1. The hearing of the application was conducted in person from the approved facility and by audio-visual link. KHC attended the hearing in person, together with Dr TN. KHC was represented by Ms Olsson, who appeared via audio-visual link. MU case manager and social worker also appeared via audio-visual link.
2. The Tribunal had before it a copy of the application, the treatment plan and the treatment order varied on 14 October 2025. No documentary evidence, including alternate medical evidence or written submissions were filed by KHC.
3. At the hearing Ms Olsson stated KHC's preference "not to contribute personally to the hearing" and that Ms Olsson would "put his views forward on his behalf". Despite Ms Olsson's submission, on some matters KHC chose to directly address the Tribunal. The Tribunal was grateful to KHC participating in the hearing.

1. Section 48 of the Act provides for the legislative framework for a renewal of a treatment order and what the Tribunal must be satisfied of before making an order to renew a treatment order.

48. Renewal of treatment order > > (1) The Tribunal may renew a treatment order on the application of any approved medical practitioner (the applicant). > > (2) An application must be made at least 10 days before the day during which the treatment order is due to expire, and is invalid if it is not. > > (3) An application is to be in accordance with section 195 and be accompanied by -

(a) a copy of the treatment order; and

(b) particulars of any recommended change in treatment; and

(ba) particulars of any recommended change to the treatment setting; and

(c) a statement by the applicant affirming that (and explaining how) the patient continues to meet the treatment criteria and is expected to continue to meet those criteria for the period of renewal.

(4) An applicant for the renewal of a treatment order -

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

(b) is -

(i) to give a copy of the application to the treating medical practitioner (if it is someone other than the applicant); and

(ii) to give a copy of the application to the CCP; and

(iii) if the patient is in, or is expected to be in, an approved facility, to give a copy of the application to the controlling authority of that facility; and

(c) is to place a copy of the application (and accompanying documentation) on the patient's clinical record.

(5) The Tribunal is to determine an application as soon as practicable after it is made and must do so by way of a hearing.

(6) To avoid doubt, a treatment order may only be renewed if it is still in effect.

(7) A treatment order in respect of a person may only be renewed if the Tribunal is satisfied that -

(a) the applicant has complied with subsection (4) ; and

(b) the person meets the treatment criteria.

(8) Under this section, a treatment order may be renewed for -

(a) if it has not previously been renewed, a period not exceeding 6 months; or

(b) in any other case, a period not exceeding 12 months.

(9) On renewing a treatment order, the Tribunal is to -

(a) give notice of the renewal to the patient (together with a statement of rights in a form approved by the President of the Tribunal); and

(b) give notice of the renewal to -

(i) the applicant; and

(ii) the treating medical practitioner (if it is someone other than the applicant); and

(iii) if the patient is in, or is expected to be in, an approved facility, the controlling authority of that facility; and

(iv) the CCP.

(10) A notice under subsection (9) is to specify the period of renewal.

13. The Tribunal must be satisfied KHC meets the treatment criteria to renew a treatment order. The treatment criteria are defined in s 40 of the Act:

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. Further, in determining whether to exercise its discretion to renew a treatment order under s 48, or make any other order, the Tribunal is required to be mindful of the objects of the Act outlined 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. The Tribunal also has regard to the rights of patients, in this case KHC, as outlined in the Act. Section 15A of the Act sets out the rights of patients, as follows:

15A. Rights of patients > > (1) Each person receiving an assessment or treatment under this Act has the following rights:

(a) the right to receive the assessment, or treatment, under this Act in accordance with the mental health service delivery principles;

(b) the right to have any restriction on, or interference with, the person's dignity, rights and freedoms to be limited as much as possible when taking into account the person's health and safety and the safety of others;

(c) the right to promote, and make prominent, the person's decision-making capacity, and to respect the person's wishes, to the maximum extent possible when taking into account the person's health and safety and the safety of others;

(d) the right to be given clear, accurate and timely information about -

(i) the person's rights as a patient; and

(ii) the person's diagnosis and treatment.

(2) In addition to the rights under subsection (1) , a person who is a forensic patient, or involuntary patient, also has the following rights while admitted to an approved facility:

(a) the right to be detained in a manner that is appropriate in respect of the patient's assessment, treatment or care requirements;

(b) the right to be given clear and timely information about the rules, and conditions, governing the patient's conduct in the relevant approved facility, including any relevant context in respect of a change in those rules or conditions while the patient is at the relevant approved facility;

(c) the right to have access to current information about local, national and world events;

(d) the right to ask for a leave of absence from the relevant approved facility;

(e) the right to seek legal advice and have contact with, including the right to correspond privately with, Official Visitors and the patient's representatives and support persons;

(f) the right to be provided with general health care;

(g) the right not to be unreasonably deprived of any necessary physical or communication aids;

(h) the right -

(i) to wear suitable clothing of the patient's own, if appropriate in the relevant approved facility; or

(ii) to be provided with basic clean clothing that is appropriate to the climate and the patient's size;

(i) the right to be provided with -

(i) food that is adequate to maintain the health and wellbeing of the patient; and

(ii) a diet that has reasonable variation; and

(iii) special dietary food, if the Chief Psychiatrist is satisfied that it is necessary for medical reasons, the patient's religious beliefs or the patient's dietary practices;

(j) the right to adequate toilet and sanitary arrangements;

(k) the right to adequate light and ventilation;

(l) the right -

(i) to practise a religion, or custom, in accordance with the patient's religious or cultural beliefs; and

(ii) if consistent with the management and security requirements of the relevant approved facility -

• (A) to join with other patients in practising the religion or custom; and

• (B) to possess such articles as are reasonably necessary for the practice of the religion or custom;

(m) the right to ask for, and receive, such reasonable help from the staff of the relevant approved facility so as to enable the patient to enjoy the rights specified in this section.

1. In exercising its responsibilities under the Act, the Tribunal must also have regard 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]). The principles set out in Schedule 1 are as follows:

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 (whether as to culture, language, age, religion, gender or other factors);

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

(f) to seek to bring about the best therapeutic outcomes 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, 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 choices;

(k) to involve persons receiving services, and where appropriate their families 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;

(q) to recognise and be responsive to national and international clinical, technical and human rights trends, developments and advances.

1. Section 10 of the Tasmanian Civil and Administrative Tribunal Act 2020 (TASCAT Act) outlines the main objectives of the Tribunal:

10. Main objectives of Tribunal > > (1) The main objectives of the Tribunal in dealing with matters within its jurisdiction are -

(a) in the exercise of its jurisdiction, to promote the best principles of public administration, including -

(i) independence in decision-making; and

(ii) natural justice and procedural fairness; and

(iii) high-quality, consistent decision-making; and

(iv) transparency and accountability in the performance and exercise of statutory functions, powers and duties; and

(b) to be accessible by being easy to find and easy to access, and to be responsive to parties, especially people with greater needs for assistance than others; and

(c) to ensure that applications, referrals, reviews and appeals are processed and resolved as quickly as possible while achieving a just outcome, including by resolving disputes through high-quality processes and the use of alternative dispute resolution processes, or compulsory conferences, wherever appropriate; and

(d) to keep costs to parties involved in proceedings before the Tribunal to a minimum insofar as is just and appropriate; and

(e) to use straightforward language and procedures (including, insofar as is reasonably practicable and appropriate, by using simple and standardised forms); and

(f) to act with as little formality and technicality as possible, including by informing itself in the manner that the Tribunal thinks fit; and

(g) to be flexible in the way in which the Tribunal conducts its business and to adjust its procedures to best fit the circumstances of a particular case or a particular jurisdiction.

(2) In furtherance of the Tribunal's main objectives, the Tribunal should, in relation to the conferral and exercise of the Tribunal's jurisdiction, consult from time to time with the agencies, organisations or bodies that it thinks appropriate.

1. As outlined in the applicable legislation summarised above, the Tribunal must be satisfied of several procedural matters before turning to the issue of whether KHC meets the treatment criteria.
2. The documents filed in the proceedings by the applicant indicated that each of the procedural matters had been satisfied. The Tribunal is satisfied that:
   1. the applicant is an approved medical practitioner as defined in s 138 of the Act (for the purpose of s 48(1));
   2. the application was:
      1. made at least 10 days before the day on which the treatment order expires, noting that to "make" the application, the applicant is to file the application with the Tribunal;
      2. made on the approved form;
      3. the information referred to in s 48(3) accompanied the application made to the Tribunal, as required;
      4. included a statement by the applicant explaining how, in his view, the patient satisfied the treatment criteria;
      5. copies of the application, together with a statement of rights was provided by the applicant to the patient, and any other required person, and a copy placed on his clinical records (s 48(4)).

1. The applicant's (Dr TN's) documentary evidence was contained primarily in the application for renewal and treatment plan. The application provides that Dr TN had formed the view that the treatment criteria had been met, based on reviews conducted by Dr TN with KHC in an inpatient setting, with the application addressing each criterion individually.
2. In the application, in summary, Dr TN stated KHC met the s 40 treatment criteria in that:
   1. KHC has received diagnoses of schizophrenia and "co morbid substance use". His illicit drug use commenced when he was 14 years of age. In 2019, after "hearing voices" he presented to hospital and was found to be psychotic. In 2021, he was diagnosed with schizophrenia and was treated for a period with antipsychotics until he self-ceased that medication. In June 2023, he experienced a traumatic injury and was "experiencing psychotic symptoms". In November 2023, he had an admission to an approved facility where he was again diagnosed with schizophrenia. Shortly afterwards he left Tasmania and became homeless interstate. In October 2024, following non-compliance with oral medications and relapse he was admitted to an approved facility in Tasmania. In November 2024, he was again readmitted following nonadherence to oral medications and relapse in his mental state. A long acting injectable depot antipsychotic medication was commenced to assist with compliance and prevent relapse. In January 2025, KHC was readmitted as he was "paranoid disorganised and agitated". Following discharge there have been ongoing difficulties in engaging KHC and "the nature of behaviour disturbances fluctuates".
   2. Dr TN states:

[KHC] has been diagnosed with schizophrenia and he has comorbid substance use he displays continuing condition with impairment of thought process (paranoid thoughts), perceptual disturbances) [sic] likely auditory hallucinations and behaviour disturbances. Ongoing substance use (THC and Meth) has been considered.

He is reluctant disclose symptoms and historically he had denied symptoms or becomes guarded.

1. The treatment plan states KHC's current symptoms as "disorganised impulsive and having delusional misidentification of health staff".

1. Relevant to whether there is a risk of serious harm to self or others if KHC is not treated, Dr TN stated KHC's has a longitudinal history of non-compliance with prescribed medications which has resulted in relapse and inpatient admissions. If untreated his mental illness is likely to deteriorate further. When unwell he has a history of threatening behaviours towards his family and conflict with neighbours. He is at risk of losing his accommodation. He is at risk of harm due to his behaviour disturbances. His parents are his primary support, however, there is likely to be damage to those relationships if he continues to make threats to his parents.
2. As to whether the treatment is appropriate and effective for KHC, Dr TN stated that treatment is currently delivered to KHC as an inpatient at an approved facility and upon discharge treatment will be through community mental health services. He explained that the current treatment prescribed is Paliperidone long-acting injectable antipsychotic medication every four weeks, oral Olanzapine and Diazepam as needed. The proposed treatment also includes KHC undergoing blood, urine, and radiological investigations as needed. The medication has been prescribed in accordance with the treatment guidelines for schizophrenia. It is anticipated that the treatment is likely to alleviate symptoms of mental illness and associated distress and improve his overall level of functioning.
3. Relevant to whether treatment could be given to KHC without a treatment order, Dr TN states without a treatment order it will be difficult to provide effective treatment to KHC due to his longitudinal history of non-compliance and ongoing difficulties with engagement in the community.
4. Dr TN states that KHC is unable to make decisions about his own assessment or treatment because of the impairment of or disturbance in the functioning of the mind or brain due to the mental disorder of schizophrenia. KHC is unable to understand information relevant to the decision because of his long-standing mental illness and inability to understand the significance of necessary information. He is unable to retain the information due to him having different priorities. The symptoms of schizophrenia render him unable to use or weigh the information taking all factors into consideration.

1. Dr TN had been treating KHC at the approved facility for two weeks. Dr TN gave evidence on behalf of the treating team at the hearing, which was consistent with the application he submitted, as detailed at paragraphs [5], [6] and [21] above. In addition to those matters:
   1. Dr TN further explained that on admission KHC's urine drug screen was positive for "THC". The ongoing use of substances together with ongoing issues with medication compliance are barriers to full recovery. Highlighting there have been readmissions to approved facilities due to relapses in November 2024, January 2025 and the recent admission.
   2. KHC has been paranoid about his neighbour playing loud music and perceives they are wanting to harm him. Upon admission KHC was "angry" and struggled to control his emotions.
   3. During the admission there has been improvement in KHC's symptoms including his emotional regulation, which is attributed to treatment and medication compliance. KHC has benefitted from antipsychotic and benzodiazepine medications. It was proposed that after the hearing, KHC would have a trial of authorised leave from the approved facility.

1. KHC displays superficial acceptance of the need for treatment. KHC lacks understanding of the importance of medication compliance, which is demonstrated by his failure to have prescriptions filled for oral medications since 2024. He shows members of the community mental health team the same partially used box of antipsychotic medication each time they ask to inspect his medications.
2. When unwell KHC is at risk of misadventure. KHC's delusional thinking influences his behaviour. Recently KHC attended at the family home and refused to leave. He knocked at the door for a considerable period and then requested a glass of water, which was given to him. KHC telephoned police, telling them his family would not provide him with a glass of water. The police contacted the family and asked if they wished them to attend. The family request police attend. After an 'altercation with police', KHC left and walked in front of a truck on the highway, the truck had to stop to avoid running over him. He was admitted to the approved facility. Previously KHC has presented with suicidal ideation however Dr TN did not consider that was a feature of his current relapse.
3. Dr TN stated psychotic phenomena including his delusions are 'influencing his thinking pattern' and affecting KHC's ability to make decisions.
4. Upon hearing evidence at hearing of KHC suffering from side effects from the medication Dr TN stated KHC has not mentioned side effects however the treating team will take it into consideration.
5. He accepted that the current treatment order did not authorise benzodiazepine medication which have been used during his hospital admission to 'calm' KHC. Dr TN sought approval for antipsychotic and benzodiazepine medication.

1. At the hearing, MU case manager for KHC stated, she had been working with him for 16 to 18 months. She stated KHC had recently had a person staying at his property and they were using cannabis. She reiterated that there was a failure by KHC to fill prescriptions for his oral antipsychotic medication. That whilst KHC stated he would continue engagement in the community she did not feel 'confident' he would. She had advocated for a three-monthly depot antipsychotic for KHC as he had made 'no secret that he's not a huge fan' of having the depot. However, now there was a question as to whether there was adequate efficacy of a three-monthly depot as opposed to a monthly depot. KHC's family have reported improvement in his mental state when being on the depot however they have stated that illicit substances have a detrimental impact on him. KHC has declined drug and alcohol counselling and community support with Baptcare. A previous admission to a rehabilitation unit was unsuccessful. MU stated that she had viewed video footage of the incident where KHC walked in front of a truck. MU stated there had been previous aggression to a former partner resulting in an 'AVO' being obtained against KHC. She supported the application for renewal of treatment order.

1. At the hearing, Ms Olsson submitted that the application should be dismissed because the treatment criteria were not met. Ms Olsson made the following submissions on her instructions from KHC:
   1. KHC accepted he had the diagnosis of schizophrenia six months ago however he no longer has schizophrenia. He instructed that previously his primary symptoms were auditory hallucinations and had not had any hallucinations for six months, which coincided with him ceasing illicit drug use. KHC disputes he has schizophrenia, that he has had a relapse, and that he has had delusional or paranoid beliefs. KHC disputes that symptoms of mental illness led to his current readmission and he disputed the need for readmission. Consequently, KHC does not accept that he has a mental illness.

1. KHC believes that his auditory hallucinations "might" return if he ceased his medication, but he also considered it was a possibility that they 'might not' return. His belief is that abstinence from methamphetamines has resulted in symptoms of schizophrenia ceasing.
2. The antipsychotic medication "may" have a role in his symptom management, and if he was not on a treatment order, he would continue to take his medication and attend appointments with the community mental health team.
3. KHC states that he has side effects of extreme fatigue and struggles to "get out of bed" in the morning. He has difficulty focusing. He has informed the treating team.
4. KHC's view is that he has decision-making capacity to make decisions about his mental health and treatment, which is evidenced by his decision to cease methamphetamine use, which has had a corresponding reduction in the symptoms he was experiencing.
5. KHC has spring/summer employment to undertake upon discharge from the approved facility.

1. At the hearing Ms Olsson conceded that she did not have any competing medical evidence to support her submissions and had not been instructed to seek one.
2. Ms Olsson submitted that if the Tribunal make a treatment order, it would be appropriate to include benzodiazepine medication and that should have been done when the order was varied upon readmission.

1. KHC reiterated that he has side effects from the medication including finding it "hard to wake up", "get through the day" and focus. He has reported it to the treating team.
2. KHC stated that his parents are inconsistent. "I'm welcome one day, then I'm not welcome the next. That's why I spent years homeless". It had been his home for 10 years before he recently moved into his own home. Recently the Police had requested he not visit the 'family home' for 14 days. Irrespective KHC visited, he "politely" knocked on the door, he wanted to pat his dog, have a glass of water and play video games with his brother who was there for night. He had to "beg" his family for a glass of water. He rang the police to "say could you check on my licence" that it was his family home. He then left and "walked across town" to his own home. There was no aggression. He stated in the past he had become angry with his father and threatened to punch him. He also said his father had physically assaulted him by dropping him to the ground and punching him to the head.
3. KHC did not walk in front of the truck "on purpose". He stated he was "just crossing the road", and the truck came upon him quickly as it was speeding.

1. The Tribunal took the whole of the evidence before it into account, as well as the submissions made by Ms Olsson on behalf of KHC and KHC's direct evidence.
2. In making its decision the Tribunal found the medical evidence presented by the treating team persuasive and compelling. The Tribunal preferred the evidence of Dr TN and MU when considering the treatment criteria. In considering all the evidence available the Tribunal was satisfied the evidence addressed all the treatment criteria.
3. The Tribunal was satisfied that:
   1. The applicant was an approved medical practitioner; and
   2. The application for renewal was made on 15 October 2025 which was at least 10 days before the day during which the treatment order was to expire namely 29 October 2025;
   3. The application was in accordance with s 195 of the Act and was accompanied by the relevant documents; and
   4. Copies of the application had been provided to all parties as required under s 48(4) of the Act.

1. Turning specifically to the s 40 treatment criteria of which we must be satisfied, before we can make a treatment order in respect of KHC:

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. The Tribunal accepted and preferred the evidence of Dr TN in relation to the question of whether KHC had a mental illness. The evidence was that KHC has a mental illness with diagnoses of schizophrenia and comorbid substance disorder. KHC has had a relapse in his schizophrenia, characterised by emotional dysregulation, disorganisation, irritability, impulsivity, persecutory and paranoid delusions. The Tribunal accepted the factual circumstances leading to readmission reflected deterioration in KHC's mental state. The Tribunal was satisfied the evidence establishes that KHC had a mental illness within the meaning of s 4, namely a relapse in his schizophrenia.
2. The Tribunal accepted that KHC does not accept that he has schizophrenia or symptoms of mental illness as described by the treating team nor that a relapse in his mental state resulted in his current admission to an approved facility.
3. The Tribunal was satisfied the treatment criterion was met.

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

1. In the Supreme Court decision of S v Mental Health Tribunal [2016] TASSC 34, Blow CJ when considering s 40(b) 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.

2. For the purposes of the Act, the word 'likely' means "something more than a remote or theoretical possibility ... something that might well happen": B v Mental Health Tribunal [2020] TASSC 10 at [14].
3. At the hearing, Dr TN opined that without treatment, KHC's mental illness would be likely to seriously harm his health and safety. Dr TN's evidence indicated that without treatment, KHC's mental health would deteriorate, as had occurred in October 2024, November 2024, January 2025 and the current admission.
4. The Tribunal was satisfied that there had been concerning conduct in the community, concerns of neighbours, concerns of family, concerns of police, and concerns of community mental health team. The Tribunal accepted that when unwell KHC has a history of threatening behaviours towards his family and conflict with neighbours. He is at risk of losing his accommodation. He is at risk of harm due to his behavioural disturbances. His parents are his primary support however there is likely to be damage to those relationships if KHC continues to make threats to his parents and act on his delusional thinking. The Tribunal found that, without treatment, KHC's mental illness was likely to cause serious harm to his mental health and there would be a risk of serious harm to others given the threats made to family and the events leading to readmission on 13 October 2025.
5. The Tribunal acknowledged that KHC disputed there was any serious risk of harm arising because he had not had a deterioration in his mental state, he had ultimately left the family home after he had a drink, there was no issue with him contacting police and the truck had been speeding. The Tribunal struggled to accept the alternate version of events as outlined by KHC and preferred the factual circumstances leading to his readmission as outlined by the treating team. The Tribunal preferred the evidence of the treating team regarding the nature and severity of the risks to KHC and others. The Tribunal considers the deterioration of a KHC's mental health to amount to serious harm. It is these factors which enabled the Tribunal to be satisfied that without treatment KHC's health and safety and the safety of others may be seriously harmed.
6. Accordingly, the Tribunal was satisfied the treatment criterion was met.

The treatment of KHC's mental illness will be appropriate and effective - s 40(c)

1. The Tribunal must be satisfied that the proposed treatment for KHC is appropriate and effective as referred 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. Dr TN advised that KHC is currently prescribed antipsychotic medication and benzodiazepine medication. Both medications are clinically recognised treatment for schizophrenia. In hospital, KHC has improved, with an observed reduction in emotional dysregulation, which the treating team attributed to compliance with medication. It is anticipated that the treatment is likely to alleviate symptoms of psychosis and associated distress and improve his overall level of functioning. The Tribunal was satisfied that improvement in KHC's mental state is attributed to treatment delivered under the treatment order.
2. The Tribunal acknowledged that KHC attributed the reduction in symptoms of schizophrenia to his cessation of methamphetamine use. Whilst the Tribunal congratulated KHC on his abstinence from methamphetamine use, the Tribunal accepts the evidence of the treating team that KHC continued to have symptoms of mental illness that ultimately led to his readmission to an approved facility for delivery of treatment. The Tribunal accepted that ongoing use of substances including THC, together with ongoing issues with medication compliance are barriers to full recovery.
3. The Tribunal was advised that the proposed future treatment for KHC involved approved period of leave from inpatient treatment, and monitoring of the leave. Given the recent relapse under a three-month depot, the treating team would consider the frequency of the delivery of the long-acting injectable antipsychotic medication together with side effects reported by KHC. Upon discharge KHC would have ongoing support from the community mental health team.
4. The Tribunal was satisfied treatment is clearly within the ambit of the definition of treatment under s 6 of the Act. The Tribunal was satisfied on the evidence the treatment was appropriate and effective treatment for KHC's mental illness.
5. The Tribunal was satisfied the treatment criterion was met.

The treatment cannot be adequately given except under a treatment orders - 40 (d)

1. Dr TN stated that treatment could not be adequately given except under a treatment order because of KHC's longitudinal history of non-compliance and ongoing difficulties with engagement in the community.
2. The Tribunal accepted the evidence of the treating team that the treatment cannot be adequately given except under the auspices of a treatment order. We acknowledged Ms Olsson's submissions that KHC would voluntarily accept treatment and attend appointments with the treating team whilst also stating that he denied the presence of symptoms of mental illness and the need for treatment. Logically the Tribunal struggled to accept the submission, posing the question, why would treatment be accepted when KHC denied the need for treatment? That being the case, it is highly unlikely that he would accept treatment as prescribed if he were not under an order. The Tribunal placed weight on the clear evidence of KHC, that he did not believe he had a mental illness nor that it required treatment. The Tribunal accepted KHC has a history of non-compliance with antipsychotic medication, his history of relapse followed by readmissions to approved facilities at paragraph [21a.] and his failure to take oral antipsychotic in the community.
3. The Tribunal found KHC lacked insight into his mental illness and treatment. The Tribunal found that as a direct result of the symptoms of his illness, including persecutory delusions, he was lacking in decision-making capacity to understand the nature of his illness, including the reasons for his admission to an approved facility, or to use and weigh the risks verses benefits of treatment verses non treatment.
4. The Tribunal found that treatment cannot be adequately given to KHC except under a treatment order.
5. The Tribunal was satisfied the treatment criterion was met.

s 40 (e) KHC does not have decision-making capacity - s 40 (e).

1. Section 7 of the Act defines decision-making capacity and provides:

7. 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

(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).

1. Dr TN advised in his application that KHC does not have decision-making capacity because of an impairment of or disturbance in the function of the mind or brain. Dr TN stated that KHC has a diagnosis of schizophrenia. Dr TN stated psychotic phenomena including KHC's delusions are 'influencing his thinking pattern' and affecting KHC's ability to make decisions. He is unable to retain the information relevant to the decision due to him having different priorities and views. The symptoms of schizophrenia render him unable to use or weigh the information taking all factors into consideration.
2. The Tribunal accepted the expert opinion of Dr TN regarding KHC's lack of decision-making capacity because of his current mental state. The Tribunal was satisfied KHC is unable to understand information relevant to the decision of assessment and treatment as he does not understand his current mental illness and denies its presence. KHC does not believe he has a mental illness, despite explanation from health professionals. He does not appreciate and understand the risks associated with relapse in schizophrenia and his non-compliance with medication. He does not accept the severity of the events leading to readmission. He does not accept his persecutory delusions influence his actions and decisions.
3. The Tribunal found that KHC is unable to retain the information given to him regarding his diagnosis or treatment. He is therefore not able to use the available information, about the benefits or risks of treatment versus non treatment to make treatment decisions.
4. The Tribunal was satisfied that the assessment of KHC's decision-making capacity was evidence based and consistent with all the information available to the treating team in respect to KHC.
5. The Tribunal was satisfied the treatment criterion was met.

1. Having determined that each of the treatment criteria had been met, the Tribunal then considered the terms of the current order and the application for renewal of it, and whether to exercise its discretion to renew the order. The Tribunal acknowledged the current terms of the treatment order at paragraph [4]. The Tribunal also accepted that KHC is being treated with benzodiazepine medication. The Tribunal accepted the submission from Dr TN and Ms Olsson that the treatment order should provide authorisation of benzodiazepine medication. At the hearing the Tribunal reiterated the importance of the treatment order reflecting and authorising the treatment delivered to KHC for his mental illness. Consequently, the Tribunal also authorised the use of benzodiazepine medication as part of treatment of KHC's mental illness.
2. The Tribunal determined that the treatment order would be renewed and varied in respect of KHC for a period of 12 months commencing 29 October 2025 until 28 October 2026. With the terms of the renewal of treatment order including those outlined at paragraph [4] with the addition of benzodiazepine medication.