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Skye

My name is Skye and I am Noongar / Yamigi born in Perth. My mum is Yamagi born in Mount Magnet. I was given the name Skye Faith because my mum loved the sky and all it’s seasons. She felt that the sky connected her with hope and faith.

I was 15 when I began to struggle with anxiety and depression. It started when we became homeless. I used to love school. I was never late but homelessness changed all that. I am 19 now.

My artwork for the Office of the Chief Psychiatrist is about the healing powers of nature. Walking and looking at nature helps me find peace. I love taking photos and I hope they help other people find peace.

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Mental Health Act 2014 Forms

Approved Mental Health Act 2014 forms for clinical use.

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The Mental Health Act 2014 requires clinicians and other officers to use forms approved by the Chief Psychiatrist to discharge certain powers and record certain treatments.

Please note:

  • Modification other than margin identifiers may invalidate these approved forms.
  • All forms are available as writable PDFs with the exception of Form 12A. Each form may be also printed, filled out in pen and scanned.
  • Many of these forms are now able to be completed directly on Psychiatric Services Online Information System (PSOLIS) with a print function to enable you to print and store in the patient’s medical record. If you have access to PSOLIS, this is the preferred method for MHA 2014 Form completion.

Only appropriately authorised individuals can complete MHA 2014 forms. Fraudulent use of these forms is prohibited.

These forms are password protected. To obtain the password, please contact the OCP during business hours, or your local HSP outside of business hours.

Printable forms are available via the Department of Health.

 

Referral for Examination / Detention

Form code Form Public Private
Form 1A Referral for examination by a psychiatrist Public Private
Form 1A attachment Information provided by another person in confidence Public Private
Form 1B Variation of referral Public Private
Form 2 Order to detain voluntary inpatient in authorised hospital for assessment Public Private
Form 3A Detention order Public Private
Form 3B Continuation of detention Public Private
Form 3C Continuation of detention to enable a further examination by a psychiatrist Public Private
Form 3D Order authorising reception and detention in an authorised hospital for further examination Public Private
Form 3E Order that person cannot continue to be detained Public Private

 

Transport / Transfer Orders

Form code Form Public Private
Form 4A Transport order

For additional information on mental health patient transport, visit the Department of Health website.

 Public Private
Form 4B Extension of transport order Public Private
Form 4C Transfer order Public Private
Form 4D Interstate transfer order (currently unavailable) N/A N/A
Form 4E Approval of interstate transfer order (currently unavailable) N/A N/A

 

Community Treatment Orders

Form code Form Public Private
Form 5A Community Treatment Order Public Private
Form 5B Continuation of Community Treatment Order Public Private
Form 5C Variation of terms of Community Treatment Order Public Private
Form 5D Request made by a supervising psychiatrist for a practitioner to conduct the monthly examination of a patient Public Private
Form 5E Notice and record of breach of Community Treatment Order Public Private
Form 5F Order to attend Public Private

 

Inpatient Treatment Orders

Form code Form Public Printable
Form 6A Inpatient treatment order in authorised hospital Public Private
Form 6B Inpatient treatment order in general hospital Public Private
Form 6B attachment Inpatient treatment order in a general hospital: report to Chief Psychiatrist Public Private
Form 6C Continuation of inpatient treatment order Public Private
Form 6D Confirmation of inpatient treatment order Public Private
Form 7A Grant of leave to involuntary inpatient Public Private
Form 7B Extension and/or variation of leave Public Private
Form 7C Cancellation of grant of leave Public Private
Form 7D Apprehension and return order Public Private
Form 8A Record of search and seizure Public Private
Form 8B Record dealing with seized article Public Private

 

Treatments

Form code Form Public Private
Form 9A Record of emergency psychiatric treatment Public Private
Form 9B Report to Chief Psychiatrist about provision of urgent non-psychiatric treatment Public Private

 

Restraint

See also Restraint Reporting to the Chief Psychiatrist (Flowchart).

Form code Form Public Private
Form 10A Record of oral authorisation of bodily restraint Public Private
Form 10B Written bodily restraint order Public Private
Form 10C Record of informing medical practitioner and treating psychiatrist of bodily restraint Public Private
Form 10D Record of observations made of restrained person Public Private
Form 10E Record of examination of restrained person and possible extension of bodily restraint Public Private
Form 10F Variation of bodily restraint order Public Private
Form 10G Revocation of expiry of bodily restraint order Public Private
Form 10H Review of bodily restraint order by a psychiatrist Public Private
Form 10I Record of post-bodily restraint examination Public Private

 

Seclusion

See also Seclusion Reporting to the Chief Psychiatrist (Flowchart).

Form code Form Public Private
Form 11A Record of oral authorisation of seclusion Public Private
Form 11B Written seclusion order Public Private
Form 11C Record of informing medical practitioner and treating psychiatrist of seclusion Public Private
Form 11D Record of observations made of secluded person Public Private
Form 11E Record of examination of secluded person and possible extension of seclusion Public Private
Form 11F Revocation or expiry of seclusion order Public Private
Form 11G Record of post-seclusion examination Public Private

 

Access to Information

Form code Form Public Private
Form 12A Nomination of nominated person Public (non-writable) Private (non-writable)
Form 12B Record of refusal of patient’s request to access document Public Private
Form 12C Restriction on freedom of communication Public Private
Form 12C attachment Record of confirmation, amendment or revocation of restriction of freedom of communication Public Private

 

Electroconvulsive Therapy (ECT)

Form code Form Public Private
Form 13 Statistics about ECT (contact OCP monitoring if required) Email us Email us
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