Emergency examination authorities

Overview

On 5 March 2017, emergency examination orders under mental health legislation will be replaced by emergency examination authorities under public health legislation.

This change recognises the fact that persons brought into an emergency department under these emergency provisions may be suffering from conditions or an illness other than a mental illness.

Transport to emergency departments

A police officer or ambulance officer may bring a person into an emergency department, without their consent, in particular circumstances. These circumstances are:

• a person’s behaviour indicates the person is at immediate risk of serious harm, and
• the risk appears to be the result of major disturbance in the person’s mental capacity caused by illness, disability, injury, intoxication or other reason, and
• the person appears to require urgent examination, treatment or care.

The police officer or ambulance officer is not required to decide whether the person's behaviour is caused by illness, disability, injury, intoxication or another reason.

A police officer or ambulance officer may bring the person to any public sector health service facility. However, if the facility is not an inpatient hospital, the transport of the person to the facility requires the approval of the person in charge of the facility, to ensure that appropriate treatment can be provided to the person.

Making of an emergency examination authority

When a police officer or ambulance officer brings a person into an emergency department, the officer must immediately make an emergency examination authority in the approved form. The person may be detained in the emergency department while the emergency examination authority is being made.

The officer must then give the emergency examination authority to a health service employee in the emergency department.

The fact of a person being received in an emergency department under an emergency examination authority needs to be recorded in the emergency department’s information management system. The emergency examination authority must also be kept in a safe place for future use.

Examination

The person subject to the emergency examination authority may be detained for up to 6 hours in the emergency department, or another place in the hospital, without the person's consent. The person may be detained with the help, and using the force, that is necessary and reasonable in the circumstances. 2

A doctor or health practitioner may extend the period of detention up to a total period of 12 hours if it is necessary to carry out or finish the examination. This must be recorded on the emergency examination authority.

A doctor or health practitioner must explain the effect of the emergency examination authority to the person.

A doctor or health practitioner must examine the person to decide the person's treatment and care needs.

An examination may be undertaken without the person's consent and with the help, and using the force, that is necessary and reasonable in the circumstances.

An examination may also be undertaken using an audio-visual link.

The doctor or health practitioner must then decide the appropriate treatment and care for the person.

The person may be discharged from the authority once the examination is completed and it is safe to do so.

If the person may have a mental illness, a doctor or authorised mental health practitioner may examine the person to see if recommendation for assessment should be made under the Mental Health Act 2016.

Transfer to another hospital

A doctor or health practitioner may authorise the transport of a person under an examination authority to another hospital. The person may be transported by a police officer, an ambulance officer, a health service employee appointed by the service or a security officer, without the person’s consent.

Where this occurs, the period of detention that a person can be detained under emergency examination authority – namely a maximum period of 12 hours from when the person is received at the first service – is not extended.

Urgent healthcare

It should be noted that the emergency examination authority provisions do not affect the urgent healthcare provisions under section 63 of the Guardianship and Administration Act. As such, a health practitioner may provide urgent health care to an individual under the urgent healthcare provisions, regardless of whether or not the person is under an emergency examination authority.

Return to the community

If, at the end of the examination, the person is to return to the community, the emergency department must take reasonable steps to ensure the person is returned to a place reasonably requested by the person. 3

Absconding patients

Provisions of the legislation apply when a person absconds from a hospital while under an emergency examination authority. Where this applies, the person in charge of the hospital may authorise a police officer, a health service employee appointed by the service or a security officer, to return the person without the person’s consent.

The authorisation must be in the approved form and is only valid for three days.

A warrant may also be sought from a magistrate if a power is required to enter someone’s home or other premises using force.

When the person is returned to a hospital, the period of detention under the emergency examination authority recommences.

Searches

The legislation also enables a doctor or health practitioner to search a person who is being detained under an emergency examination authority if the doctor or health practitioner believes the person may have a ‘harmful thing’. A harmful thing means anything that may be used to threaten the security or good order of the hospital, threaten a person’s health or safety, or that is likely to adversely affect the patient’s treatment or care. Examples of harmful things are dangerous drugs, alcohol, sharps or medications.

The Act defines different types of searches that may be undertaken. A search requiring the removal of clothing requires the approval of the person in charge of the hospital.