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Mentally-disordered Persons (Amendment) Act 2016

REPUBLIC OF NAURU

MENTALLY- DISORDERED PERSONS (AMENDMENT) ACT 2016

______________________________

No. 25 of 2016
______________________________


An Act to amend the Mentally-disordered Persons Act 1963

Certified: 12th May 2016


Table of Contents

1 Short Title

2 Commencement

3 Amendment of Mentally-disordered Persons Act 1963

4 Amendment of Section 3

5 Amendment of section 4

6 Insert new section 4B

7 Insert new section 4C

8 Repeal and replace section 6

9 Insert new section 6A

10 Insert new section 6B

11 Insert new section 6C

12 Insert new section 6D

13 Insert new section 6E

14 Insert new section 6F

15 Insert new section 6G

16 Insert new section 6H

17 Insert new section 6I

18 Insert new section 6J

19 Repeal of section 7

20 Insert new Section 7

21 Repeal of section 8

22 Insert new Section 8

23 Repeal of section 10

24 Repeal of section 11

25 Insert new section 21

26 Repeal and replacement of Schedule

FORM 1

FORM 2

FORM 3


Enacted by the Parliament of Nauru as follows:

1. Short title

This Act may be cited as the Mentally-disordered Persons (Amendment) Act 2016.

2. Commencement

This Act commences upon certification by the Speaker.

3. Amendment of Mentally-disordered Persons Act 1963

The Mentally-disordered Persons Act 1963 is amended by the provisions of this Act.

4. Amendment of section 3

(1) Section 3 is amended as follows:

Omit
'medical practitioner’ means a person registered or licensed as a medical practitioner under the law of a State or Territory of the Commonwealth of Australia, of New Zealand or of the United Kingdom;
Substitute
'medical practitioner' means a person registered or licenced as a medical practitioner under the laws of Nauru, Australia, New Zealand, the United Kingdom or of any other country approved by the Minister;‟

(2) Insert in alphabetical order the following definitions:

'designated mental health facility' means a place that has been declared by the Minister as a mental health facility in accordance with section 4B;
'Director of Medical Services' has the meaning given in the Health Practitioners Act 1999;
'mental disorder' means a disturbance or defect, to a substantially disabling degree, of perceptual interpretation, comprehension, reasoning, learning, judgment or memory, motivation or emotion whether or not the disturbance or defect is or is caused by:
'Minister' means the Minister for Health and Medical Services;
"Secretary" means the Secretary for Health and Medical Services.

5. Amendment of section 4

(1) Insert new section 4 (c) as follows:

'(c) poses a serious danger to the health or safety of that person or others.'

(2) Insert new section 4A

4A Persons not to be regarded as mentally disordered
(1) For the purposes of this Act, a person is not be regarded as mentally disordered by reasons only that:
(2) Subsection (1)(f) does not exclude the temporary or permanent effect of alcohol or any other drug, volatile substance or other substances inducing a mental disorder.

6. Insert new section 4B

4B Declaration of designated mental health facility
The Minister may by Order in the Government Gazette declare certain places as designated mental health facilities for the purpose of this Act, including:

7. Insert new section 4C

4C Appointment of authorised officers
(1) The Secretary may appoint persons as authorised officers in accordance with this Act.
(2) The Secretary may only appoint as an authorised officer a person whom the Secretary is satisfied:

8. Repeal and replace section 6

Section 6 is hereby repealed and replaced with the following:

6 General provisions for care, treatment and support
(1) In interpreting and implementing provisions of this Act, due regard should be had to the following principles:
(2) This Act applies to children in the same way as to persons of full age subject to the following:
(3) Nothing in this Act affects the ability of a person to be assessed on a voluntary basis or to be admitted to a mental health facility as an inpatient on a voluntary basis.

9. Insert new section 6A

6A Involuntary Assessments
(1) A person may, subject to available resources, be assessed on an involuntary basis in accordance with the procedures in this section.
(2) A Request for Transfer and Initial Assessment in Form 1 of the Schedule may be made by a health practitioner registered under the Health Practitioners Act 1999 where the health practitioner reasonably believes that the person may be a mentally disordered person.
(3) A transfer in accordance with the Request for Transfer and Assessment must be carried out by the Nauru Police Force as soon as possible, with the assistance of an authorised officer where available.
(4) The person may be assessed at a hospital or a designated mental health facility and must be assessed within 24 hours of arrival at the hospital or designated mental health facility.
(5) An assessment under this section may only be carried out by an authorised medical practitioner and in accordance with any prescribed requirements.
(6) During the assessment process under this section, treatment may be given if this is necessary, in the opinion of a medical practitioner, to reduce the person‟s risk to themselves or others.
(7) Following an assessment under subsection (4), the medical practitioner must either:
(8) An assessment made in accordance with Form 2 "Request for Assessment by a Second Medical Practitioner" must be conducted within 48 hours of the arrival of the person to the designated mental health facility.
(9) Following an assessment under subsection 8, the second medical practitioner must either:
(10) The further period of assessment referred to subsection 9(a) runs for a period of five days from the time of completion of the assessment by the second medical practitioner.

10. Insert new section 6B

6B Detention
(1) A person may be detained for assessment in a hospital or designated mental health facility only:
(2) A health practitioner or medical practitioner requesting transfer or involuntary assessment in accordance with section 6A must not be the primary carer or near relative of the person or have any other interest in relation to the person that might affect the practitioner's professional judgement or give rise to a real or perceived conflict of interest.

11. Insert new section 6C

6C Powers of Nauru Police Force
(1) A police officer may request a person to accompany the officer to a hospital or designated mental health facility if the officer:
(2) If it is not reasonably practicable to arrange for examination by a medical practitioner except at a designated mental health facility, the officer may request the person to accompany the officer to the nearest facility for that purpose.
(3) The officer should take action as in subsection (2), if the police officer reasonably believes that:
(4) If, when requested under subsection (2) or (3), a person refuses to accompany a police officer to the premises of a medical practitioner, or to a designated mental health facility, as the case may be, the police officer may:
(5) A police officer acting pursuant to subsection (4) may request the assistance of an authorised officer or any other person if the police officer is of the opinion that there are concerns relating to the safety of the person being arrested or to other persons.

12. Insert new section 6D

6D Assistance by police officers
(1) A health practitioner may request the assistance of a police officer to assist the implementation of the transfer and assessment procedure under subsection 6, or to find and return a person who has is being involuntarily assessed and detained and is absent from the mental health facility without approved leave and police officer must, if practicable:
(2) A police officer acting in relation to a person pursuant to subsection (1) may:
(3) An arrest under subsection (2) must be carried out humanely and:

13. Insert new section 6E

6E Person to be brought before Magistrate
(1) At the conclusion of the 5 day period under section 6A (10), or earlier if necessary, an application for an inpatient treatment order must be made and filed in the District Court by the Director of Medical Services, or the person must be released.
(2) A person may be detained for a maximum of 14 days from the date of filing of the application until the application is determined.
(3) The Director must submit all relevant assessment documents made with regard to that person.
(4) If the Magistrate is of the opinion that it is advisable to remand the person further and make an inpatient treatment order then the Magistrate may issue an order for a period not exceeding 3 months.
(5) At or before the expiration of the period specified in an order made in subsection (4), the person to whom the order relates must be brought before a Magistrate so that the examination and inquiry may be completed.
(6) Unless otherwise determined by the Court, inpatient treatment will continue during any period of appeal against the order.

14. Insert new section 6F

6F Making of inpatient treatment orders
The criteria for an inpatient treatment order for a person are that:

15. Insert new section 6G

6G Terms of an inpatient treatment order
(1) An inpatient treatment order may require the person subject to the order:
(2) The terms and conditions imposed under subsection (1) must only be such as are in the opinion of the medical practitioner in the best interests of the mental health of the person who is subject to the order.

16. Insert new section 6H

6H Assistance of interpreters
(1) Subject to subsection (2), health care professionals or a medical practitioner, as the case may be, must take all reasonable steps to have an appropriate interpreter present at the medical examination or assessment of persons under this Act if the person is unable to communicate adequately in the English or Nauruan language but is able to communicate in another language or if the person requests an interpreter.
(2) If it is not reasonably practicable to arrange for an interpreter to be present within 24 hours:

17. Insert new section 6I

6I Right to be given order, statement and explanation of rights
(1) If a person is made subject to an inpatient treatment order, the medical practitioner who applied to the Magistrate under section 6I must within 24 to 72 hours of making the order or application give to the person:
(2) If the medical practitioner considers it to be in the best interest of the person, or if the person so requests, the documents referred to in subsection (1) must also be given to the person's primary carer and the person's lawyer.

18. Insert new section 6J

6J Emergency medical treatment or surgery for involuntary patients
(1) Subject to subsection (2), a medical practitioner may in writing authorise the administering of medical treatment or the performance of a surgical operation, except sterilisation or a surgical operation upon an unborn child, on an involuntary patient if the medical practitioner is of the opinion that:
(2) Before giving an authority for the administering of medical treatment or for an operation under subsection (1), the medical practitioner must take all reasonable steps to obtain informed consent of the primary carer of the patient to the treatment or the operation, and may proceed as if the patient had consented only if the primary carer:
(3) The medical practitioner or authorised officer at the hospital or designated mental health facility in which the involuntary patient is detained must, as soon as practicable after the administration of treatment or performance of a surgical operation performed under this section, notify the Director of Medical Services and the Minister.
(4) Informed consent given to an emergency medical treatment or surgical operation by a primary carer of a patient who does not have the capacity to consent has the same effect as if it were given by the patient and the patient had the capacity to consent.
(5) Where sterilisation or a surgical operation upon an unborn child is indicated as a medical emergency under section 6J 1(b), and application must be made to the District Court for its direction and the Court may make such order relating to the matter as it thinks proper.

19. Repeal of section 7

Section 7 is hereby repealed.

20. Insert new Section 7

7 Removing persons detained for assessment or under an inpatient treatment order from a mental health facility
A person must not, without lawful excuse, remove an involuntary inpatient from a treatment centre, or aid such a patient to leave the centre.
Maximum penalty: $2000 or imprisonment for 1 year.

21. Repeal of section 8

Section 8 is hereby repealed.

22. Insert new Section 8

8 Confidentiality and records
(1) Subject only to subsection (3), information about a person obtained in the course of providing care, treatment and support to a person under this Act must be kept confidential and only used for the purpose of assessing, monitoring or improving the mental health of the person.
(2) All such information and records are the property of the Secretary of the Department of Health and must be made available to the Secretary of the Department or the Director of Medical Services immediately upon request.
(3) Disclosure may be made with the authority of the Director of Medical Services in order to avoid serious physical or mental harm to the person or other persons or in accordance with law.

23. Repeal of section 10

Section 10 is hereby repealed.

24. Repeal of section 11

Section 11 is hereby repealed.

25. Insert new section 21

21 Regulations
(1) The Minister may make Regulations to give effect to the provisions of this Act and subject to the express requirements of the Act, consistent with its principles and objectives.
(2) Without limiting subsection (1), Regulations made under this Act may make provision or additional provision, for or with respect to:
(3) Regulations made under subsection (1) may:

26. Repeal and replacement of Schedule

The Schedule, including all Forms are repealed and replaced as follows:


FORM 1

Subsection 6A (2)

REQUEST FOR ASSESSMENT AND TRANSFER

I,_____________________________ of _________________________, a health practitioner in accordance with the Mentally-disordered Persons Act 1963:

am of the opinion that ______________________________ of ____________________________ ___________________________________ is a mentally-disordered person and that it is proper for him/her to be taken charge of and detained under care or treatment; and

I have formed that opinion on the following grounds:

(i) Facts observed by myself (state facts below):

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

(ii) Facts communicated to be by other person (state facts and addresses and names of informants below):

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

I request the person named above to be transferred to _______________________________, a designated mental health facility, to be detained and assessed.

Date: __/ __/ __ Time:

Name

Position

Signature:

Registration Number under Health Practitioners Act:

Approved:

Director of Medical Services

Date:
Time:

FORM 2

Subsection 6A(7)(a)

REQUEST FOR ASSESSMENT BY SECOND MEDICAL PRACTITIONER

I,_____________________________ of _________________________, a medical practitioner under the Mentally-disordered Persons Act 1963 hereby certify that:

On __/ __/ __, at _________________________, I personally examined ____________________________________________ of

_____________________________;

(a) I am of the opinion that the said ___________________________________ is a mentally-disordered person and that it is proper for him/her to be kept in detention under care and treatment; and

(b) I have formed that opinion on the following grounds:

Facts observed by myself (state facts below):

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________


Date: __/ __/ __ Time:

Name

Position

Signature:

Registration Number under Health Practitioners Act:

Approved:

Director of Medical Services

Date:
Time:

FORM 3

Subsection 6A(9)(a)

REQUEST FOR A FURTHER PERIOD OF ASSESSMENT AND DETENTION

I,_____________________________ of _________________________, a medical practitioner under the Mentally-disordered Persons Act 1963 hereby certify that:

(a) On __/ __/ __, at _________________________, I personally examined ____________________________________________ of _____________________________;
(b) I have considered previous assessments and examinations conducted on __/__/__ by ___________________________________ [1] and
(c) I am of the opinion that the said ___________________________________ is a mentally-disordered person and that it is proper for him/her to be kept in detention for a period of up to 5 days for further assessment.
(d) I have formed that opinion on the following grounds:

Facts observed by myself (state facts below):

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

Date: __/ __/ __

Name

Position

Signature:

Registration under Health Practitioners Act:

Approved:

Director of Medical Services

Date:
Time:


[1] Insert name of medical practitioner


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