Procedure - Admission of offenders to an external Mental Health Facility

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Purpose
1.	General
1.1	Assessment
1.2	Custodial Response
1.3	Legal requirements for documentation
1.4	Transfer to an authorised mental health facility
1.5	Private hospitals
2.	Change of Legal Status
2.1	Changes in Circumstances
3	Return to custody - patients under custodian's assessment authorities
4	Notification of Next of Kin or offender contact person
5	Contact People

Purpose

To facilitate and provide continuity of mental health care, including transfers to external Mental Health facilities, for offenders who have been clinically assessed as requiring specialist mental health treatment.

1. General

This procedure covers the assessment, treatment, admission and return of offenders to an authorised mental health facility.

Medical records must not accompany offenders to an external mental health facility.

Offender Health Service staff must ensure that-

1. all relevant documentation is completed; and
2. all relevant personnel are notified of the required transfer.

Refer procedure - Transfer of Offenders

1.1 Assessment

If an offender is examined by a doctor or an authorised mental health practitioner (Queensland Health) and the examiner is satisfied that the person meets the criteria for involuntary assessment, as outlined in the Mental Health Act 2000, a Recommendation for Assessment may be made.

The nurse unit manager or the senior nurse on duty will notify the General Manager or his/her nominee as soon as a Recommendation for Assessment has been completed.

Once the Recommendation for Assessment is made, an Agreement for Assessment must be sought from an appropriate authorised mental health service. Refer Mental Health Act 2000, Part 2 Requirements for involuntary assessment, ss 16-21

Each Offender Health Service must have the contact details for the administrators of authorised mental health services.

* NB - The administrator of an authorised mental health service will only sign an agreement if they can manage the patient.

1.2 Custodial Response

Following the completion of the Recommendation for Assessment and when an Agreement for Assessment is in place, all the relevant information is to be conveyed to the General Manager or his/her nominee.

The General Manager or his/her nominee is required to complete a Custodian's Assessment Authority, thus transferring the offender into the legal custody of Queensland Health.

The authority must state the name of the service where the assessment will be carried out (ie the service that provided the agreement).

Refer Mental Health Act 2000, Part 3 - Procedures leading to involuntary assessment ss 25-32

The authority authorises police or corrective service officers to transport the person as soon as practicable (but within 7 days) to the in-patient mental health service stated on the order.

*NB Please ensure Sentence Management within the Queensland Corrective Service (QCS) facility is notified when arranging an Involuntary Mental Health Transfer.

The General Manager or his/her nominee need to make decisions on operational grounds and in accordance with QCS procedure - Transfer of Offenders.

The offender's property, that is clothing and all personal effects, including radio, cassette etc, must be transferred with the offender to the authorised mental health service (refer procedure - Property of Offenders).

1.3 Legal requirements for documentation

A copy of each form must be placed in the offender's medical record and the offender management file. Original forms must be transferred with the offender to the authorised mental health facility.

The offender's medical record must remain at the Offender Health Service within the transferring corrective services facility.

A referral letter or discharge summary must accompany the offender providing full clinical assessment details of the current episode, any past relevant medical history, current medications, known allergies and any other relevant material that could impact on the provision of health care for the offender.

1.4 Transfer to an authorised mental health facility

When an offender is transferred to an authorised mental health service, the following documentation is required by the authorised mental health service-

1. Recommendation for Assessment ;
2. Custodian's Assessment Authority; and
3. a referral letter or discharge summary that must accompany the offender as outlined in 1.3.

1.5 Private hospitals

Offenders may have access to private medical practitioners and private medical treatment at their own expense. This will also include associated costs such as transport and corrective services officers escorting the offender. Refer procedure - Private Medical Treatment

The number of corrective services officers required will depend on the offender's classification. Refer procedure - Escort of Offenders (in-confidence); appendices - Escort Staffing, Weapons and Restraint Matrix (Location) (in-confidence); Escort Staffing, Weapons and Restraint Matrix (Method QCS) (in-confidence)

Offenders may apply in writing for private medical treatment by a doctor or psychologist nominated by them in accordance with Corrective Services Act 2006 (CSA) s 22.

The chief executive or delegate may give approval for an offender to be treated by a private medical practitioner if satisfied -

1. the offender is able to pay for the examination or treatment and associated costs;
2. the examination or treatment is considered necessary;
3. the doctor or psychologist nominated by the offender is willing and available to carry out the examination or treatment of the offender; and
4. the provision of the examination or treatment does not pose a risk to the good order or security of the facility.

Offenders and doctors must be aware that offenders in a high or low security facility do not have Medicare cards or Medicare numbers and are therefore ineligible for any Medicare reimbursement.

2. Change of Legal Status

Specific provisions of the Mental Health Act 2000 relate to the transfer of an offender from the Corrective Services Act 2006 to the Mental Health Act 2000.

Once the offender has been received into the authorised mental health service, the patient becomes a classified patient under the Mental Health Act 2000 and the administrator of that service assumes legal custody to detain the patient within the health service facility.

2.1 Changes in Circumstances

The authorised Mental Health facility must notify the general manager/ nominee of the QCS transferring facility of all changes of circumstances inclusive of-

1. classified patient absconding;
2. discharge to liberty;
3. death; and
4. change in legal status as directed by the court.

3 Return to custody - patients under custodian's assessment authorities

Refer Mental Health Act 2000 ss 88-90A

When the patient no longer needs to be detained as a classified patient the process for returning a patient to custody is outlined below -

1. the Director of Mental Health must immediately give written notice to the custodian who made the Custodian's Assessment Authority for the patient by completing a Report to Director of Mental Health: Patient does not need to be detained for treatment as a classified patient;
2. within one (1) day of receiving the director's notice, the custodian must organise a police officer or corrective service officer to take the patient from the authorised mental health service to a corrective services facility. It is at this time the offender's legal status transfers to the provisions of the Corrective Services Act 2006;
3. the authorised mental health service should provide a discharge summary giving details of the offender's current mental health status, physical condition, changes to treatment and medication regimes. On return to the corrective services facility the discharge summary should be delivered directly to the senior nurse on duty to ensure continuity of care for the offender and relevant information in the ongoing management of the offender shared with relevant QCS staff;
4. the senior nurse on duty will inform the relevant medical officer or psychiatrist that the offender has returned to the facility and place the offender on the medical officer's next session date for review; and
5. the general manager or nominee at the facility that is the primary location for the offender must complete a Form 9 in the QCS electronic recording system to facilitate the offender's return to the facility.

4 Notification of Next of Kin or offender contact person

The general manager or nominee of the facility must notify the offender's next of kin or contact person of the offender's intended transfer to a mental health facility.

This contact information must also be provided to the mental health service accepting the transfer. This will ensure that Queensland Health staff are able to advise next of kin or the offender's contact person of any changes in the offender's mental health condition and/or when the offender is being transferred back to the corrective services facility.

5 Contact People

1. Director of Mental Health
   
   Queensland Health
   
   147-163 Charlotte Street
   
   BRISBANE QLD 4000.
   
   
2. Mental Health Act Liaison Officer
   
   Telephone: 07 3234 0417 or 07 3234 1323
   
   1800 989 45107.
   
   
3. Enquiries may also be directed to:
   
   Offender Health Services Branch
   
   Telephone: 07 3227 6246.
   
   
   
   
   
   

KELVIN ANDERSON
Director-General

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