What this report is for
An involuntary treatment order takes away a person's right to decide about their own treatment, and the tribunal exists to check, at intervals the Act sets, that the legal grounds for doing so are still met. The tribunal's members, typically a lawyer, a psychiatrist and a community member, are not treating the person and are not asking whether treatment is a good idea. They are asking whether each criterion in the Act is established on the evidence in front of them, today. Your report is that evidence.
The criteria differ between jurisdictions but follow a pattern: that the person has a mental illness as the Act defines it; that because of it there is a risk of serious harm to the person or others, or of serious deterioration, in the Act's particular words; that treatment is available and appropriate; that there is no less restrictive way of providing it; and, in several Acts, either that the person lacks capacity to consent to the treatment or that their views and preferences have been considered. The report addresses each, under its own heading, in the Act's words.
The person will read the report, with their representative, before the hearing. That does not change what the report says. It changes how.
What it must contain
- The order and the history of orders. The current order, when it was made, what it authorises, and the person's legal status over the relevant period.
- The date of examination. The examination the report rests on, stated. The criteria are assessed against the present.
- Diagnosis, and the basis for it. The condition in the Act's definition of mental illness where the Act has one, the criteria met, and the history that supports it.
- Current mental state. On the stated date, in specific observations rather than summary adjectives.
- History of the illness and its treatment. Episodes, admissions, treatments and responses, adherence, and what has happened when treatment stopped. This is where the evidence for most of the criteria lives.
- Risk, with dates. The events that evidence risk to the person or to others, or deterioration, each with a date and a source. The risk if the order were not in place, reasoned from that history. Not "risk of harm" as a phrase, but what happened, when.
- Treatment. What is proposed, where, for how long, with what aims, and how response will be judged.
- The less restrictive alternative. What has been offered or tried that is less restrictive than the order sought, when, and what happened. Why, on that history, the person cannot be treated less restrictively now.
- Capacity, or views and preferences, as the Act requires. Where capacity is an element: the person's capacity to decide about this treatment now, with reasoning. Where views and preferences must be considered: what they are, in the person's words where possible, and how the plan responds to them.
- The person's strengths, supports and recovery goals, and the plan for transition to a less restrictive setting or to voluntary care, with what would need to be true for that to happen.
- The criteria, one by one. A closing section that takes each element of the Act's test in its words and states whether, in your opinion, it is met and by what evidence above.
- Signature block.
Writing risk
Risk is where tribunal reports most often fail as evidence. "Risk of harm to self and others" is a conclusion, and a tribunal cannot weigh a conclusion. What it can weigh is that on a date the person did a specific thing, recorded by a specific source, and that in the period after medication stopped in a specific month the following occurred. Dated events, sourced, in a sequence, let the tribunal reason from the history to the present; a paragraph of adjectives does not, and the representative will say so.
Where reports fall short
- The criteria are not addressed as the Act states them, so the tribunal has to build its own case from a clinical narrative.
- Risk is asserted rather than evidenced with dated events.
- The less restrictive alternative is stated ("cannot be treated in the community") with no account of what was tried.
- The person's views are missing, or paraphrased into agreement they did not express.
- The mental state paragraph is the last report's, with the date changed. Tribunals read the file in sequence and notice.
- The report describes the person rather than their condition, in language they will read.
- No plan, no duration, no transition, so the order looks indefinite.
- The examination is not dated, or is weeks old.
A skeleton that works
Related documents
Applications about electroconvulsive therapy, where the tribunal's role exists, have their own criteria on capacity, consent and alternatives, and are a different document. Appeals to the general administrative tribunal against other decisions use the Tribunal - AAT / ART Appeal Report preset. The Legal - Guardianship / Capacity Support preset addresses guardianship and administration matters, which turn on capacity rather than on the mental health criteria.
How PsychDispatch drafts this
The Tribunal - Mental Health Tribunal Report preset drafts the report against the criteria in the structure above, and Patient Intelligence supplies the part a tribunal weighs most and a memory holds least reliably: the dated sequence of episodes, admissions, treatments, cessations and what followed each, drawn from the record as it was written at the time. The mental state section is drafted from the current examination rather than carried forward, every dated event is verified against its source before you sign, and the report goes out on your letterhead.