Nominated persons

A consumer can nominate a person to receive information and to provide them with support in the event they become unwell and require compulsory mental health treatment.

Nominated person - role

The role of a nominated person is to provide support and to help protect the patient’s interests. A nominated person may assist the patient to exercise their rights and can help represent the patient’s views and preferences about their treatment and recovery to members of the treating team.

A nominated person will be given information and consulted at key points in the patient’s treatment and recovery, such as when the patient is placed on a Temporary Treatment Order and when there is a Mental Health Tribunal hearing.

Nominated person requirements

Any person can be nominated provided they are willing, available and able to fulfil the functions and responsibilities of the role. The nominated person is usually someone who is significant in the life of the person, such as a family member or carer.

There is no age restriction on who may nominate a person or who may be nominated. For example, a person may nominate a teenage child who provides them with care or support, as long as the child is willing, available and able to fulfil the role.

A member of the treating team or any other person who will be making decisions about the person’s mental health treatment should not be appointed as the person’s nominated person.

Making a nomination

A person can make a nomination at any time, provided they understand what a nomination is and the consequences of making the nomination.

Before making a nomination, a person should consider and discuss with the person they are planning to nominate the extent of support they want, the person’s availability and ability to take on the role.

The person must be willing for the nominated person to be consulted about their treatment and to be given information about their health. They should discuss these matters with the nominated person and clarify how they expect the nominated person to respond to contacts from the treating team and the way they want their personal information handled.

The role of a nominated person takes effect when the person who made the nomination becomes a patient.

A nomination must:

• be in writing
• be signed and dated by the person making the nomination
• specify the name and contact details of the person being nominated
• include a statement signed by the nominated person stating that they agree to be the nominated person
• include a statement signed by an authorised witness stating that -
  • in their opinion, the person understands what a nomination is and the consequences of making a nomination
  • the witness observed the person sign the nomination
  • the witness is an authorised witness.

A nomination template is available as a guide. Use of the nomination template is for guidance only and is not a requirement.

Revoking a nomination

Revoking a nomination means that the nomination ends and has no further effect.

A person who has made a nomination may revoke it at any time provided they understand the consequences, for example the nominated person will no longer be routinely given information or consulted about treatment.

A revocation must:

• be in writing and state that the nomination is revoked
• be signed and dated by the person revoking the nomination
• be witnessed by an authorised witness
• include a statement signed by the authorised witness stating that -
  • in their opinion, the person understands what a revocation is and the consequences of making a revocation
  • the witness observed the person sign the revocation
  • the witness is an authorised witness.

A revocation will be valid if it meets the above requirements. A revocation template is available as a guide. Use of the revocation template is optional and is not a requirement.

A person who revokes a nomination must take reasonable steps to tell the nominated person of the revocation.

If the person is currently a patient, they must tell the authorised psychiatrist that they have revoked the nomination.

A nomination is also revoked if the person makes a new nomination.

If the nominated person wants to stop being a nominated person, they must take reasonable steps to inform the person who made the nomination and, if the person that has appointed them is a patient, to inform the patient’s authorised psychiatrist. Once this is done, the nomination no longer has effect.

Authorised witness - role

An authorised witness needs to understand what a nomination is so they can assess whether a person making a nomination understands what it is and the consequences of making or revoking it.

The consequence of making a nomination is that the nominated person will be given information and consulted about the patient’s treatment. For example, the nominated person will be told when a Temporary Treatment Order is being made or if the patient is going to be granted a leave of absence.

The consequence of revoking a nomination is that the nominated person will no longer be routinely given information or consulted about the patient’s treatment.

The authorised witness should check the identity of the person making or revoking the nomination by asking them if they are the person who is making the nomination.

It may not be good practice for a person who may be involved in providing compulsory mental health treatment to the person in the future to witness a nomination.

The person who is being nominated cannot witness the nomination.

Nominated persons – notification

A nominated person will be informed when:

• an Assessment Order, Court Assessment Order, Temporary Treatment Order or Treatment Order is made, varied, revoked or expires
• a Court Assessment Order is completed
• a patient’s right to communicate is restricted
• a restrictive intervention is used on a person
• a patient is absent without leave from a designated mental health service
• the authorised psychiatrist grants, varies or revokes a patient a leave of absence
• a second psychiatric opinion report is made (and reasonable steps must be taken to provide the nominated person with a copy of the report)
• the Chief Psychiatrist reviews a patient’s treatment following an application for review after a second psychiatric opinion report is made (and reasonable steps must be taken to notify the nominated person of the outcome of the review in writing)
• the Chief Psychiatrist makes a written direction to a designated mental health service in respect of the mental health services provided to the person
• the Mental Health Tribunal lists a matter for hearing
• the Mental Health Tribunal grants or refuses to grant an application for the performance of electroconvulsive treatment
• the Secretary to the Department of Justice grants, varies or revokes monitored leave for a security patient
• a security or forensic patient is received at or taken to another designated mental health service
• a security patient is discharged as a security patient.

The obligation to notify the nominated person only arises to the extent that is reasonable in the circumstances. For example, the clinician has made reasonable attempts to telephone the nominated person to tell them that the patient’s Treatment Order has been varied.

Nominated person - consultation

A nominated person will, to the extent that is reasonable in the circumstances, be consulted when:

• a Temporary Treatment Order or Treatment Order is made, varied, revoked or expires
• the setting of a Temporary Treatment Order or Treatment Order is determined or varied
• the Mental Health Tribunal makes a Treatment Order and determines its setting
• an authorised psychiatrist grants, varies or revokes a patient a leave of absence
• an authorised psychiatrist makes a treatment decision for a patient, including a decision about medical treatment
• a psychiatrist gives a second psychiatric opinion (the psychiatrist must also take reasonable steps to provide the nominated person with a copy of the report)
• the Chief Psychiatrist reviews the treatment of a patient following an application for review after a second psychiatric opinion is provided (the Chief Psychiatrist must also ensure that reasonable steps are taken to notify the nominated person of the outcome of the review in writing)
• the authorised psychiatrist makes an application to the Mental Health Tribunal to perform a course of electroconvulsive treatment on a patient or young person
• the Secretary to the Department of Justice grants, varies or revokes monitored leave for a security patient
• the authorised psychiatrist determines whether a security or forensic patient will be taken to another designated mental health service
• an application is made to the Mental Health Tribunal to transfer a compulsory patient to an interstate mental health facility.

The obligation to consult the nominated person only arises to the extent that is reasonable in the circumstances. For example, if the Mental Health Tribunal sends the nominated person a notice of the patient’s hearing but the nominated person does not attend, the Mental Health Tribunal’s obligations are fulfilled.

Other support people

There is no requirement for a patient to have a nominated person. If a patient does not have a nominated person or does not wish to make a nomination, they must be supported by the treating team to make or participate in decisions about their treatment. In addition, the patient may be assisted by their carer or family members if appropriate. See carers and families.