences of the main choices understand how the consequences affect them make the decision based on the above information and communicate the decision in whatever way they can.
Delegate	A person that has been given the responsibility of the person they are the delegate for example, the delegate for the Chief Psychiatrist could be a psychiatrist at the hospital. The delegate of the care coordinator could be anyone with the training, experience and personal qualities necessary to exercise the functions of the role.
Detainee	A person serving a custodial sentence in a correctional facility, under section 6 of the Corrections Management Act 2007 who requires treatment, care or support at an approved mental health facility.
Doctor	A person registered under the Health Practitioner Regulation National Law ACT to practise in the medical profession
Electroconvulsive therapy (ECT)	A therapeutic medical procedure that can be used for the treatment of severe psychiatric disorders. This therapy involves passing small, and carefully controlled electric currents through the brain while you are under anaesthetic. The electrical current helps balance electrical activity in the brain to reduce symptoms.
Emergency electroconvulsive therapy order	An order under section 162 of the Act for the emergency administration of electroconvulsive therapy to a person
Emergency detention 3 day (ED3)	An order allowing a person to be held involuntarily at an approved mental health facility. It is based on an initial examination, when two doctors who are satisfied that the person meets the criteria set out in s. 81(2) of the Act. A person can be detained for a maximum of 3 days on this order.
Emergency detention 11 day (ED11)	An order allowing a person on an ED3 to be held involuntarily at an approved mental health facility for up to a further 11 days. The person detained must continue to meet the criteria for detention. An application is made by the Chief Psychiatrist or their delegate to ACAT who approves this period of detention.
Emergency leave	Leave, generally granted for person detained in a secure mental health or community care facility, where the person requires urgent medical care that cannot be provided in the secure mental health or community care facility.
Eligible person	an individual who the Minister for Mental Health is satisfied is suitable to hold a licence to operate a private mental health facility.
Executive, for the purposes of the Act	Chief Minister and such other Ministers as are appointed by the Chief Minister under the Australian Capital Territory Self-Government Act 1988.
Forcible giving of medication	The therapeutic use of medication, against a person’s will, to prevent any immediate and substantial risk of the person causing harm to themselves or someone else. The treatment provided at this time can only be to minimise immediate risk, rather than for longer-term improvement. Regarding the forcible giving of medication, minimum treatment, care or support generally means not administering treatment, care or support that will impact the person’s function for longer than three days. However, section 88 of the Act provides an exception, if the Chief Psychiatrist or delegate believes that the person has a mental illness for which they believe long-acting medication is the most appropriate treatment. Note: only a person on emergency detention or a mental health order can be forcibly medicated.
Forensic community care order (FCCO)	Authorises the involuntary treatment, care and support of someone with mental disorder who is involved with the criminal justice system. It can be either as an inpatient or in the community and can be made for up to three months. If 4 consecutive forensic community care orders have been made for a person for one year, a further one year order can be made.
Forensic patient	A person in relation to whom a forensic mental health order may be or has been made.
Forensic psychiatric treatment order (FTPO)	Authorises the involuntary treatment, care and support of someone with mental illness who is detained in a correctional facility, at a place of detention or is serving a community-based sentence, on parole, or where a court has found that person to be ‘unfit to plead’ or ‘mentally impaired’ under the Crimes Act 1900 ACT or the Crimes Act 1914 Commonwealth. It can be either as an inpatient or in the community and can be made for up to three months. If 4 consecutive FTPOs have been made for a person for one year, a further one year order can be made.
Frisk search	A search conducted by quickly running the hands over the person's outer garments and examining anything worn or carried by the person is conveniently and voluntarily removed by the person under Mental Health Secure Facilities Act 2016.
Guardian	A person who has the power to make decisions on your behalf if you are unable to make decisions for yourself. All guardians, including public guardians and health attorneys, are appointed by ACAT under the Guardianship and Management of Property Act 1991 (ACT). Your guardian’s decision is not enforceable against your disagreement. Guardians are required to be consulted about decisions made by ACAT, the Chief Psychiatrist or the care coordinator or their delegates.
Health attorney	Someone that is closely connected to you, who can consent to medical treatment on your behalf at the request of a doctor. This is for immediate or short-term treatment only. In the ACT, a health attorney may be a domestic partner, carer or close relative or friend. Defined under the Guardianship and Management of Property Act 1991 (ACT).
Health direction	A written statement advising the medical treatment a person does not consent to being given, or the medical treatment they want withdrawn, generally or specifically, in the event they do not have decision-making capacity. Health Directions are made under the Medical Treatment Health Directions Act 2006.
Initial examination	An assessment of a person’s mental state and immediate health issues. The examination is conducted, in person, by a consultant psychiatrist, a psychiatric registrar with consultation from a psychiatrist, or another doctor with consultation from a psychiatrist.
Interstate authorised person	An interstate authorised ambulance paramedic, doctor, mental health officer, or police officer who may exercise any function conferred on them under a corresponding law or under a law of another state that provides for the treatment care or support the person with mental illness or mental disorder. These functions include: apprehending an interstate patient who is in contravention of their mental health order apprehending a patient from the ACT, who is in another state, and has contravened their mental health order They may also transfer a person interstate if: the person is under mental health or forensic mental health order and ACAT makes an interstate transfer order in relation to the person the person is detained on emergency detention and the Chief Psychiatrist directs the person be transferred to an interstate mental health facility.
Interstate involuntary treatment order	An order made under a corresponding law for the involuntary treatment of a person with a mental disorder or mental illness at an interstate mental health facility or in the community.
Interstate mental health facility	A hospital or other mental health facility in another state that a person may be admitted to under a corresponding law for treatment, care or support for mental illness.
Interstate patient	A person who is on to an interstate involuntary treatment order.
Involuntary	Your legal status if you are apprehended, involuntarily detained, on a mental health order, emergency detention, or are otherwise treated without your consent under the Act.
Leave in emergency or special circumstances for a patient under a forensic mental health order	Leave can be granted by the Chief Psychiatrist or care coordinator if there is an emergency or special circumstances for granting the leave for a person on a forensic mental health order who is an inpatient at a mental health or community care facility.
Legal status	The legal authority, under the Act, which determines the level of treatment, care and support that can be provided either with, or without, the person’s consent. A person can have two legal status. Mental health legal status – voluntary, involuntary, correctional patient under the Act. Correctional Corrections Act 1900 legal status – detainee, community detainee.
Mechanical restraint	The physical restraint of a person using a device, material or equipment attached to or near a person’s body. The restrained person is unable to control or easily remove the device which is deliberately intended to prevent a person’s free movement to maintain their safety and wellbeing, or that of others around them.
Mental disorder	A disturbance or defect, to a substantially disabling degree, of perceptual interpretation, comprehension, reasoning, learning, judgment, memory, motivation or emotion; but does not include a condition that is a mental illness. A mental disorder can be secondary to dementia, intellectual disability, acquired brain injury or other degenerative neurological conditions. A mental disorder significantly affects a person’s ability to function in day-to-day life.
Mental health officer	A nurse, nurse practitioner, psychologist, occupational therapist or social worker and appointed by the Chief Psychiatrist, to undertake specific functions under the Act.
Mental health status	The legal authority, under the Act, which determines the level of treatment, care and support that can be provided either with, or without, the person’s consent. There are two types of mental health status can be either people held under the Act - voluntary or people held under the Act - involuntary,
Mental illness	A condition that either temporarily or permanently seriously impairs mental functioning of a person in one or more areas of thought, mood, volition, perception, orientation or memory. It can be characterised by presence of: delusions, hallucinations, serious disorders of streams of thought, serious disorders of thought form, or serious disturbance of mood sustained or repeated irrational behaviour that may be taken to indicate the presence of at least one of the symptoms mentioned in the dot point above. A mental illness may be secondary to mood disorders. For example, major depressive disorder and bipolar disorder and psychotic illnesses such as schizophrenia.
Mental impairment	A legal defence against a criminal charge. It can be used if you are charged with a crime, where you have a mental illness or mental disorder and did not understand the nature of your actions, did not know that your conduct was wrong or could not control your conduct. Where a court finds you mentally impaired in relation to a criminal charge, you will not be held criminally responsible.
Nominated person	Someone you can choose to ensure your rights and interests are respected if you need mental health treatment, care, or support. They are to be informed and consulted about your treatment, care and support and ensure that the person’s interests and rights are respected. They do not have the power to make decisions on your behalf but are able to support and advocate for you.
Nurse practitioner	An advanced practice nurse endorsed by the Nursing and Midwifery Board of Australia to practice within their scope under the legislatively protected title 'nurse practitioner'.
Official visitor	An individual authorised to visit locations where people are being provided treatment, care or support, including mental health facilities. Their roles include: inspecting facilities to make sure the Act and a person’s rights are being upheld receiving feedback (both positive and negative) from people who are in the care of the ACT Government, including those who may be receiving involuntary treatment or care.
Ordinary search	A search of a person, or of articles in a person’s possession, that may include requiring the person to remove their overcoat, coat or jacket and any gloves, shoes, hat or bag, and an examination of those items.
Person in charge of an approved mental health facility	The senior member of staff in charge of an approved mental health facility at any given time. This may be the clinical director, assistant Director of Nursing, clinical nurse consultant (CNC) or a delegate, after hours. The Mental Health Act 2015 gives certain powers and responsibilities to this person.
Physical examination	An examination including the following: comprehensive physical health history and review including use of tobacco, alcohol and any other substances general observations - pulse, temperature, blood pressure, height, weight review of all major organ systems and other relevant systems as indicated by the person’s history.
Police officer	An officer of the Australian Federal Police.
Private psychiatric facility	A hospital or other facility, that is not operated by the ACT Government.
Psychiatrist	A doctor who is registered under the Health Practitioner Regulation National Law (ACT) to practice the specialty of psychiatry, or who meets requirements by law.
Psychiatric examination	An examination including the following: taking a comprehensive history of relevant issues risk assessment, including risk of suicidality cognitive tests appropriate to the person’s presentation collecting and other relevant information, such as collateral information from carers Mental state examination (MSE)
Psychiatric surgery	A specialised neurosurgery for psychiatric conditions.
Psychiatric treatment order (PTO)	A type of mental health order made by ACAT under the Act. A PTO authorises the involuntary treatment, care and support of someone with mental illness when they require longer term treatment, care and support. It also authorises certain restrictions, such as admission or detention in an approved mental health facility, to ensure that this treatment, care and support can occur safely and effectively. A PTO can be made for up to 6 months, and can authorise involuntary treatment, care and support either as an inpatient or in the community.
Public Advocate	An independent statutory position that is appointed under the Human Rights Commission Act 2015, whose role is to protect and promote the rights and interests of vulnerable people in the ACT. The Mental Health Act 2015 says the Public Advocate must receive certain information and be consulted about decisions that are being made about your treatment, care, or support if you are unable to make decisions for yourself and if there is no-one else suitable or available to act as your guardian.
Reasonable force	Use of force to the minimum extent necessary to safely provide adequate treatment, care and support in a manner that maximises safety for both the person and those involved in the person’s care. This may include: forcing entry into a person’s property forcible giving of medications to sedate or otherwise restrain the person physical restraint of the person - locking the person from leaving, physical holds, use of straps.
Referring officer	Referring officers can mean multiple people. A police officer who: arrests a person in connection with an offence or is satisfied that there are sufficient grounds on which to charge a person in connection with an offence or charges a person in connection with an offence. A member of the staff of the director of public prosecutions who is responsible for the prosecution of an offence against a person. If the person is required to accept supervision by someone else as a condition of bail under the Bail Act 1992. The Corrections Director-General for an adult. A child may be supervised by the if the person is required to accept supervision by someone else as a condition of bail under the Bail Act 1992.
Rehabilitation	Support provided to a person to restore a person to health, as much as is possible. This may include teaching of skills needed for independent living such as support to improve social confidence, and assistance to improve work skills.
Removal order	An order made by ACAT where a person fails to engage in the tribunal process or comply with an assessment order. The order may require that the person is to be taken to an approved mental health facility for the assessment to be carried out.
Restraint	This is a process in which your physical movements are restricted. Physical restraint involves applying bodily force or mechanical restraint to your body to restrict your movement.
Restriction order	An order made by ACAT that states where a person must live or which facility they must stay at. It may also indicate any people they must not see or talk to, places they must not go and/or things they must not do.
Scanning search	A search of a person by electronic or other means that does not require the person to remove their clothing or to be touched by someone else. For example, using a handheld wand to scan a person’s body. Note: Scanning searches can only be conducted by security officers who are trained and licensed to use the scanning equipment.
Seclusion	Confinement at any time of the day or night, alone in a room or area from which free exit is prevented. Confinement is any restriction of movement or liberty of a person that does not include placing the person in a room on their own and preventing them from leaving. This could mean telling a person that they must stay in a room and having a security officer or other staff member observe them to ensure that they do not leave.
Secure mental health unit	An approved mental health facility, which the Minister for Mental Health declares to be a secure mental health facility.
Section 309 - order made under the Crimes Act	An order made under the Crimes Act 1900, where, during proceedings at the Magistrates Court, the court has reasonable grounds for believing that an accused person requires immediate treatment or care because of mental impairment. The court may require the person to undergo a mental health assessment, without requiring the accused to submit to the jurisdiction of the ACAT. Under this order, the accused person will be taken to an approved mental health facility and detained for clinical examination for the sole purpose of deciding whether they need immediate treatment or care because of mental impairment.
Special circumstances leave	Leave, generally from a secure mental health or community care facility, under special circumstances. Leave may include, but is not limited to, leave to visit a family member who has a life-threatening illness, injury, to attend a relative’s funeral or to attend court.
Supported decision-making	A process that ensures a person is given all the help they might need to make decisions about their treatment, care or support. This may mean: providing information about treatment, care and support in different ways such as using an interpreter) using other people, that the person trusts, to help them understand the decision they are making may also be helpful.
Transfer direction	A written decision made by the Chief Psychiatrist that a person who has a mental illness and is being held at a place of detention or a detention centre be transferred to an approved mental health facility, if: the Chief Psychiatrist is satisfied that the person would receive more appropriate treatment, care or support at the approved mental health facility the person does not meet the criteria for a mental health order or a forensic mental health order.
Treating team	The group of people who work together in your home or supported accommodation to provide you with treatment, care, or support. This includes allied health staff, doctors including psychiatrists, nurses and professional carers who are employed to work in a person’s home or supported accommodation.
Treatment care and support	Things done or services provided by health professionals to promote your recovery, remedy a mental disorder or mental illness, or lessen the effects or the pain or suffering it causes. This may include the giving of medication, counselling, training, therapeutic and rehabilitation programs, care, or support.
Treatment and location determination (TPLD) form	A written instruction, made by the treating team, which accompanies an application to ACAT for a psychiatric treatment order, a community care order, forensic psychiatric treatment order, or a forensic community care order. It specifies: where the person is to receive care as community or inpatient if the person is to receive treatment, care or support in the community, the times when and the place where the person is required to attend to receive treatment, care or support or to undertake a counselling, training or therapeutic, or rehabilitation program in accordance with the order if the person is to receive treatment, care or support as an inpatient at an approved mental health facility or approved community care facility, whether the person is able to be granted leave from the approved mental health facility and, if not, why leave cannot be granted.
Treatment care and support	Things done or services provided by health professionals to promote a person’s recovery, remedy the disorder or illness or lessen its ill effects or the pain or suffering it causes. This may include the giving of medication, counselling, training, or therapeutic and rehabilitation programs. Any treatment, care or support provided to the person under the Mental Health Act on an involuntary basis must have a clear relationship with restoring the person’s mental health. For example, if a person requires antipsychotic medication to treat their psychosis, blood levels must be checked regularly to ensure the safe and therapeutic administration of the antipsychotic, therefore requiring a blood test constitutes treatment, care or support under the Act. A person cannot be required to accept treatment for a non-related physical health condition because they are receiving care under the Act.
Tribunal liaison officer	A staff member employed by Canberra Health Services to undertake key liaison functions between Canberra Health Services and ACAT associated with applications and orders of the Tribunal. The TLO can be contacted by email at Tribunal.Liaison@act.gov.au or telephone on 02 5124 5410.
Younge detainee	A child or young person who is: in custody following arrest remanded in custody under the Crimes (Sentence Administration) Act 2005 in detention under the Crimes (Sentencing) Act 2005 otherwise in custody or detention under the Children and Young People Act 2008 or another territory law or a law of the Commonwealth or State required to be held in the Children and Young’s People Director-General’s custody
Unfit to plead	Your legal status if you are charged with a criminal offence but your mental process is disordered or impaired, affecting your ability to understand important court processes.
Voluntary	The legal status of a person under the Act if they are not on a mental health order and are not otherwise held under the Act.

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