Am I obliged to notify Ahpra about a practitioner I am treating?

Only at a high threshold. Under the National Law a treating practitioner must make a mandatory notification if they form a reasonable belief that the practitioner-patient is placing the public at substantial risk of harm by practising with an impairment; the threshold for treating practitioners was raised in 2020 precisely so that practitioners seek treatment, and Western Australia exempts treating practitioners from mandatory notification for impairment altogether. Below that threshold, treatment and, where appropriate, a voluntary notification with the patient's involvement are the path. Read Ahpra's guidelines, linked under Sources, and talk to your medical defence organisation before deciding either way.

Should I conduct the health assessment for the Board myself?

No. Where a Board requires a health assessment it appoints an independent assessor, and a treating psychiatrist should not be that assessor for their own patient. Your role is the treating practitioner's report: what you have observed, treated and monitored over time, declared as such, which the Board weighs alongside the independent assessment.

Does the Board get the whole record?

No. It gets what the practitioner has consented to or what the conditions on their registration require, which is usually a periodic report from the treating practitioner addressing defined matters. Confirm the scope with the practitioner before writing; they are entitled to see the report, and a report that ranges beyond the scope damages both trust and standing.

What if the practitioner disagrees with my report?

Discuss it with them, correct any factual error, and do not alter a clinical opinion because they would prefer a different one. Where disagreement remains, the report can note it. A treating relationship that depends on favourable reports is not one that can produce evidence a Board will rely on.

How often are reports required?

As the conditions on the practitioner's registration specify, commonly at fixed intervals of a few months, and on any material change. Missing a due date is itself a breach of conditions for the practitioner, so the schedule matters as much as the content.

Does the same framework apply to nurses, psychologists and other professions?

Yes. The National Law covers every registered health profession through its National Board, with the same definition of impairment, the same notification provisions and the same powers to require assessment and impose conditions. The report structure on this page applies whichever Board is reading it.

The fitness-for-registration report: treating a health practitioner, and reporting to their Board

What this report is for

A registered health practitioner with a mental health or substance use condition is a patient like any other until their regulator becomes involved, and then a second reader appears. The National Board, through Ahpra, is asking a specific question defined by the National Law: does the practitioner have an impairment, meaning a condition that detrimentally affects or is likely to detrimentally affect their capacity to practise their profession, and if so, can the risk to the public be managed by conditions on their registration rather than by suspension. Your report, as treating psychiatrist, is evidence on that question, weighed against any independent health assessment the Board has commissioned and read by the practitioner themselves.

The report is written for that question, not for the clinical file. Capacity to practise is a functional matter in a particular setting, and the Board needs it described that way. It also needs honesty about monitoring, adherence and setbacks, because the practitioner's continued registration, and the public's safety, rest on the Board being able to trust the treating practitioner's account.

The National Law's frame

Three parts of the Law shape the report. The definition of impairment ties the condition to its effect on capacity to practise, so diagnosis alone establishes nothing; function does. The mandatory notification provisions set a high threshold for a treating practitioner, a reasonable belief that the practitioner-patient is placing the public at substantial risk of harm by practising with an impairment, and exempt treating practitioners entirely in Western Australia; the Ahpra guidelines on when that threshold is and is not met are the reference. The Board's powers include requiring an independent health assessment, imposing conditions or accepting undertakings, and monitoring compliance, and a treating practitioner's periodic report is usually one of the conditions.

Where you are reporting because conditions require it, the conditions themselves define what the report must address. Read them and answer them.

What it must contain

Your standing and the treating relationship. Treating psychiatrist since when, frequency, date last seen, and a declaration that this is a treating practitioner's report rather than an independent assessment.
The basis for the report. The practitioner's consent, or the condition on their registration that requires it, quoted.
Diagnosis. The condition, its basis, its course.
Treatment and adherence. What has been provided, what is current, and how the practitioner has adhered to it, including missed appointments and medication changes.
Insight. The practitioner's understanding of their condition, its effect on their practice, and the early signs of relapse, in their own words where useful.
Stability and relapse indicators. The period of stability, the indicators you and the practitioner have agreed would signal relapse, and whether any have appeared.
Monitoring results, where relevant: drug and alcohol screening results with dates and any missed or diluted samples, plainly stated.
Capacity to practise, functionally. The practitioner's actual work (setting, hours, procedures, on-call, access to scheduled medicines) and your opinion of their capacity for each part of it, with reasoning.
Conditions. Whether the current conditions are being met; whether they remain appropriate; and any change you recommend, with reasons (hours, setting, supervision, restricted access to particular medicines, further monitoring).
Prognosis and the next report. Expected course, the date of the next report under the conditions, and what would prompt an earlier one.

Capacity to practise, functionally

The Board cannot use "fit to practise" any more than a licensing authority can use "fit to drive". It needs the components: judgement and decision making under load; concentration and reliability across a shift; boundaries with patients and colleagues; the handling of scheduled medicines where the work involves them; the capacity to respond to emergencies and to recognise one's own deterioration; fatigue and the effect of the treatment itself. Each component is described in relation to the practitioner's actual setting, because capacity in a supervised, daytime, non-procedural role is a different question from capacity in solo rural practice with after-hours cover. A report that restricts the setting can support a practitioner staying in work when a report that pronounces on fitness in the abstract cannot.

Where reports fall short

Fitness is asserted without any account of function in the practitioner's actual work.
Monitoring results, missed samples or missed appointments are softened or omitted, and appear in the pathology provider's report to the Board anyway.
The specific conditions in force are not addressed, so the Board cannot tell whether they are being met.
The report reads as advocacy for the practitioner rather than evidence about them, and is discounted.
The treating relationship is not declared.
The report is late against the schedule the conditions set.
Relapse indicators are not identified, so neither the Board nor the practitioner has a shared early warning.
A mandatory notification question that has arisen is neither addressed nor discussed with a defence organisation.

A skeleton that works

To the [National Board], via Ahpra. Attention [Case officer]. Reference [number].

Re: Dr / [Title] [Name], [profession], registration number [number].

Basis for this report. This report is provided [with the practitioner's consent / as required by condition [number] on the practitioner's registration, which states: "..."].

Treating relationship. I am [Name]'s treating psychiatrist and have been since [date], seeing them approximately every [interval], most recently on [date]. This is a treating practitioner's report, not an independent health assessment.

Diagnosis. [Condition; basis; course.]

Treatment and adherence. [Current treatment; changes since the last report; attendance; adherence.]

Insight and relapse indicators. [Understanding of the condition and its effect on practice; the agreed early-warning signs; whether any have appeared.]

Monitoring. [Screening results with dates; missed or diluted samples; other monitoring.]

Capacity to practise. [Name] currently works [setting, hours, duties, on-call, access to scheduled medicines]. In my opinion: [each component of the work, with capacity and reasoning].

Conditions. The current conditions [are / are not] being met: [detail]. In my opinion they [remain appropriate / should be varied as follows: ..., because ...].

Prognosis and next report. [Expected course.] The next report is due [date]. I will report earlier if [triggers].

[Name, qualifications, AHPRA registration number, provider number, date]

Related licences and clearances

The same discipline, function against a defined standard for a non-clinical decision-maker, governs the neighbouring documents. Fitness to drive has its own guide in this library and its own national standard. Firearms licensing sits with state police, who ask specific questions about mental health history and risk; the Misc - Firearms Licence Mental Health Report preset is built for them. Pre-employment clearances, where an employer's occupational health process asks for a psychiatric opinion, use the Misc - Pre-Employment Mental Health Clearance preset and should say only what the role's inherent requirements make relevant. Aviation and rail safety have their own national medical standards and their own accredited examiners; a treating psychiatrist's role there is usually to provide history to the examiner rather than the opinion itself.

How PsychDispatch drafts this

The Fitness for Licence / Registration preset drafts the report against the conditions you paste in, in the structure above, with capacity described component by component in the practitioner's actual setting. Patient Intelligence holds what a Board's monitoring turns on: attendance and adherence over time, medication changes with dates, screening results as recorded, the agreed relapse indicators and whether any have appeared since the last report, so each periodic report is drafted from the record of the interval rather than from recollection. Every statement is verified against the source before you sign, and the report goes out on your letterhead.