An inpatient treatment order authorises the compulsory inpatient treatment of a person with a mental illness in a treatment centre. People who are subject to an inpatient treatment order are required to receive psychiatric treatment, even if they do not want to [ss 24, 28, 31] . They must also stay in the treatment centre unless granted leave of absence or permission to leave with treatment centre staff [s 34]. The person can also be required to receive treatment for any other illness, but only one that is a cause of or is contributing to the mental illness, whether or not they agree to that treatment [ss 24, 28, 31].

There are three levels of inpatient treatment orders.

This order can be initially made by a medical practitioner or authorised mental health professional [s 21].

It must be reviewed within 24 hours by a psychiatrist or authorised medical practitioner (not being one who made the original decision to detain) [s 21(5)].

If this cannot be done, then the review must occur as soon as possible [s 21(5)].

A level 1 inpatient treatment order can be revoked by a psychiatrist or authorised medical practitioner who has examined the patient at any time during the period of the order. Where a psychiatrist or authorised medical practitioner revokes a level 1 inpatient treatment order they may, in substitution, make a level 1 community treatment order [s 21(7)].

Required review of a level 1 inpatient treatment order

The South Australian Civil and Administrative Tribunal (the Tribunal) must automatically review the circumstances involved in the making of a level 1 inpatient treatment order if the order has been made within 7 days after the expiry or revocation of a previous inpatient treatment order applying to the same person. The review must be conducted as soon as practicable after the making of the level 1 inpatient treatment order [s 79(1)(c)]. This review is taken to come within the Tribunal's original jurisdiction [s 79(5)]. As such, there is a further right of internal review of the Tribunal's review decision under Part 5 section 70 of the South Australian Civil and Administrative Tribunal Act 2013 (SA) [s 83A].

This order can be made by a psychiatrist or authorised medical practitioner before the expiry of a level 1 order [s 25].

A level 2 inpatient treatment order can be revoked by a psychiatrist or authorised medical practitioner at any time during the period of the order [s 25(8)].

Required review of a level 2 inpatient treatment order

Where a decision is made to extend a level 2 inpatient treatment order the Tribunal must automatically review the circumstances involved in the decision as soon as practicable [s 79(1)(ca)]. This review is taken to come within the Tribunal's original jurisdiction [s 79(5)]. As such, there is a further right of internal review of the Tribunal's review decision under Part 5 section 70 of the South Australian Civil and Administrative Tribunal Act 2013 (SA) [s 83A].

This order can only be made by the Tribunal upon application of the Public Advocate or the Director of an Approved Treatment Centre (or his/her nominee) for a person on current level 2 or level 3 orders [s 29].

If a person is subject to a current level 1 or 2 inpatient treatment order, such an order is automatically revoked when the Tribunal makes a level 3 inpatient treatment order [s 29(4a)].

On application the Tribunal can vary or revoke an order while the order is in force [s 29(6)].

Required review of a level 3 inpatient treatment order

The Tribunal must automatically review an order of longer than 3 months for a child under 18 years of age within 3 months after the order was made [s 79(1)(d)]. This review is taken to come within the Tribunal's original jurisdiction [s 79(5)]. As such, there is a further right of internal review of the Tribunal's decision under Part 5 section 70 of the South Australian Civil and Administrative Tribunal Act 2013 (SA) [s 83A].

What steps are required when someone is detained?

The person who is the subject of an inpatient treatment order must receive a statement of rights and a copy of the order, or variation or revocation of order. Assistance should be provided for those who have difficulty understanding the information provided including interpreter assistance. When a psychiatrist or an authorised medical practitioner makes, revokes or varies an order, a guardian, medical agent, relative, carer or friend of the detained person should also receive this information unless their whereabouts cannot be located or it is considered not to be in the detained person’s best interests to release this information.

Treatment and Care Plans should be developed for all people on level 2 and level 3 orders in collaboration with the person and their significant others [s 41]. A patient can request the involvement of a guardian, medical agent, relative, carer or friend or advocate in significant meetings with treatment centre staff.

Appealing Inpatient Treatment Orders

A legal representation scheme is provided free of charge to all persons who are subject to an order under review or appeal [s 84]. The Legal Services Commission administers the scheme. Other parties to an appeal will need to make their own arrangements for legal representation.

Appealing a level 1 or level 2 inpatient treatment order

All decisions to make level 1 or level 2 inpatient treatment orders can be reviewed by application to the Tribunal [s 81]. A review may be sought at any time while the order is in place [s 81(2)]. For these reviews, the Tribunal must be constituted by at least one medical practitioner and one legal practitioner [s 81(2a)].

Appealing a level 3 inpatient treatment order

As level 3 inpatient treatment orders are made by the Tribunal, any decision to make such an order is subject to an internal review by the Tribunal [s 83A(b)]. For an internal review in these cases the Tribunal must not be constituted by a medical practitioner sitting alone [s 83A(e)(i)].

Appealing a required review of an inpatient treatment order

The decision of the Tribunal on a required review (see required reviews above) is subject to further internal review [ss 79(5) and 83A].

An application for internal review must be made within one month of the the Tribunal's decision [South Australian Civil and Administrative Tribunal Act 2013 (SA) s 70(2)].