There are two types of ways a person can be admitted to a mental health unit: one way is to admit yourself voluntarily, and the other is to be admitted involuntarily.

Voluntary Admission

Voluntary admission is when you either:

  • Have chosen to be admitted to a mental health facility voluntarily
  • Have a guardian who has consented on your behalf for you to go into a mental health facility
  • Have been previously admitted “involuntarily” but then had your status changed to “voluntary” admission through an agreement with an AUTHORISED MEDICAL OFFICER or as determined by the MENTAL HEALTH REVIEW TRIBUNAL

How do I admit myself to hospital voluntarily?

When you present yourself to hospital, the authorised medical officer on duty needs to decide if you would benefit from receiving treatment and being admitted to a mental health unit.

If they decide you will benefit from being admitted to a mental health unit for specialist care, you will be asked to wait up to two hours for an initial assessment to be done by an authorised medical officer.

To be admitted to mental health unit, the authorised medical officer needs to document their reasons for accepting you.

Involuntary Admission

Involuntary admission is when you have been taken from the community and sent to a mental health unit against your will to undergo a mental health assessment.

There are many ways you can be taken from the community to a mental health unit against your will to undergo a mental health assessment. Some of these are outlined below.

Ways that you can be taken to a mental health unit against your will:

  1. When a medical practitioner like a GP or specialist doctor has observed and assessed you and has decided that admitting you to mental health unit is the most necessary, safe and the least restrictive care or treatment option available.

Note: The medical practitioner making the decision to admit you involuntarily cannot be related to you or have an unlawful reason to be involved such as financial or other gain for themselves or others close to them such as a relative of theirs, partner or assistant.

  1. A paramedic (ambulance officer) can decide whether you need a mental health assessment and take you to a mental health facility against your will if they believe it is beneficial for your welfare. Police may be called to assist if there is a risk to your safety or the safety of others.
  2. A police officer can also make a decision to take you against your will to a mental health facility if they have “reasonable grounds” to believe:
    • You have committed a crime and a magistrate has ordered for medical examination and observation
    • You have attempted suicide or at risk of harming yourself
    • You are at risk of physically hurting someone else
    • It is deemed as beneficial for your own welfare to be admitted to a mental health unit
  3. A magistrate has decided that admitting you to a mental health unit is most beneficial way to manage your care and mental health issues
  4. You are transferred from another health facility if the doctor decides you are too mentally unwell
  5. Your carer, relative or friend has sent a written request to an authorised medical officer of a mental health unit and the medical officer is satisfied there is enough information to decide that you need urgent admission and treatment. It is up to the authorised medical officer to decide whether or not you are admitted to a mental health unit.

Can I be reclassified from involuntary to voluntary admission status?

Yes, if it is decided as beneficial for your care and treatment. You can have your status changed by the authorised medical officer on duty at your mental health unit or by the Mental Health Review Tribunal.

What are my rights as someone who has voluntarily admitted myself to a mental health unit?

When voluntarily admitting yourself to a mental health unit, you should receive a verbal and written explanation of your “Statement of Rights”. These include the following:

  • You have a right to ask about your treatment
  • You have a right to decline treatment at any time
  • You have a right to discharge yourself from the mental health facility once you have consulted the authorised mental officer on duty.

Note: you can only do this once you have been held for two hours at the mental health unit and are properly assessed by the on duty authorised medical officer. The medical officer has to be satisfied that you do not require further mental health assessment and require to be reclassified to “involuntarily” status. If your status changes to “involuntary”, you cannot leave the unit without being formally discharged by the on duty authorised medical officer or by the Mental Health Review Tribunal.

Discharge

  • You have a right to nominate up to two designated carers
  • You have a right to see an official visitor who can help explain and advocate for your rights
  • You have a right to ask staff to repeat and clarify the statement of rights to you so it makes sense
  • You have a right to request for an interpreter or translator if you need one to help you better understand your rights
  • If you have a guardian, they need to consent to you being discharged before you are able to end your stay at the mental health unit.

What are my rights as an someone involuntarily admitted to a mental health unit?

You must be assessed within 12 hours of your admission to the mental health unit by the authorised medical officer on duty. If you are found not to be mentally unwell then you must be allowed to leave.

  • You have a right to object to taking appropriately prescribed medication but do not have a right to refuse it.

Note: Medication must be prescribed at a dosage that is consistent with proper care so that you are still able to function and communicate with your legal representative, particularly before hearings with the Mental Health Review Tribunal.

  • You have the right to request an internal review to change your status from “involuntary” to “voluntary” by asking the authorised medical officer or medical superintendent on duty
  • You have a right to request an external review of your status as someone who has been involuntarily admitted through the Mental Health Review Tribunal
  • You have a right to apply for discharge
  • You have a right to request the authorised medical officer on duty to discharge you and appeal their decision via the Mental Health Review Tribunal if they refuse
  • If refused discharge by the Mental Health Review Tribunal you can also appeal this to the Supreme Court. Note that you will need to seek legal advice before doing so as the cost can be quite high. For further advice on this please reach out to Legal Aid.

Other Rights:

  • You have a right to ‘least restrictive care or treatment’ 
  • You have a right to physical safety, effective care and treatment. This means staff are unable to willfully strike, wound, ill-treat or neglect you
  • You have a right to dignity and respect
  • You have a right to be informed of your “Statement of Rights”
  • You have a right to procedural fairness of admission and review
  • You have a right to ask staff to explain the statement of rights to you verbally or have it translated or interpreted for you. You can also ask for this information to be repeated until it makes sense
  • You have a right to seek legal representation and have a lawyer represent you at a hearing of the Mental Health Review Tribunal
  • You have a right to access your medical records relating to your mental health assessment or the Mental Health Review Tribunal hearing
  • You have a right to request information about the medication you will be taking, its side effects and dosages
  • You have a right to request a moderation of your medication so you can adequately communicate with your legal representative
  • Medication cannot be used as a form of punishment or for the convenience of others
  • You have a right to be involved in you discharge and treatment plans
  • You have a right to privacy and confidentiality. Your personal details should not be disclosed publicly without the consent of the Mental Health Review Tribunal
  • You have a right to ask to see an official visitor who can help explain and advocate for your rights
  • You have a right to lodge a complaint. For details on how to do this visit the If you would like to escalate the matter further, you can visit the Health Care Complaints Commission Website or call 1800 043 159.

How many mental health examinations do I need to go through once I have been admitted to a mental health unit?

For a mental health unit to decide if you are mentally unwell they usually need to conduct about 2-3 mental health examinations. Below is a diagram of how this process works:

Figure 1

WANT TO LODGE A COMPLAINT?

Consider first providing feedback or making a complaint directly to the health service or staff. Click the link

If you would like to escalate the matter further, you can click here to make an inquiry or lodge a complaint online to the Health Care Complaints Commission or call 1800 043 159.

NEED ADVOCACY SUPPORT?

Visit the Official Visitors website or call 1800 208 218 for more information.

NEED LEGAL SUPPORT?

Contact Mental Health Advocacy Service, Legal Aid on 02 9745 4277 or 1300 888 529. You can also visit the Legal Aid website.

[1] Health Education and Training Institute (HETI). (2017). NSW Mental Health Act (2007) no. 8 Guide Book: 8th Edition Incorporating the 2015 Mental Health Act Amendments. HETI. NSW State Government. Australia, NSW, p.28 https://www.heti.nsw.gov.au/data/assets/pdf_file/0009/457983/mental-health-act-2017-guidebook.pdf

 

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A summary version of this resource is distributed as a printed pamphlet in NSW mental health inpatient and community mental health units, and other clinics.
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