The Mental Health Act 2007 NSW allows for the admission to hospital of a child or adolescent against their will, and at times, against the will of their parents or guardians. Involuntary admission of people under the age of 16 does not happen very often. It can occur when the doctors are of the view that there is a risk of harm to someone because of the mental illness of the child or adolescent.

In the rare event that a child or adolescent is admitted involuntarily, every effort is made to allow inpatient care on a voluntary basis, preferably with the consent of their parents or guardian.

Occasionally a court may order a mental health assessment for a young person, but this does not mandate admission and will be limited to the child or adolescent being taken to a hospital for assessment.

Child and Adolescent Mental Health Services (CAMHS) inpatient units are specialist units for young people, but they are not available in all Local Health Districts. Some private hospitals have services for the voluntary admission of young people. They are like public hospital services, but these services are limited and not available in all districts.

For more information, visit the NSW Health information on Child and Adolescent Health Services here – https://www.health.nsw.gov.au/mentalhealth/services/children/Pages/programs-children-teens.aspx

The doctor in a hospital must make every reasonable effort to contact the parents or guardian when a person under the age of 16 years is admitted to a mental health inpatient unit as a voluntary patient. Doctors cannot admit a person under the age of 14 to a mental health inpatient service as a ‘voluntary patient’ without their parent’s or guardian’s consent.

If a person 14 or 15 years old is admitted as a voluntary patient, they must be discharged if the parent or guardian objects. However, the child can agree to continue as a voluntary patient.

You may read elsewhere that child and adolescent mental health services are trauma informed, person centred and collaborative, least restrictive and disruptive. (2)

For family members and carers these terms may not be very meaningful. The following may help you in discussions with mental health services:

• Overall, treatment services should aim to reduce, as much as possible, further trauma to the child or adolescent.
• Services should be based on the needs of the child or adolescent, and this may require some flexibility from the service.
• Collaboration means that the consumer and the carers discuss with the treating team the options for care and treatment. In some cases, the treating team and the consumer may agree on care and treatment independent of the parent or carer.
• ‘Restrictive and disruptive’ means that services should minimise restrictions on a person’s movement and interrupt their preferred daily routine as little as possible.
• Keep in mind that family members and carers of teenagers may have different views to health professionals about risk taking and disruptive behaviour so some compromise may need to be negotiated.

You, as the parent and carer, can ask for a conversation with the treating team to make sure they know your wishes or when you feel these principles are not being followed.

Mental health services may have a ‘care pathway’ (a written plan) that they follow during the assessment and treatment of certain conditions, for example, eating disorders. Family members and carers can ask if there is a written ‘care pathway’ available. An explanation or a copy of the ‘care pathway’ may help you, as the carer, to understand the care and treatment you can expect at that mental health service.

It is important that the treating team have recorded, in the medical record of the young person, your contact and relationship details. These details should be recorded regardless of whether the service is inpatient or community service, or public or private. It is a good idea to check with the treating team if you are recorded as the designated carer or principal care provider for the person. A person under the age of 18 cannot exclude their parents from being given notice and information as if they were a designated carer.