Today I’m asked

… two questions … [on] the role of Royal Flying Doctor Service (RFDS) and mental health in rural NSW.

Firstly do RFDS nurses have the authority to section mental health patients without a doctor present or would they have to wait for a doctor, ambulance or police to come and section a patient.

Secondly would they be able to transport a patient to a public mental health facility due to their role as 24/7 medical response in rural areas?

The use of the phrase ‘section mental health patients’ is old fashioned language but what I understand the question to mean is ‘can an RFDS nurse detain a competent patient in order to treat their mental illness or mental disorder?’ and ‘can the nurse authorise the staff of a mental health facility to continue that detention?’

The short answer is ‘no’. The Mental Health Act 2007 (NSW) says police, and arguably ambulance officers, can detain a person who is mentally ill or mentally disordered (ss 22 and 20, respectively) and take them to a mental health facility.  A person may also be detained on the basis of a certificate issued by a medical practitioner who has examined the patient (s 19). That examination may be in person or remotely (s 19A).

Once at a mental health facility a person may be detained on the basis of the information provided by the police or ambulance officers (ss 18(1)(b) and (c)) or on the basis of the medical practitioner’s certificate (s 18(1)(a)).

There is nothing to say a nurse can detain a patient, nor anything that a ‘person may be detained in a declared mental health facility’ on the basis of information provided by, or on the opinion of, a registered nurse.

If a person is lawfully detained (eg a medical practitioner has issued a certificate under s 19) then s 81(1) says the following persons can transport the patient to the mental health facility:

(a) a member of staff of the NSW Health Service,

(b) an ambulance officer,

(c) a police officer,

(d) a person prescribed by the regulations.

An ambulance officer means a member of NSW Ambulance (see s 4, definition of ‘ambulance officer’ and Health Services Act 1997 (NSW) s 67A).

The Mental Health Regulation 2019 (NSW) r 45 says, that for the purpose of s 81(1)(d) ‘a person who provides a transport service approved by the Secretary for the purposes of that section is prescribed.’ 

The RFDS can ‘transport a patient to a public mental health facility’ if they have been approved by the Secretary of Health for that purpose.

Other states

The answers to these questions depend on the terms of the Mental Health Act 1997 (NSW). The RFDS operates across Australia and the answer may be different in different jurisdictions.  Further if the RFDS can lawfully ‘section’ a person in another state/territory they may also be able to transfer them to NSW on the basis that the person is lawfully detained in and being transported from that other state.  The answer above is an answer only in NSW.

Conclusion

In NSW, RFDS nurses do not have the authority to section mental health patients (if, by that, we mean detain them and provide treatment to a competent person without their consent and/or authorise the staff of a mental health facility to detain them).  To do that would require action by police or ambulance officers or an certificate by a medical practitioner.

The RFDS is able to transport a patient to a public mental health facility within NSW if they have been approved by the Secretary of Health for that purpose.

This blog is made possible with generous financial support from the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.