The MHRT understands that the review process places extra burdens on busy clinicians. Nonetheless, the review process is prescribed by law, and is regarded as an important protection of patient rights. Therefore, we expect clinicians to lend their full cooperation to the review process, and provide evidence according to high professional standards, to assist us to make sound decisions.
Hearings are a process of investigation, not a contest between opposing parties. No one carries a burden of proof, although we do expect responsible clinicians to justify their decisions in relation to the legal status of patients. The focus of evidence should be on the decision that we are called upon to make.
In the case of patients subject to compulsory treatment orders, we are required to decide whether or not they are fit to be released from compulsory status. This means considering whether the patient's condition meets the definition of mentally disordered as it is defined in the Mental Health (Compulsory Assessment and Treatment) Act 1992.
The Act defines this as follows:
mental disorder, in relation to any person, means an abnormal state of mind (whether of a continuous or an intermittent nature), characterised by delusions, or by disorders of mood or perception or volition or cognition, of such a degree that it—
(a) poses a serious danger to the health or safety of that person or of others; or
(b) seriously diminishes the capacity of that person to take care of himself or herself;—
and mentally disordered, in relation to any such person, has a corresponding meaning.
Most often, the issue is whether the second part of that definition applies.
In the case of special patients, other tests apply.
We expect responsible clinicians to not only provide conventional clinical evidence, but to analyse that evidence for how it can be applied to the legal tests relating to a patient's status.
Although judges are required to consult with health professionals other than responsible clinicians, that requirement does not apply to the Review Tribunal. Nonetheless, the Tribunal considers the evidence of other health professionals to be very important. Therefore, we expect that clinicians who have good knowledge of applicants will be present at hearings. They are not required to prepare reports specifically for the Tribunal, but are welcome to do so.
The Clinical Report Writing Guidelines contains guidance about preparing reports.