Detention and Restraint in Non-Authorised Clinical Settings

The Office of the Chief Psychiatirst (OCP) has taken a lead role in informing hospital staff of the current state of the law with respect to the detention and restraint of people in authorised hospitals under the Mental Health Act 2014 (MHA 2014); and in non-authorised clinical settings.

The OCP recently delivered a presentation to staff at the North Metropolitan Health Service as part of the Grand Rounds education program. The presentation followed the recent District Court case of a man, detained in Sir Charles Gairdner Hospital, in which the judge directed the jury that hospital staff have no lawful right to prevent a voluntary patient from leaving a hospital, and that any force used to do so will constitute an unlawful assault upon the patient.

• Grand Rounds Presentation – PowerPoint
• Grand Rounds Presentation – text
• Grand Rounds Presentation – video (accessible via WA Health email address)

This presentation followed a number of others hosted by the OCP, which include:

• Online Community of Practice events in August 2022 and March 2023 to brief WA healthcare providers (including both public and private providers) on the legislative authority for restraining or detaining a patient. These events were voluntary and were attended by staff from all Health Service Providers (HSPs). Approximately 200 staff attended, including psychiatrists, mental health nurses and other mental health clinicians. Emergency Department (ED) physicians and security officers also attended the March 2023 event, which included a presentation by an ED physician.
• A question-and-answer session hosted by the Chief Psychiatrist in partnership with the WA Branch of the Australasian College for Emergency Medicine on the use of restraint in EDs. ED physicians from across WA attended, including physicians from each of the HSPs.

The Chief Psychiatrist will soon publish a guideline under section 547(3) of the MHA 2014, which will provide staff working in non-authorised healthcare settings with guidance and practical strategies on the use of detention and restraint of people who present with disturbed behaviour because of medical, mental health or alcohol or other drug-related issues.

The Chief Psychiatrist has established a Working Group to develop an education package for staff across the WA health system. This directly supports a finding by the Parliamentary Inspector of the Corruption and Crime Commission, in a report dated February 2023 on the use of unlawful detention in public hospitals, following the District Court case, that “there is a need to ensure that all hospital staff are made aware of the state of law so that future incidents of this kind are avoided”. The Working Group is chaired by the Deputy Chief Psychiatrist and includes consumer and carer representatives, as well as emergency clinicians, security officers and clinicians from across all HSPs. The education package will be rolled out to all public hospital staff in the very near future.

The OCP understands the Director General of the Department of Health will soon be issuing a policy framework, under section 26 of the Health Services Act 2016, that will ensure a consistent approach by all public hospital staff to the detention and restraint of persons in clinical settings.

If you’re concerned about how this information may apply to an individual case, please seek legal advice from your Health Service Provider.