A security patient is a person who has committed a criminal offence, who is ordered to be detained in a designated mental health service for psychiatric treatment. A security patient can be:
• a person found guilty of an offence where the court has sentenced them by way of a court secure treatment order (CSTO), for a specified duration, under section 94A of the Sentencing Act 1991 (Vic), in accordance with part 11, division 2 of the MHA 2014 (replacing the hospital security order under MHA 1986);
• a person imprisoned or detained in prison or elsewhere (e.g. a remand centre, police jail, youth residential centre or youth justice centre) who is taken to and detained and treated at a designated mental health service under a secure treatment order (STO) made by the secretary to the Victorian Government Department of Justice and Regulation under part 11, division 3 of the MHA 2014 (replacing the restricted hospital transfer orders under section 16(3)(b) of MHA 1986).
A security patient subject to a CSTO can apply (under s 272) for a hearing to challenge their detention and treatment to the MHT. Similarly a security patient on a STO can apply for revocation of that order (under s 278).
Before a CSTO can be made a psychiatrist must examine the person and be satisfied that all the following criteria in section 94B(1)(c) of the Sentencing Act 1991 (Vic) are met:
• the person has mental illness;
• because of the mental illness they require treatment to prevent serious deterioration in their mental or physical health or to prevent serious harm to the person or someone else;
• the treatment will be provided if the person is put on a CSTO; and
• there is no less restrictive means reasonably available to enable the person to receive the treatment.
The authorised psychiatrist of the relevant approved mental health service must also recommend the order be made, and confirm the availability of facilities and services for the person’s treatment.
Almost identical criteria exist in section 276 for the making of a STO.
In determining whether to make a STO, the court must consider the person’s current mental condition, their medical, psychiatric and forensic history and their social circumstances (s 94B(1)(b) Sentencing Act 1991 (Vic)).
Security patients also have the right to seek a second psychiatric opinion under part 5, division 4, and to have their advance statement taken into account at various times (if they have one), and their nominated person consulted and informed of various matters at relevant times (if they have one).
MHA 2014 sets out a range of processes and criteria to be applied for security patients on matters such as leave of absence, monitored leave and transfer to another designate mental health service, as well as applications to the MHT in relation to transfers, and the making of interstate transfers.
For more information, see the DHHS’s ehandbook to the MHA 2014 (www.health.vic.gov.au/mentalhealth).