Forensic Mental Health in Victoria: Overview

• Forensic Mental Health is a specialist area within Victoria’s health and justice systems.
• This PowerPoint provides a brief, basic overview of services in Victoria across three main sectors:
  • Prison Mental Health Services
  • Hospital Services
  • Community Programs
• Key facilities/units listed under Prison Mental Health Services:
  • Acute Assessment Unit (Melbourne Assessment Prison)
  • Ballerrt Yeram-boo-ee Forensic Mental Health Unit (Ravenhall Correctional Centre)
  • Marrmak Unit (Dame Phyllis Frost Centre)
  • Mobile Forensic Mental Health Service (Metropolitan Remand Centre)
  • St Paul’s Unit (Port Phillip Prison)
• Hospital Services include:
  • Thomas Embling Hospital
• Community Programs include a range of supports and services:
  • Community Transition and Treatment Program
  • Non-Custodial Supervision Order Consultation and Liaison Program
  • Problem Behaviour Program
  • Court Mental Health and Response Service
  • Forensicare Serious Offender Consultation Service
  • Court Reports Service
  • Mental Health Program Primary Consultations
  • Forensic Clinical Specialist Program Coordination
  • Youth Justice Mental Health Program Coordination
  • Victorian Fixated Threat Assessment Centre
• Legal status and regulatory framework:
  • Crimes (Mental Impairment and Unfitness to be Tried) Act 1997
  • Sentencing Act 1991
  • Mental Health and Wellbeing Act 2022
  • Secure Treatment Order
  • Types of Supervision Orders:
  • Custodial Supervision Order
  • Non-custodial Supervision Order
• Other referenced elements:
  • Victorian Fixated Threat Assessment Centre (VF TAC)
  • Forensicare as the specialized mental health service provider within this domain
• Context and relevance:
  • Forensic Mental Health operates at the intersection of mental health care and the criminal justice system.
  • Emphasizes coordination between health services, courts, prevention, and post-release support.
  • Ethical and practical implications include balancing patient rights with public safety, risk management, and interagency collaboration.

Prison Mental Health Services

• Prison Mental Health Services reflect a mix of acute assessment, treatment, and ongoing support within custodial settings.
• Key points from the overview:
  • Can present challenges but are often rewarding for staff and patients.
  • Staff are described as very well trained.
  • Wards are relatively safe despite inherent risks.
  • Staff commonly develop in-depth knowledge of individual patients.
  • Heavy reliance on teamwork to manage risks and deliver care.
  • Overall risk levels can be high but are reported as well managed.
  • Consumers (patients) may not always be aware of crimes committed; this implicates consent, disclosure, and safety considerations in care.

Hospital Services

• Thomas Embling Hospital is the designated hospital-based forensic mental health service.
• Role within system:
  • Provides specialized assessment, treatment, and care for individuals with complex forensic needs outside custodial settings.
  • Supports transition and continuity of care across settings (prison

Community Programs

• A suite of programs designed to support transition, supervision, risk management, and court-facing needs.
• Programs listed include:
  • Community Transition and Treatment Program: supports movement from custody to community with ongoing treatment and supervision.
  • Non-Custodial Supervision Order Consultation and Liaison Program: provides guidance and coordination for individuals under non-custodial supervision.
  • Problem Behaviour Program: targets maladaptive or high-risk behaviours with tailored interventions.
  • Court Mental Health and Response Service: delivers mental health expertise and response within the court system.
  • Forensicare Serious Offender Consultation Service: offers expert consultation for serious offenders.
  • Court Reports Service: produces forensic court reports to inform judicial proceedings.
  • Mental Health Program Primary Consultations: initial mental health assessments and consultations.
  • Forensic Clinical Specialist Program Coordination: coordinates clinical specialists within forensic populations.
  • Youth Justice Mental Health Program Coordination: aligns mental health services with youth justice needs.
  • Victorian Fixated Threat Assessment Centre: specialized center addressing fixated threat concerns.
• VF TAC (Victorian Fixated Threat Assessment Centre) operates as part of risk assessment and threat management in the community context.
• Real-world relevance:
  • These programs support risk management, community safety, and rehabilitation through coordinated care.
  • Emphasize collaboration with courts, police, and community services to reduce re-offending and promote wellbeing.

Legal Status and Statutory Framework

• Core Acts and regulatory instruments shaping practice and orders:
  • Crimes (Mental Impairment and Unfitness to be Tried) Act 1997: governs how individuals with mental impairment are treated within the criminal process when unfit to stand trial or dealing with mental impairment as a factor in crimes.
  • Sentencing Act 1991: provides framework for sentencing, including consideration of mental health factors.
  • Mental Health and Wellbeing Act 2022: contemporary legislation governing mental health treatment, rights, and service delivery.
  • Secure Treatment Order: a type of order used to provide secure treatment for individuals with significant mental health needs (details depend on statutory provisions).
• Supervision Orders:
  • Custodial Supervision Order: supervision within custody or custodial settings.
  • Non-custodial Supervision Order: supervision in the community or non-custodial contexts.
• These mechanisms underpin decision-making about treatment, risk management, and public safety in forensic contexts.

Forensic Mental Health Nursing: Practice and Experience

• Forensic Mental Health Nursing is portrayed as a challenging yet rewarding specialty.
• Key professional features:
  • High level of staff training and competence.
  • Wards are described as relatively safe given risk management strategies.
  • Nurses get to know patients well, supporting therapeutic relationships and individualized care.
  • Strong emphasis on teamwork and interprofessional collaboration.
  • Risk can be high, but with established controls and protocols, risks are well managed.
  • Acknowledgement that consumers may not always be aware of the crimes they are associated with; implications for consent, information sharing, and therapeutic engagement.
• Educational and informational resources referenced:
  • Nursing at Forensicare: Nursing-focused overview and practice context (video): https://youtu.be/5kgfkwh4niE
  • Recovery Model: Patient-centered recovery concepts in forensic settings (video): https://youtu.be/XizG5-zj8Uo
• References:
  • Victorian Institute of Forensic Mental Health, Forensicare (as a foundational source for practice context and standards)

Key Concepts, Connections, and Implications

• Intersections with law and ethics:
  • Balancing patient autonomy and rights with public safety and risk management in a forensic context.
  • Use of supervision orders and secure treatment orders as coercive interventions, with safeguards and review processes.
• Interdisciplinary and interagency collaboration:
  • Close cooperation among health services, courts, police, and community organizations to deliver seamless care and reduce re-offending risks.
• Real-world relevance:
  • Forensic mental health care supports rehabilitation and social reintegration through community programs (transition programs, supervision orders) and hospital/prison-based care.
• Practical considerations for practice:
  • Ensuring staff safety while delivering compassionate care.
  • Ongoing professional development to maintain high competency in a high-risk environment.
  • Understanding and applying the Recovery Model and other contemporary care paradigms in forensic settings.
• What to watch for in exams or applications:
  • Names and purposes of major units and programs.
  • The statutory acts and the types of supervision orders.
  • The roles of different service settings (prison, hospital, community) in the forensic pathway.

References and Resources

• Video resources:
  • Nursing at Forensicare: https://youtu.be/5kgfkwh4niE
  • Recovery Model: https://youtu.be/XizG5-zj8Uo
• Foundational references:
  • Victorian Institute of Forensic Mental Health, Forensicare
• Note: Page references from the transcript indicate a very concise overview; use these sections to guide study and recall of the Victorian forensic mental health framework.