The Mental Health (Compulsory Assessment and Treatment) Act 1992

A person may be treated under the Mental Health Act (the Act) if they experience significant mental health challenges. There is a set of criteria that health professionals use to decide whether someone needs to be assessed and treated for their mental health needs.

For a person being assessed and treated, it can be a challenging and confusing time for them and their whānau. Te Pou, with support from Manatū Hauora Ministry of Health, has developed a range of resources for people and their whānau. These resources aim to provide clear and simple information about:

• the Act and the process involved in administering the Act
• the rights of people and whānau throughout the process of being assessed and treated
• what people and whānau can expect from their mental health team
• where people can get support and advice.

A District Inspector (DI) is a lawyer appointed by Manatū Hauora Ministry of Health who helps to protect the rights of people receiving treatment under the Act. Below is a series of videos from Annette, a local DI. She explains the role of a DI, what she can do as a DI, and how she can help both the person and whānau of the person that is experiencing the Act. Please note that these videos were filmed when DHBs where still in place and this has changed to health localities.

Investigation of negative events

Annette explains how as part of her role as a DI, she has access to all units and makes regular visits. This allows DIs to have a hands-on practical overview of what is happening in areas where people are being assessed and treated under the Act.

Promotion of rights

Annette explains how an important part of her role as a DI is to promote the rights of people experiencing the Act. DIs are usually available outside of business hours as it is important people get the information and reassurance they need as soon as they need it. DIs can also talk to whānau, investigate complaints, and are independent from the Manatū Hauora Ministry of Health.

DI role

Annette explains how the role of a DI is akin to an ombudsperson and how there is a focus on using a human rights lens in her work. She explains how in her day-to-day work as a DI, she may explain her role to people, use various materials to explain a person’s rights both in the Act process and on a broader human rights level. DIs also do educational work to explain their role in an effort to break down the barriers for people accessing mental health services.

Complaints

Annette highlights some of the helpful parts of the Act administration process. This includes that the person’s rights are clearly articulated and that there are checks and balances in place for complaints.

Clear provisions to consult

Annette shares how the Act has several very clear provisions that advise clinicians to consult with whānau and respect a person’s cultural beliefs. She hopes by encouraging clinicians to work in this way, they begin to understand that people come from a community and will return to this community after an in-patient stay.

Tailored responses

Annette discusses how when the Act is administered there needs to be the right balance between the need for treatment and the use of compulsion. Often people feel that they are not heard, and that medication is the only tool used. Annette stresses that this is not the best way as one response won’t fit for everyone. It is important to explain to people and their whānau why there might be a need to use compulsion in order to uphold a person’s right to appropriate treatment.

Role explanation

Annette explains that in her role she is required to visit people who are sectioned under the Act at certain stages of the assessment process. In the video she explains the purpose of these visits, which is to explain why a person is under the Act, what that means, timeframes, and legal rights in terms of challenging the assessment.

Whānau inclusion

Annette discusses what collaborative care means to her as a DI. She shares how they hope to see an equal relationship between the person, their whānau, and people who are providing treatment. Annette further explains how a frequent concern for DIs is that responsible clinicians are failing to adequately consult with whānau, which has implications* for the person under the Act.

*The implications include that decisions in terms of care are not made with all of the information available, there is not good long term planning of care, the persons views are not being heard and that there is not a therapeutic process that people can feel they are contributing to rather than being imposed on them.

Inspection part of role

Annette explains how part of her role involves physically inspecting the mental health unit. She goes on to explain another part of her role is investigating complaints and making recommendations, which is taken to the director of area mental health services (DAMHS). The reports from DIs are taken very seriously and there is an obligation to act on these recommendations, which is followed up by Manatū Hauora Ministry of Health.

Challenging assumptions

Annette discusses how her role means she works with all the people involved in administering the Act. She believes DIs are interested in promoting that use of the Act is not just paperwork, and that there are real, tangible long-term outcomes for people that are placed under the Act. She also raises several considerations that are important to think about before clinicians decide to administer the Act.

Meeting with clinical staff

Annette explains how they have regular meetings with key leadership personnel, which helps everyone to understand that DIs are a real presence that provide ongoing support and advice.