B v Mental Health Tribunal [2020] TASSC 10;

CMB v Mental Health Tribunal [2021] TASFC 4;

S v Mental Health Tribunal [2016] TASSC 34.

The decision has been anonymised for the purpose of publication

1. TFD (the patient) is a 39-year-old woman.
2. At the time of the application and hearing, TFD was an involuntary patient at [an approved facility].
3. On 28 July 2025, Dr LT (the applicant) filed with the Tasmanian Civil and Administrative Tribunal (the Tribunal) an application for a treatment order for the patient pursuant to s 37 of the Mental Health Act 2013 (Tas) (the Act). In her application, Dr LT provided the following circumstantial overview:

[TFD] is a 39 year old lady with complex mental health history, but prominent decline in functioning and mental state over the last few months. She has had multiple instances where she voiced suicidal ideation and was agitated in terms of behaviour, which required being brought to hospital by Police and Ambulance. She has had admissions under General Medicine Orthopaedics recently which required Consultation Liaison Psychiatry input. Working diagnosis of First Episode of Psychosis. Now she presents with perplexity, bizarre affect, disorganisation, delusions of reference and persecution. Believes there is an identity theft going on so she went randomly talking to her neighbours about it. In the past she has been on risperidone. Has been on Treatment Order before... > > [TFD] has been deteriorating over the past few months in terms of functioning and mental state. She presented brought in by Ambulance with acute behavioural disturbance, wailing, bizarre behaviour, has randomly tried to knock on neighbour's door worrying there in [sic] an identity theft going on. She also has been suspicious of others and isolative, which led to mom's concerns about mental state. While in the Emergency Department she was challenging to engage with and tried to leave hospital. [TFD] struggles to explain a myriad of sensory abnormalities that she names "interferences" and lead to intense distress and crying. [TFD] is presenting with increased risks to self by misadventure, of further decline and risks to her reputation.

4. Dr LT sought an interim treatment order pursuant to s 38 of the Act. On 27 May 2025, a single Member of the Tribunal made an interim treatment order, effective until 9:21am on 8 August 2025, in relation to the patient in the following terms:

• (A) is authority for the patient to be admitted to and if necessary detained in an approved facility for the purposes of receiving treatment;
• (B) authorises a combination of treatment settings and the admission or readmission of the patient to those settings, including treatment in the community; and
• (C) authorises the following:

1. The patient is to take the following medication (depending on clinical indication):

1. Antipsychotic medication 2. Mood stabilising medication 3. Antidepressant medication 4. Benzodiazepine medication 5. Anticholinergic medication for treatment of any extrapyramidal side effects from taking antipsychotic medication

Medications may be administered orally and/or by intra-muscular injection and/or by depot injection as prescribed by a treating psychiatrist within clinical guidelines, with dosages adjusted according to clinical response and tolerability.

2. Standard medical and/or blood, and/or urine tests and/or diagnostic radiological and medical imaging tests, as clinically indicated and as directed by the treating team.
3. Adult Community Mental Health Service (ACMHS) appointments (inclusive of home visits as arranged when being treated in the community.
4. A Notice of Hearing was issued by the Tribunal advising that a hearing to determine the application for a treatment order would be held on 1 August 2025 before a three-member panel of the Tribunal.
5. The hearing proceeded as scheduled on 1 August 2025 and a treatment order was made. Brief oral reasons for the decision were given at the hearing.
6. Following the hearing, TFD submitted a written request for reasons for the orders made on 1 August 2025. These are our reasons.

1. The hearing was conducted by audio-visual link between the Tribunal Members and [an approved facility]. TFD did not attend the hearing. Dr LT attended the hearing from [an approved facility]. The patient's mother, BT, also attended the hearing from the approved facility.
2. The application and associated supporting documentation were filed by the applicant and the patient's treating team prior to the hearing. No documentary evidence or submissions were provided by the patient.
3. Upon the commencement of the hearing, the Tribunal was advised by Dr LT that attempts had been made to discuss the hearing with TFD but that she remained very disorganised and was not able to give any answer about whether she wished to attend, and was not able to attend the hearing.

1. Section 39 of the Act provides the Tribunal with authority to make a treatment order:

39. Determination of application for treatment order > > (1) The Tribunal may make a treatment order in respect of a person if, and only if, it is satisfied that -

(a) an approved medical practitioner has applied for a treatment order in respect of the person; and

(b) the requirements of section 37 have been met in respect of the application; and

(c) the person meets the treatment criteria; and

(d) a treatment plan has been prepared for the person; and

(e) the requirements of section 53(2) appear to have been met with respect to the treatment plan.

...

1. Pursuant to s 39(1)(b), the Tribunal can be satisfied that a treatment order should be made where the application has fulfilled the requirements under s 37:

37. Application for treatment order > > (1) Any approved medical practitioner may apply to the Tribunal for a treatment order in respect of a person. > > (2) The application may be made whether or not the person is subject to an assessment order. > > (3) If the person is subject to an assessment order, the application should only be made if -

(a) the applicant has assessed the person under the authority of the assessment order; and

(b) the applicant is satisfied from the assessment that the person meets the treatment criteria.

(4) If the person is not subject to an assessment order, the application should only be made if -

(a) the person has been assessed by the applicant and one other approved medical practitioner, separately, within the preceding 7 days; and

(b) the applicant and the other approved medical practitioner are both satisfied from their respective assessments that the person meets the treatment criteria.

(5) The application in relation to a person is to be in accordance with section 195 and be accompanied by -

(a) a statement by the applicant affirming that (and explaining how) the person meets the treatment criteria; and

(b) . . . . . . . .

(c) an indication as to whether an interim treatment order is needed; and

(d) if the person is subject to an assessment order, a copy of that order.

(6) The applicant is to -

(a) give a copy of the application to the person (together with a statement of rights in a form approved by the President of the Tribunal); and

(b) place a copy of the application (and accompanying documentation) on the person's clinical record (ensuring that such a clinical record is created if one does not already exist).

1. Further, we must be satisfied that the person the subject of the application meets the treatment criteria provided under s 40:

40. Treatment criteria > > The treatment criteria in relation to a person are -

(a) the person has a mental illness; and

(b) without treatment, the mental illness will, or is likely to, seriously harm -

(i) the person's health or safety; or

(ii) the safety of other persons; and

(c) the treatment will be appropriate and effective in terms of the outcomes referred to in section 6(1); and

(d) the treatment cannot be adequately given except under a treatment order; and

(e) the person does not have decision-making capacity.

1. We note that in relation to the requirement for a treatment plan, a treatment plan is defined under s 50 of the Act as an instrument which outlines the treatment the patient is to receive and in accordance with s 52, must be in a form approved by the Chief Civil Psychiatrist. Section 39(1)(e) prescribes that the Tribunal must be satisfied that the requirements of s 53(2) appear to have been met in relation to a treatment plan:

53. Preparation of treatment plan > > (2) In preparing a treatment plan, a medical practitioner -

(a) is to consult the patient; and

(b) may, after consulting the patient, consult such other persons as the medical practitioner thinks fit in the circumstances.

1. Further, in determining whether to make a treatment order pursuant to s 39, we need to be cognisant of the objects of the Act in s 12:

12. Objects of Act > > The objects of this Act are as follows:

(a) to provide for the assessment and treatment of persons with mental illnesses;

(b) to provide for appropriate oversight and safeguards in relation to such assessment and treatment;

(c) to give everyone involved with such assessment and treatment clear direction as to their rights and responsibilities;

(d) to provide for such assessment and treatment to be given in the least restrictive setting consistent with clinical need, legal and judicial constraints, public safety and patient health, safety and welfare;

(e) to promote voluntary over involuntary assessment and treatment and the making of free and informed assessment and treatment choices;

(f) to provide for all incidental and ancillary matters.

1. Finally, in exercising our responsibilities under the Act, we must refer to the mental health service delivery principles set out in Schedule 1 of the Act (s 15: see B v Mental Health Tribunal [2020] TASSC 10 at [39] and CMB v Mental Health Tribunal [2021] TASFC 4 at [31]). Schedule 1 provides:

SCHEDULE 1 - Mental health service delivery principles

2. The mental health service delivery principles are as follows:

(a) to respect, observe and promote the inherent rights, liberty, dignity, autonomy and self-respect of persons with mental illness;

(b) to interfere with or restrict the rights of persons with mental illness in the least restrictive way and to the least extent consistent with the protection of those persons, the protection of the public and the proper delivery of the relevant service;

(c) to provide a service that is comprehensive, accessible, inclusive, equitable and free from stigma;

(d) to be sensitive and responsive to individual needs including, but not limited to -

(i) needs relating to culture, language, age, religion, gender, gender identity, sexual preference, sexuality or other personal factors; and

(ii) in relation to patients who are Aboriginal persons or Torres Strait Islanders, that there is a recognition of and response to their distinct cultural and identity needs; and

(iii) needs that require recognition of and response to relevant cultural and identity needs generally; and needs related to trauma-informed care;

(e) to emphasise and value promotion, prevention and early detection and intervention;

(f) to seek to bring about the best therapeutic outcomes, including the use of evidence-based care, and promote patient recovery;

(g) to provide services that are consistent with patient treatment plans;

(h) to recognise the difficulty, importance and value of the role played by families, carers, children and support persons of persons with mental illness;

(i) to recognise, observe and promote the rights, welfare and safety of the children and other dependants of persons with mental illness;

(j) to promote the ability of persons with mental illness to make their own decisions, including decisions about the person's assessment, treatment and recovery that involve a degree of risk;

(k) to involve persons receiving services, and where appropriate their families, carers, children and support persons, in decision-making;

(l) to recognise families, and support persons, of persons with mental illness as partners, with mental health service providers, in the provision of their treatment and care to the extent that this is appropriate and consistent with their own wishes;

(m) to respect the wishes of persons receiving services, and the wishes of their families and support persons, to the maximum extent consistent with the health and safety of those persons and the safety of others;

(n) to promote and enable persons with mental illness to live, work and participate in their own community;

(o) to operate so as to raise community awareness and understanding of mental illness and to foster community-wide respect for the inherent rights, liberty, dignity, autonomy and self-respect of persons with mental illness;

(p) to be accountable and to have robust clinical governance and quality and safety processes;

(q) to recognise and be responsive to national and international clinical, technical and human rights trends, developments and advances and meet the requirements to national accreditation;

(r) to ensure that persons receiving mental health services have their medical and other health needs, including any alcohol and other addiction problems, recognised and responded to;

(s) to ensure that the best interests of children and young persons are recognised and promoted as a primary consideration, including receiving services separately from adults, whenever possible;

(t) to ensure that the needs, wellbeing and safety of children, and other dependants, of persons receiving mental health services are recognised and protected;

(u) to ensure that staff working in mental health services have access to the support, supervision and appropriate training, including cultural diversity training, required to maintain quality, safety and a highly skilled workforce;

(v) to provide a mental health service that -

(i) is easily accessible, and safe; and

(ii) provides persons with mental illness with timely treatment, care and support that is high quality and based on contemporary best-practice principles; and

(iii) promotes recovery in the least restrictive manner that is consistent with the needs of persons with mental illness;

(w) to ensure that people who require mental health care and treatment have timely referrals, and access to specialist mental health services, when appropriate.

1. In accordance with the provisions outlined above, the Tribunal must be satisfied of a series of what are essentially important procedural matters prior to determining whether the patient meets the treatment criteria.
2. The documents filed by the applicant and the patient's treating team lead us to conclude that the procedural matters had been satisfied, specifically:

(a) the applicant is an approved medical practitioner pursuant to s 138 of the Act (s 39(1)(a));

(b) in circumstances where the patient is subject to an assessment order, the applicant has assessed the patient under the authority of the assessment order and is satisfied that the patient meets the treatment criteria (s 37(3)); and

(c) the application was: made on the approved form; included a statement by the applicant explaining how the patient satisfied the treatment criteria; indicated that an interim treatment order was required; accompanied with an assessment order; copies of the application together with a statement of rights were provided by the applicant to the patient; a copy had been placed on the patient's clinical records; and the applicant had made a note on the patient's clinical records of those actions (ss 37(5),(6)); and

(d) a treatment plan has been prepared for the patient, such plan having been prepared by the applicant dated 28 July 2025, and that the patient was consulted in the course of preparing the plan (ss 39(1)(d)(e) and 53(2)), albeit she did not agree with the treatment plan as she did not consider that she had, or required treatment for, a mental illness.

1. We now turn to an examination of the evidence and submissions as to whether the patient meets the treatment criteria.

The person has a mental illness pursuant to s 40(a)

4. Meaning of mental illness > > (1) For the purposes of this Act -

(a) a person is taken to have a mental illness if he or she experiences, temporarily, repeatedly or continually -

(i) a serious impairment of thought (which may include delusions); or

(ii) a serious impairment of mood, volition, perception or cognition; and

(b) nothing prevents the serious or permanent physiological, biochemical or psychological effects of alcohol use or drug-taking from being regarded as an indication that a person has a mental illness.

...

1. In Dr LT's application for the order, she opined that TFD presents with first episode of psychosis/relapse of psychosis. She also stated -

Her symptoms include disorganisation, perplexity, delusions of reference ("being interefered" [sic]) and persecution ("identity theft"). She has bizarre affect as well. Likely auditory hallucinations as well, hearing sounds and beeps that "interfere" somehow with herself/her body/her movements, which [sic] patient also struggling to describing [sic] those leading to more distress.

2. In the treatment plan prepared by Dr LT on 28 July 2025, Dr LT stated TFD "does not perceive herself as having mental illness." In the application, Dr LT noted that the patient "struggles to acknowledge that her symptoms are part of mental health condition".
3. At the hearing, Dr LT stated that TFD was presenting with psychosis that affects her thought content, her thought form, her organisation and impacts her ability to differentiate what is reality and what is not.
4. At the hearing, the patient's mother said, in respect to the issue of concerns about identity theft, that she has been worried about that for some time. BT did not think that TFD would have been "imagining everything". She said TFD is a very smart person, has always been very level-headed. BT said it would probably be good to give her the benefit of the doubt about this as it was just something TFD was generally worried about.
5. BT said her daughter has been terribly stressed out with everything. BT explained that TFD had been going through a breakdown of her marriage and her children had gone to live with her ex-husband and his parents. She explained this was a terrible loss to TFD and she had been quite depressed with it all. She did not like living alone and there have been times when she was crying all the time.
6. BT said that she had thought this was depression and that perhaps TFD could just have a "Zoloft or something" for depression. She said TFD had declined to take that as she thought she had tried it in the past and she is "a bit anti taking medication". She said "I think its been a build up of stresses with her. Its just gotten out of hand really... and it's just resulted in all of these horrible, awful behaviours..."
7. Dr LT responded to these observations and comments. She said the symptoms TFD was displaying were not restricted to depressive symptoms, in particular, the disorganisation of mind and behaviour. She said that they were not taking the depression lightly, but the priority is to manage the risks to TFD's safety.
8. There is no evidential onus of proof on an applicant for a treatment order, or any other form of order, that an applicant requests be made by the Tribunal under the Act. Rather, in light of the protective nature of the jurisdiction being exercised, a commonsense approach to evidence should be taken. The approved medical practitioner as applicant, or other member of a patient's treating team supporting an application, must present evidence and information sufficient to enable the Tribunal to conclude, having taken account of the nature of the order requested and the consequences which might flow to the patient, that on the balance of probabilities each criterion required to enable an order to be made has been met.
9. Dr LT, in her written application and at hearing, provided cogent evidence which explains why the view has been formed that TFD has a mental illness in the form of a psychosis. It appeared to the Tribunal that there was no dispute as to whether there was a mental illness, but quite appropriately, there was discussion points raised by BT as to whether other diagnoses could be considered. We are satisfied to the requisite standard upon the evidence and information provided by the treating team, that the criterion in s 40(a) of the Act is met. That is, the patient has a mental illness as defined by the Act.

Without treatment, the mental illness will, or is likely to, seriously harm the person's health or safety; or the safety of other persons pursuant to s 40(b)

1. The issue for us to decide on this criterion was whether we could be satisfied that without treatment, the patient's mental illness will, or is likely to, seriously harm the patient's health and safety. This criterion has been the subject of interpretation by his Honour Blow CJ in two matters.
2. In S v Mental Health Tribunal [2016] TASSC 34, his Honour said at [22]:

The thresholds for the satisfaction of the criteria in s 40(b) and (c) are fairly low. To be satisfied as to (b), a medical practitioner need not be satisfied of any risk to other persons, nor of any risk to the safety of the patient. It is sufficient if the practitioner is satisfied that, without treatment, the mental illness is likely to seriously harm the person's health, which of course includes the person's mental health.

3. Subsequently, his Honour provided additional comments as to the interpretation of this criterion in the matter of B v Mental Health Tribunal [2020] TASSC 10 at [14]:

Section 40(b) is concerned with what is "likely". When that word is used in legislation, it can have various meanings. It can mean "more probable than not" or "more than a 50% chance". It can refer to something that might well happen. It can refer to a possibility that is more than a remote or theoretical possibility. The meaning of the word has been considered in a great many cases. See, for example, Boughey v The Queen (1986) 161 CLR 10; Tillmanns Butcheries Pty Ltd v Australasian Meat Industry Employees' Union [1979] FCA 85; (1979) 42 FLR 331 at 339; Cream Holdings Ltd v Banerjee [2003] EWCA Civ 103; [2003] 3 WLR 999. Much depends on the legislative context. It is significant that the principal purpose or object of s 40(b) is the protection of mentally ill persons and others from risks of harm. Having regard to the purpose and context of the provision, I consider that "likely" should be given a wide interpretation. It should not be interpreted as meaning "more probable than not". It must be interpreted as meaning something more than a remote or theoretical possibility. I think it should be interpreted as referring to something that might well happen. Having regard to the evidence that I have referred to, I consider that it was open to the Tribunal to conclude that, without treatment, the appellant's mental illness was "likely" to result in her killing herself.

4. In the application, Dr LT set out the risks to the patient if she were not treated as follows:

If left untreated, [TFD] is in risk of further deterioration, risks to reputation ([TFD] was randomly knocking on neighbour's doors worried about identity theft), risks to self via misadventure. There is also risk of harm to relationship with her family members (children and mom).

5. At hearing, Dr LT spoke further to the risk of harm to TFD if she were untreated, explaining that she may place herself in situations that would harm her reputation and integrity and that her erratic behaviour could lead to "serious consequences". She also spoke of the high levels of distress and agitation the patient was experiencing.
6. BT spoke of TFD not being her normal self, things having got "out of hand" and of all these "horrible, awful behaviours". She spoke of TFD's marriage breakdown, but the Tribunal understood this to be for context in respect to the stressors which caused the episode, rather than being a result of the episode of mental illness.
7. We are satisfied that the evidence indicates that without treatment the patient's mental health is likely to further deteriorate, resulting in significant distress to TFD and placing her reputation, health and safety at risk of serious harm in context of her disorganised thought content, thought form and behaviours.

The treatment will be appropriate and effective in terms of the outcomes referred to in s 6(1) pursuant to s 40(c)

1. In determining whether to exercise the discretion to make a treatment order, we must be satisfied that the outcome of the proposed treatment is appropriate and effective with regard to the meaning of "treatment" in s 6(1) of the Act:

6. Meaning of treatment > > (1) For the purposes of this Act, treatment is the professional intervention necessary to -

(a) prevent or remedy mental illness; or

(b) manage and alleviate, where possible, the ill effects of mental illness; or

(c) reduce the risks that persons with mental illness may, on that account, pose to themselves or others; or

(d) monitor or evaluate a person's mental state.

1. In the matter of S v Mental Health Tribunal (supra), his Honour Blow CJ provided commentary as to the interpretation of this criterion, at [22] - [23] as follows:

The thresholds for the satisfaction of the criteria in s 40(b) and (c) are fairly low.... > > ..... > > Although s 40(c) uses the words "the treatment will be appropriate and effective", it is clear that the legislation is intended to apply to mentally ill individuals whose symptoms cannot be treated or ameliorated in any way. For the purposes of s 40(c) treatment will be "appropriate and effective" if it is treatment directed towards the management of the ill effects of mental illness, or even just the monitoring of a person's mental state: s 6(1)(b) and (d).

2. In the application, Dr LT outlines the current treatment to include antipsychotic medication (Olanzapine) and benzodiazepine medication (Lorazepam) and anticholinergic medication. Future treatment will include increasing the antipsychotic medication as tolerated (monitoring efficacy and tolerability), inpatient admission, mood stabilisers, benzodiazepines and anticholinergic medications, routine blood, urine and medical tests, and imaging if indicated. Dr LT described this as evidence-based treatment for psychosis and noted that TFD had reportedly had some response to antipsychotics in a previous admission. Dr LT stated that:

The proposed treatment is expected to provide risk mitigation, relapse prevention, improvement of symptoms and psychosocial functioning.

3. At the hearing, Dr LT confirmed her view that the treatment would be appropriate and effective. She said it is the first line of treatment for first episode psychosis and that TFD had been, prescribed another antipsychotic, Risperidone in the past in respect to a delirium.
4. BT expressed some concern with the use of benzodiazepine medication and antipsychotic medication (Olanzepine). As the Tribunal understood it, BT was concerned about the sedative effect of the benzodiazepine use and the possible side effect of weight gain in respect to the Olanzepine. Dr LT explained the need for TFD to have medication with a sedative effect to assist her with current levels of distress and agitation until she is more settled and also that TFD was "not having much" benzodiazepine medication. Regarding the potential for weight gain as a side effect of using Olanzepine, BT said that she was concerned that weight gain from the medication would make TFD "feel dreadful".
5. Whilst BT raised these issues for consideration by the treating team, she also acknowledged "but of course, she's got to have something to help her through this awful period of her life". She went on to say "I'm just sort of wondering how it's all going to leave her".
6. Dr LT agreed that weight gain can be a concerning side effect but explained that it is quite early in the presentation and the current goal is have the symptoms settle and then for the treating team with work with TFD to consider the best options going forward and weigh the 'pros and cons' of the medication options.
7. We accepted the evidence as to the professional opinion of Dr LT that the treatment proposed in the application was appropriate and effective for the patient as defined in the Act and that such treatment would be within accepted treatment guidelines. The prescribed medications are directed towards the management of the ill effects of the patient's mental illness, which currently needs to be managed in an approved facility with discharge to community management in due course. The Tribunal noted it was very early in TFD's presentation with medication usage still being optimised. This criterion is satisfied.

The treatment cannot be adequately given except under a treatment order pursuant to s 40(d)

1. In the application for the treatment order, Dr LT provided the following opinion in relation to this criterion:

[The patient] struggles to acknowledge that her symptoms are part of mental health condition and does not underand [sic] them as a risk to her functioning and to her health. [LFD] had moments of agitation while in Hospital which required presence of security and sedation. She also tried to leave Hospital multiple times as she does not comprehend her symptoms as part of mental illness.

2. Dr LT, at the hearing, said that TFD is quite adamant that she does not need to be in hospital, despite her symptoms, and that hospitalisation has no role in her needs. TFD has expressed to her that all that she needs is to go home and sleep.
3. Relevant to this criterion, Dr LT explained that as part of the process of ruling out organic causes for her symptoms, LFD was explained the need for an ECG (electroencephalogram) and agreed to have it but when taken down for the test, she became extremely distressed, started wailing and expressed wanting to leave the hospital.
4. At the hearing, BT did not make any submissions specific to whether TFD could be treated without a treatment order.
5. Having accepted the evidence of the treating team that the patient is not yet able to understand her mental health condition and weigh information in respect to it, or the need to stay in hospital to receive treatment for it, we are satisfied that the required treatment cannot be currently given without the imposition of a treatment order. The patient is currently unable to give informed consent. At present, she is not accepting of recommended treatment, including staying in hospital. We are satisfied that this criterion is made out by the evidence.

The person does not have decision-making capacity pursuant to s 40(e)

1. The Act defines 'decision-making capacity' in s 7:

1. Capacity of adults and children to make decisions about their own assessment and treatment

(1) For the purposes of this Act, an adult is taken to have the capacity to make a decision about his or her own assessment or treatment (decision-making capacity) unless a person or body considering that capacity under this Act is satisfied that - > > > (a) he or she is unable to make the decision because of an impairment of, or disturbance in, the functioning of the mind or brain; and > > > > (b) he or she is unable to - > > > > > (i) understand information relevant to the decision; or > > > > > > (ii) retain information relevant to the decision; or > > > > > > (iii) use or weigh information relevant to the decision; or > > > > > > (iv) communicate the decision (whether by speech, gesture or other means).

2. In her application, Dr LT opined a view that the patient lacked decision making capacity, stating that TFD is experiencing a relapse of psychosis. She said further:

[The patient] is unable to make decisions about her management due to her disorganised thought process and significant reference and persecutory delusions. Her decision making capacity is impaired in the context of poor insight... > > Her psychotic symptoms / persecutory delusions are impacting her understanding of relevant information and she struggles to correlate them as part of her mental illness. > > She is urrently [sic] unable to use or weigh information relevant to her mental health management. She is unable to correlate her symptoms and the risks involved with lack of treatment. She is unable to consider the various aspects of her symptoms and the need fo [sic] treatment.

Even though she is quite open about those symptoms... she doesn't understand the seriousness of those symptoms and how they are negatively impacting her life and her well-being.

4. As an example, Dr LT explained that TFD's symptoms, such as the idea that someone is trying to steal her identity, and that the phone numbers in her phone have been changed, have led her to such a point of desperation that she knocks on the neighbour's doors, demonstrating that she does not have a sense of reality. She said TFD does truly believe that those experiences are real, despite being proven otherwise. This affects her understanding of the need for treatment as she does not relate her symptoms to a mental illness. For this reason, when the treating team explain how the symptoms can affect her life, she cannot relate to the potential consequences of not having treatment.
5. The Tribunal received clear evidence that TFD was unable to recognise her current experience as reflective of the symptoms of mental illness and is unable to understand or use and weigh information in respect to treatment decisions. We accept the evidence of the treating team that the patient does not have decision making capacity, as defined by the Act, to make decisions as to the assessment and treatment of her mental health. This criterion is satisfied.

1. The Tribunal is satisfied that TFD meets the treatment criteria. We are also satisfied that the other procedural matters have been met with as outlined under s 39 of the Act (see [18] above). Accordingly, we can proceed to decide whether to exercise the discretion to make a treatment order for the patient. We note that in exercising our discretion we need to consider the objects of the Act (in s 12) and the mental health delivery principles (in Sch 1).
2. The Tribunal concluded that TFD has a mental illness and that she is currently experiencing a relapse of the illness. At present, we hold the view that the patient requires a treatment order to ensure that her mental illness is both treated and that she is kept under observation for the purpose of management of the illness. We deduced that TFD is currently incapable of making autonomous decisions about the treatment she requires for her mental illness. In expressing this view, we are guided by the analysis of Pearce J in CMB v Mental Health Tribunal (supra) at [31]:

Patients are to be subject to the least restriction, but only as far as is consistent with public safety and patient health, safety and welfare. Moreover, the submission that the terms of the legislation favour "patient autonomy" carry little weight when, at the relevant time, the patient is incapable of making an autonomous decision. In my view it is for the Tribunal to weigh the various, sometimes competing, considerations and to reach the appropriate balance.

3. The Tribunal is satisfied that a treatment order should be made for the patient in the terms sought by the applicant for a period of six months, noting that unless the order is discharged sooner, it will be reviewed by the Tribunal within 60 days. We also note that without further involvement of the Tribunal, in the event that an approved medical practitioner assesses the patient as no longer meeting the treatment criteria provided in s 40 of the Act, then subject to s 49(3), the practitioner must discharge the treatment order we have made (s 49(2)) and has the authority to do so (s 49(1)(a)).

1. The treatment order, in the terms requested by the applicant, was issued on 1 August 2025 at 9:55 am. The substantive provisions of the order were in identical terms to the interim treatment order made by the Tribunal on 29 July 2025 (see [4] above). The order was issued on the approved form and complied with the requirements under s 41 of the Act. The order will expire on 31 January 2026 unless discharged sooner, or renewed. The order has not been replicated in its entirety in these reasons to ensure that the identity of the patient is not disclosed as mandated by cl 11 of Pt 2 to Sch 4 of the Act.