4.4 - Processes for accessing medical information

• Obtain an authority to act;
• Write a letter to the treating service to obtain the relevant medical records and attach the authority;
• If the client is on an Involuntary Treatment Order or a Forensic Order request a section 238 report.

Access medical information through FOI/Administrative processes. If a diagnosis is confirmed in the material from the authorised mental health service or another treating service, this can be used as collateral information and provided to the medical expert in the initial letter of instruction for evidence to put before the Court.

If a person is charged with an indictable or simple offence, and the person is the subject of an ITO or FO, the forensic provisions under Chapter 7 Part 2 of the Act apply. It is important to note that under section 236, the forensic provisions also apply to a person who is not currently under an order, but who becomes subject to such an order after the police lay a charge against the defendant.

When Chapter 7 Part 2 applies, there is no automatic change to the patient's treatment or detention status. Thus, if the Court grants bail and the person is currently treated under the community category of an ITO the person can remain in the community until their next hearing.

Psychiatric Assessments & Reports

It is of course appropriate to advise and to assist impecunious clients to make a Legal Aid application to undertake a psychiatric assessment from an appropriate psychiatrist. Make sure you include supporting information such as a medical report from the client's GP. Although it is not mandatory, it can be persuasive.  

When choosing a psychiatrist to make an assessment and report on behalf of a client, it is important to understand which particular clinicians have experience and expertise in specific areas. Legal Aid Queensland's Mental Health Unit may be able to assist in this regard.

It is important to ask the practitioner to undertake an ‘adaptive functioning test' and to report on the raw scores and outcomes.

It is also very important lawyers request the psychiatrist to consider the utility of community service orders or other alternative non-custodial sentences for their clients. It may be appropriate to have the psychiatrist include their view within their report.