Episode of care—mental health legal status, code N

Identifying and definitional attributes

• Health, Superseded 20/01/2021
• Tasmanian Health, Standard 19/06/2020

Mental health care:

This metadata item is required to monitor trends in the use of compulsory treatment provisions under state and territory mental health legislation by Australian hospitals and community health care facilities, including 24-hour community based residential services. For those hospitals and community mental health services which provide psychiatric treatment to involuntary patients, mental health legal status information is an essential metadata item within local record systems.

Value domain attributes

Representational attributes

Collection and usage attributes

CODE 1     Involuntary patient

Involuntary patient should only be used by facilities which are approved for this purpose. While each state and territory mental health legislation differs in the number of categories of involuntary patient that are recognised, and the specific titles and legal conditions applying to each type, the legal status categories which provide for compulsory detention or compulsory treatment of the patient can be readily differentiated within each jurisdiction. These include special categories for forensic patients who are charged with or convicted of some form of criminal activity. Each state/territory health authority should identify which sections of their mental health legislation provide for detention or compulsory treatment of the patient and code these as involuntary status.

CODE 2     Voluntary patient

Voluntary patient to be used for reporting to the Community mental health care NMDS, where applicable.

CODE 9     Not reported/unknown

This code is to be used if the mental health legal status for the patient is either not reported or unknown.

Data element attributes

Collection and usage attributes

The mental health legal status of admitted patients treated within approved hospitals may change many times throughout the episode of care.

Patients may be admitted to hospital on an involuntary basis and subsequently be changed to voluntary status; some patients are admitted as voluntary but are transferred to involuntary status during the hospital stay. Multiple changes between voluntary and involuntary status during an episode of care in hospital or treatment in the community may occur depending on the patient's clinical condition and his/her capacity to consent to treatment.

Similarly, the mental health legal status of residents treated within residential care services may change on multiple occasions throughout the episode of residential care or residential stay.

Approval is required under the state or territory mental health legislation in order to detain patients in hospital for the provision of compulsory mental health care or for patients to be treated compulsorily in the community.

Admitted patients are to be reported as involuntary if the patient is involuntary at any time during the episode of care.

Residents in residential mental health services are to be reported as involuntary if the resident is involuntary at any time during the episode of residential care.

Patients of ambulatory mental health care services are to be reported as involuntary if the patient is involuntary at the time of a service contact.

Relational attributes