Requesting a mental health care decision
We work with health care providers to make decisions about mental health treatments for adults who cannot make decisions for themselves, including involuntary treatment. These decisions are made on a case-by-case basis.
Our role is to support you in delivering the best care while upholding your patient’s rights and wellbeing.
Who can request us to make a decision for mental healthcare?
We can make a decision to provide, or refuse, consent for medical treatments for adults with impaired decision-making ability. As an authorised doctor, psychiatrist or mental health practitioner, you can request a decision when we're:
- Appointed to provide decision making services for a person’s health care matters
- An attorney (under an enduring power of attorney or advance health directive) for the adult.
You can only request a decision if you’re the healthcare provider delivering the treatment, or someone acting under their supervision or direction.
Please note, we cannot make decisions for people under 18 years of age, and we will not make a decision about mental health treatment as the Statutory health attorney. Should there be no formal appointment for healthcare matters, you may need to contact the adult’s statutory health attorney.
For more information visit Statutory health attorney (SHA).
How do you request a decision from us?
If you’re an authorised doctor, psychiatrist or mental health practitioner seeking a decision to treat a client where we provide decision making services relating to health care matters, follow these steps:
- Read the guide: Applying to the Public Guardian for mental health treatment consent
- Complete the Application for mental health treatment consent form
- Email the form to us.
We’ll decide whether to provide consent within 10 business days of receiving of your application.
If you have any questions, please call us on 1300 653 187.
When is a decision not required?
A decision is not required when:
- The adult has an AHD that states their views, wishes and preferences and details the directions that must be followed, or
- They're subject to an order under the Mental Health Act 2016 which allows for involuntary mental health treatment.
We also cannot make decisions for ‘special health care’, including:
- Electroconvulsive therapy
- A non-ablative neurosurgical procedure.
Only the Queensland Civil and Administrative Tribunal (QCAT) or the Supreme Court can make decisions for special health care.
QCAT can appoint us to represent our client’s views, wishes and preferences when the tribunal is considering special health care.
What updates are required if consent is given?
If we consent to mental health treatment for a client, we will ask you, as their authorised doctor to provide regular updates on their mental and general health and wellbeing.
How long does our consent apply?
We typically consent to mental health care for a limited time but not less than the minimum time needed for our clients to meet their treatment needs.
This allows us to review our client’s treatment and care at regular intervals.
How do we make mental health care decisions?
Queensland laws includes principles that guardians, attorneys and others must follow when making decisions for adults with impaired decision-making ability.
These principles are based on the rights all Queensland adults have under the Queensland Human Rights Act 2019.
What healthcare principles must we follow?
When we make a healthcare decision for a client, we must consider:
- The nature of any medical condition they have and their prognosis
- Any alternative treatment to what has been proposed
- Whether the health care can be delayed because a better treatment might soon be available, or they’re likely to soon regain their decision-making ability
- The risks of treatment and the consequences if it’s not provided.
What policies guide mental healthcare decisions?
Public guardian policy
Our policy clarifies how we manage mental health care professionals’ requests for consent to treat our clients.
Chief psychiatrist policy
Queensland’s chief psychiatrist has published a policy covering the treatment of people who have a mental illness and do not have capacity to consent to be treated.
All authorised doctors, psychiatrists and mental health practitioners must comply with the policy when treating patients who lack capacity.
Read the chief psychiatrist’s policy.