According to reports over the weekend the MP Jami-Lee Ross has been admitted to mental health care after being ‘sectioned’. But what does that mean?

What is sectioning?

In New Zealand, when you have a mental illness, you can generally decide your treatment options. Sectioning is a term that covers situations where someone needs mental health treatment but they are not in a position to ask for it, or they are refusing treatment. It’s also known as a compulsory treatment order.

The Mental Health (Compulsory Assessment and Treatment) Act, also known as The Mental Health Act, mandates for a person to have treatment for a mental illness even if they don’t agree to it. A person with mental health issues can be placed as a patient under this Act. If that happens they no longer have a right to refuse treatment.

What is a compulsory treatment order?

According to the Community Law website, a compulsory treatment order is a court order stating that a person who is assessed as having a mental disorder will have to receive treatment for up to six months. For the first month, the patient must accept treatment. From the second month onwards, the patient is not required to accept treatment unless they give informed consent, or treatment is considered in the interests of the patient by an independent psychiatrist (not being the responsible clinician), or the patient needs emergency treatment and it is not possible to get their consent.

Treatment does not just include medication. It can also cover rehabilitation programmes, education programmes, counselling and discussion groups. But these must be related to the mental disorder.

Can anyone be sectioned?

Yes. According to the Community Law website, anyone over 18 years old who believes that you may be suffering from a mental disorder, and who has seen you within three days of the date of the application, can apply to have you assessed to see whether you do have a “mental disorder” under the Mental Health Act. The application is made to the Director of Area Mental Health Services (DAMHS).

According to the Health and Disability Commissioner website, you can receive compulsory assessment or treatment under the Mental Health Act 1992 or the Alcoholism and Drug Addiction Act 1966. For mental health issues, you would go into an inpatient unit within a hospital, or be treated under a community treatment order in the community. For alcoholism and drug addiction, treatment is given at specially certified agencies.

What are my rights if I’m being sectioned? 

Section 7A of the Mental Health Act requires mental health and addiction services to consult with your whānau during the compulsory assessment and treatment process unless it is not in the best interests of your whānau member, or it is not reasonably possible. The clinician must consult your whānau before deciding whether whānau consultation is in their best interests.

According to the Citizens Advice Bureau, you can apply for a review of the clinician’s assessment at any time during their assessment of your mental health.

If the clinician has applied to the Court for a compulsory treatment order to be made, you have the right to go to the hearing and be heard by the Court. In some cases you may not be allowed to appear, for example, if the judge decides it’s not in your best interests to appear at the hearing. You can choose to represent yourself or be represented by a lawyer. The local District Inspector can help you find a lawyer, or – if you can’t afford a lawyer – you may be eligible for a legal aid lawyer.

Once a compulsory treatment order has been made, whether and how you can challenge the order depends on the situation:

• if the clinician reviews your compulsory treatment order (which they must do periodically) and decides you are still not fit to be released you can apply to the Review Tribunal.
• if you are in hospital under an inpatient order (a compulsory treatment order which requires you to get treatment in a hospital), you (or someone on your behalf) can apply to the High Court for a judicial inquiry to look at the legality of your detention.

If you are unhappy with your diagnosis or treatment, you can ask an independent psychiatrist for a second opinion.

What is an enduring power of attorney?

Under the Protection of Personal and Property Rights Act 1988 (PPPR Act) a competent person may grant to someone an enduring power of attorney (EPOA) to make health care decisions on their behalf, in the event they become incompetent to make their own health care choices. An enduring power of attorney can be activated when a person is no longer competent to make their own decisions, for example in the case of dementia.

The person granted the EPOA will often have a close relationship with the person giving the EPOA which means they may be able to best reflect what that person would have wanted in a particular situation.

What are my rights if a member of my whānau is being sectioned?

If you know your whānau member is receiving treatment and you have not been contacted, you can ask to be involved. If the clinician decides that consulting with you is not in the best interests of your whānau member, be sure to ask the reasons for the decision, and in what other ways you can be involved. You can also take a support person to the meetings.

Sources: Community Law, Citizens Advice Bureau, and Health and Disability Commissioner