(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.

As per section 39(1)(b), the Tribunal can only 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).

Further, the Tribunal must be satisfied that the person the subject of the application meets the treatment criteria set out in s 40 of the Act, as follows:

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.

A treatment plan is defined in s 50 of the Act as an instrument which outlines the treatment the patient is to receive. It must be in a form approved by the Chief Civil Psychiatrist. Section 39(1)(e) of the Act 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.

Further, in determining whether to make a treatment order pursuant to s 39, the Tribunal needs to be alive to 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.

Finally, in exercising its responsibilities under the Act, the Tribunal 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 > > 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; > > (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, wherever 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 -

1. is easily accessible, and safe; and
2. provides persons with mental illness with timely treatment, care and support that is high quality and based on contemporary best-practice principles; and
3. promotes recovery in the least restrictive manner that is consistent with the need 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. At hearing, we were satisfied that the applicant was an approved medical practitioner and the requirements of s 37 of the Act were met - i.e.:
   1. The applicant had assessed NN under authority of the assessment order;
   2. The applicant was satisfied from the assessment that NN met the treatment criteria;
   3. The application is in accordance with section 195 of the Act; and
   4. The applicant has given a copy of the application to the patient and placed a copy of it on the patient's clinical record.
2. We were also satisfied that a treatment plan has been prepared in accordance with s 53(2) of the Act a copy of which was received by the Tribunal on 11 March 2025.

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

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

17. The meaning of mental illness is defined in s 4 of the Act as follows:

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 evidence on the papers and at hearing was that NN was experiencing a first episode psychosis characterised by a manic episode of bipolar affective disorder (BPAD) precipitated by an acute stress reaction.
2. Dr NC gave evidence of the background to NN's manic episode. According to the doctor, whose evidence on this point was not contradicted at hearing, NN experienced significant psychosocial stressors in the period leading up to admission, including intense personal losses and a high stress professional role as a [registered health practitioner].
3. Dr NC shared collateral history from ON that, over the preceding month, her husband had commenced displaying pressured speech marked with excessive detail, irritability which was unusual for him, out of context anger and behaviours that were bizarre and out of keeping with his usual self. He was spending excessive amounts of money on watches ($7700) and gold bracelets. He also experienced sleep disturbance manifested by an acute lack of sleep even when taking into account night shifts given that he had not been sleeping at all during the day, and at times his whereabouts were not known for large parts of the day.
4. NN was initially taken by police to [an approved facility] on 03 March 2025 for assessment before being transferred to another [approved facility] on 4 March 2025. On admission to the second approved facility, NN was noted by Dr NC to be labile in mood, with impaired insight and judgment. The view of the treating team was that his acute stressors had triggered a manic episode with psychotic features. He was expressing grandiose delusions about himself and his job, on the ward his behaviour was characterised by an inappropriate manner, he was over-familiar with both staff and co-patients, and his excessive spending continued.
5. Dr NC stated that at the time of hearing, NN continued to exhibit formal thought disorder, characterised by marked tangentiality, pressure of speech and flight of ideas, with him experiencing difficulty following his own ideas. In addition, he was impulsive, over-familiar, unable to maintain attention during important conversations, was easily distracted, fixated on other people's jewellery and asking irrelevant and inappropriate questions.
6. NN conceded that he had been experiencing a mental illness but believed it could be treated at home and that his wife, as a [registered heath practitioner], would be able to support him by monitoring any side-effects to his medication and contacting mental health services if he needed anticholinergic medications. He stated that he was happy to accept treatment from the treating team. On questioning by the Tribunal, NN noted that he felt 99% himself and "better than before".
7. The Tribunal accepts the evidence of the treating team, that NN is experiencing a first episode psychosis characterised by a manic episode of BPAD with psychotic features and thus has a mental illness for the purposes of the Act. This criterion is met.

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

1. Pursuant to s 40(b) we are required to consider whether, without treatment, the mental illness will, or is likely to, seriously harm the person's health or safety or the safety of other persons.
2. This criterion has been the subject of interpretation by His Honour Blow CJ, as he then was, in two matters.

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.

1. His Honour made 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... 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.

2. Dr NC at hearing outlined the risks of serious harm to NN and others should he not receive treatment for his mental illness including:
   1. risks of further deterioration in his mental state;
   2. risks of exploitation, being vulnerable to scammers online and in the "real world" due to his impulsivity;
   3. risks to his finances;
   4. risks to his reputation - given he is a highly thought of and respected member of his team;
   5. risks in his relationship with his small children - some of his behaviours have been out of character including being quick to anger.
3. Applying the decision in B v Mental Health Tribunal [2020] TASSC 10, whilst not satisfied that there was a likely risk of physical harm to others, we are satisfied of the risks to NN himself, and to his family relationships as outlined by the treating team, with supporting evidence from ON and NN himself, should his mental illness not be adequately treated, were both likely and serious. This criterion is met.

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 as outlined 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.

2. In the matter of S v Mental Health Tribunal (supra), his Honour Blow CJ provided commentary as to the interpretation of this criterion 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).

3. Dr NC noted that NN's condition had improved since admission when he was initially treated in the high dependency unit. NN was being treated with antipsychotics, benzodiazepines and, by the time of hearing, after some initial reluctance, NN had agreed to start taking a mood stabiliser.
4. Dr NC's evidence was that NN was unable to explain to the treating team why he did not want treatment with mood stabilisers. At hearing, NN said he had been concerned about the side-effects and how a mood stabiliser would make him feel. However he had been compliant with the requirement to take them for the last day.
5. The treating team's plan for treatment was to minimise the symptoms and duration of NN's manic episode, obtain better control of his mental state, prevent future admissions, and restore his social and professional functioning.
6. Dr NC's evidence, not disputed at hearing, was that antipsychotics, mood stabilisers and benzodiazepines are evidence-based treatment for BPAD consistent with the relevant guidelines and that NN's treatment should be overseen by a consultant psychiatrist.
7. We are satisfied that the treatment NN has been receiving is appropriate and effective treatment for his mental illness. This criterion is met.

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

1. Dr NC was concerned that NN remained somewhat reluctant to accept treatment, noting he had only recently agreed to take mood stabilising medication and was focused on discharge and his return to his family. The treating team felt this was understandable, but that NN did not understand the risks associated with premature discharge, including a high risk of disengagement from treatment, a high risk for future relapse and further hospitalisation.
2. Conversely, NN believed he was already quite well, 99.9% and that his best option was to obtain a script for his medication and be discharged from hospital, with his wife monitoring his adherence to treatment.
3. Ms Olsson's submission on behalf of her client was that the treatment order is not necessary, that her client has capacity and that he intends to take the medication he has been prescribed by the treating team.
4. The Tribunal is satisfied that the requirements of s 40(d) are met, relevantly that the treatment order is necessary in order to ensure appropriate treatment and provide informed consent as the patient currently lacks decision making capacity.

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

1. The Act defines 'decision making capacity' in s 7(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. Dr NC told the Tribunal that despite having improved since his admission, NN was still unable to make decisions about his assessment and treatment due to a disturbance of mind (manic episode with psychotic features) and that at the time of hearing he continued to exhibit formal thought disorder characterised by tangentiality, pressure of speech and flight of ideas. In addition, he remained highly irritable and impulsive.
3. Furthermore, while NN understands the information about BPAD and its treatment, he is unable to attribute his symptoms to a manic episode. He is easily distracted by his racing thoughts which impair his capacity to understand and focus during important discussions. This includes him not being able to maintain focus and attention during important discussions about his treatment.
4. Dr NC noted that NN could retain information for short periods of time, but struggled with his racing thoughts and disorganisation: for instance, when the treating team spoke to him about returning his phone, provided he not purchase more goods online, he said he understood and promptly made large purchases.
5. In Dr NC's opinion, NN was therefore unable to weigh up the long term consequences of his actions, due to the ongoing severity of his symptoms of mental illness.
6. Dr NC stated that NN was only superficially able to communicate decisions relating to the treatment of his mental illness. For instance, he had been adamant that he did not want to be treated with a mood stabiliser but could not articulate why.
7. Dr NC noted that NN, despite his professional expertise, lacked insight into his own mental health condition, he did not feel unwell, did not attribute his symptoms to a mental illness and did not feel that recommended medications were necessary. In the doctor's opinion NN was only compliant with treatment to allow for his discharge from hospital and was not cognisant of its role in the treatment of his mental illness or in restoring his previous level of high functioning in the community.
8. In response, NN acknowledged his spending as an issue which he was "willing to work on" with a counsellor. He did not understand that his excessive spending was a symptom of his ongoing manic episode that was amenable to treatment. When asked how he was feeling now, NN digressed and spoke about how he had previously qualified as a barrister and that there were a lot people who didn't know about him. He then stated that he felt like he was more able to feel things, more able to advocate for himself and others in the community without being confrontational.
9. When asked what the symptoms of his mental illness were - NN gave a meandering account of his family tragedies and associated grief. He was not able to identify any of the symptoms of his mental illness. When pressed about whether he thought BPAD could explain some of his symptoms or whether his presentation was rather a reaction to grief and stress - NN thought it might be both. He acknowledged that he experienced mood swings, that he could be low, he preferred "the person he is right now", but noted for everybody else that person "can be a bit chaotic". NN told the Tribunal that he believed he was back to "99.95%" of his normal self and that by seeing his children, his mental state would improve to 100%.
10. In relation to whether her client has capacity, Ms Olsson stressed the presumption of decision-making capacity, submitted the Tribunal should follow or "be persuaded by" the decision of Bell J in PBU & NJE v Mental Health Tribunal [2018] VSC 564 at [208] and [231], where it was held that a lack of insight is not in itself a basis to find that a person lacks decision making capacity.
11. The Tribunal asked Ms Olsson to establish the relevance of the case to the current matter, Ms Olsson accepted that the Tribunal is not bound by decisions of Victorian courts.
12. Ms Olsson referenced the published statement of reasons in the matter SI (60 Day Review Hearing) [2025] TASCAT 29 (12 February 2025). The Tribunal noted that if Ms Olsson wished the Tribunal to consider the relevance of that matter to the current one, she should have provided written submissions prior to hearing. While acknowledging the wider value of the cited cases for the promotion of rights of people under a disability, the Tribunal asked Ms Olsson to confine her submissions to matters of direct relevance to the Tribunal.
13. The Tribunal found that "lack of insight into illness" was not the sole factor in this case and that the treating team had demonstrated that NN was experiencing deficits across the elements of capacity outlined in the Act.
14. Ms Olsson asked the Tribunal to discount NN's unwise financial decisions as evidence of a lack of capacity. Countering Ms Olsson's suggestion, Dr NC reiterated the collateral information provided by ON that the excessive spending was uncharacteristic and recent and that in her professional opinion it was a symptom of his ongoing mania. NN gave rambling evidence about why he had been spending money and noted that he would need to get back to work to build up his savings to be able to keep spending. The Tribunal preferred the treating team's evidence that the spending was a symptom of the mental illness rather than being some unrelated behaviour that was merely unwise.
15. Ms Olsson submitted that NN has capacity, understands the nature of his illness, the side-effects of the proffered treatment, that there was evidence he could use and weigh the benefits of treatment, and that there has been improvement in his decision making.
16. NN himself did not believe he was currently unwell; he believed that his manic episode was only partially explained by his recent diagnosis of BPAD. While he demonstrated a superficial understanding that complying with treatment would allow him to return home quickly, he liked who he was currently and did not recognise that behaviours, such as his extravagant spending, were symptoms of a mental illness.
17. The Tribunal was persuaded by the treating team's evidence, that NN does not understand how the symptoms of his mental illness apply to him, and this impairs his ability to use or weigh information relevant to his treatment, such as the risks and benefits of treatment. This criterion is met

1. in relation to the discretion to make a treatment order Ms Olsson noted that orders are coercive in nature, the principle of the least restrictive option should be respected and given the support of his family and possibility of treatment in the community there are other options for treatment other than by way of an order.
2. Having been satisfied that the treatment criteria apply, we are also satisfied that it is appropriate to make the order, noting NN's good response to treatment so far and the risks posed to the patient should his treatment for some reason cease.

1. The treatment order was made on 13 March 2025 for a period of six months in the same terms as the interim treatment order.
2. The order will expire on 12 September 2025 unless discharged sooner or renewed.