Today’s correspondent is a Paramedic with NSW Ambulance who asks about the Mental Health Act 2007 (NSW) s 20. That section says:
(1) An ambulance officer who provides ambulance services in relation to a person may take the person to a declared mental health facility if the officer believes on reasonable grounds that the person appears to be mentally ill or mentally disturbed and that it would be beneficial to the person’s welfare to be dealt with in accordance with this Act.
(2) An ambulance officer may request police assistance if of the opinion that there are serious concerns relating to the safety of the person or other persons if the person is taken to a mental health facility without the assistance of a police officer.
This section appears in Chapter 3, Part 2, Division 2 of the Act. Chapter 3 is about ‘Involuntary Admission and Treatment in and Outside Facilities’. Part 2 is ‘Involuntary Detention and Treatment in Mental Health Facilities’ and Division 2 is ‘Admission to and initial detention in mental health facilities’. With respect to involuntary detention, s 12 says that a person:
… must not be involuntarily admitted to, or detained in or continue to be detained in, a mental health facility unless an authorised medical officer is of the opinion that:
(a) the person is a mentally ill person or a mentally disordered person, and
(b) no other care of a less restrictive kind, that is consistent with safe and effective care, is appropriate and reasonably available to the person.
One of the objects of the Act is ‘to facilitate the provision of hospital care for those persons on a voluntary basis where appropriate and, in a limited number of situations, on an involuntary basis’ (s 3(c)).
My correspondent tells me that
… recently we have been receiving much grief from our local police regarding management of voluntary patients. It is my understanding that we can only enact a Section 20 if a patient refuses to be transported voluntarily. Specifically, we had a patient last night who mentioned suicide during an argument with his girlfriend. We asked that he come to hospital with us for assessment and to get him out of a volatile situation. The man was quite happy to comply, did not need any convincing and walked freely to the ambulance for transport. At this point we were told that we would have to complete the Section 20 by the Police. I advised that were unable to do that under the Act as the patient was Voluntary. The harassment continued for a further 5 minutes with the Officer insisting that their Barrister had advised them that we did have the right to Section voluntary patients. I still refused as it goes against my training and understanding of the Act. To me the wording is clear in the Act in this regard, but as it’s not my area of expertise I would really appreciate your interpretation of this.
I can’t understand what the police officer was talking about. The aim of modern mental health legislation is to limit the use of involuntary treatment. As an ambulance officer, you can transport a person to where health care is required. I suppose someone might want to argue that you can only transport to a mental health facility by virtue of s 20 and s 20 is about involuntary treatment. That argument would mean you couldn’t take a voluntary patient to a mental health facility but that would be rubbish. If a person is willing to go with a paramedic, and the paramedic is willing to take them, the paramedic can lawfully drive them anywhere they want to go. The fact that ambulances only transport people to hospital is a decision of the ambulance service not some legal rule. So if paramedics want to take a person to a mental health facility and the person wants to go, so 20 is not relevant.
The question for the police officer is even if a voluntary patient can be sectioned, why would or should they be? Treating them as a voluntary patient is the least restrictive approach. If the police officer wants to ensure the person is not then free to leave the facility they can arrest them if they think an offence has been committed.
In the absence of some explanation as to why the police officer thought compulsory detention was warranted, I can’t see any reason to pretend to detain a person who is willing to go with the ambulance service on a voluntary basis.