In the metropolitan area, Mental Health Transport Officers (whom are not necessarily St John WA staff) are specially trained transport officers that will escort most involuntary patients during a mental health transfer; in some cases, the police will still be utilised. In regional areas the police will still provide this service in the interim until these officers are available locally.
The transfer plan should include a risk assessment to determinate suitability of the transfer in its current format. This does NOT override a bedside risk assessment and the officer should feel comfortable in questioning the suitability, stability and safety of the patient to be transferred.
If there are no safe means of transporting the patient, then a Mental Health Act 2014 Form is required. The absence of a form does not preclude the transfer from taking place and a complete set of forms is not required to transport all mental health patients. e.g. If Forms 1A and 3A are in place, and there is a safe way to transfer the patient (e.g. sedation), form 4A is not required and the transfer can take place.
| Referral for Examination / Detention | |
|---|---|
| Form 1A | Referral for examination by a psychiatrist |
| Form 1B | Variation of referral |
| Form 2 | Order to detain voluntary inpatient in authorised hospital for assessment |
| Form 3A | Detention order |
| Form 3B | Continuation of detention |
| Form 3C | Continuation of detention to enable a further examination by psychiatrist |
| Form 3D | Order authorising reception and detention in an authorised hospital for further examination |
| Form 3E | Order that a person cannot continue to be detained |
| Transport/Transfer orders | |
| Form 4A | Transport order |
| Form 4B | Extension of transport Order |
| Form 4C | Transfer order |
Due to changes in the current Mental Health Act 2014, Paramedics are not authorised to independently administer sedation to a patient who is the subject of a transport order under the Mental Health Act 2014 without specific authorisation from a doctor (preferably the patient’s discharging doctor).
The inter-hospital transfer form should include clear instructions from the discharging doctor allowing St John staff to administer sedation where clinically necessary en-route in accordance with our current Clinical Practice Guideline for Disturbed and Abnormal Behaviour. The Interhospital Patient Transfer Form is required to document the discharging doctor name and signature.
Suggested wording on the inter-hospital transfer form could include:
"The use of sedation as per SJWA Clinical Practice Guideline – Disturbed and Abnormal Behaviour – is approved for this patient in the event that other, less restrictive measures have failed."
The discharging doctor may choose to authorise doses of sedation below those found in our guidelines if there are specific patient factors that make that clinically sensible. This should be completed in the special medication section and signed by the discharging doctor.
Key Terms & Links
eLearning package:
www.mhc.wa.gov.au
Clinician's Practice Guide:
www.chiefpsychiatrist.wa.gov.au
Mental Health Handbook:
www.mhc.wa.gov.au
Approved forms:
www.chiefpsychiatrist.wa.gov.au
Document Control
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