{"html": "<div class=\"lf-doc\"><p class=\"lf-p\">M/F minors with .................. .................. ................ .............. mental health ................ (Name) (ID No) (D.O.B.) (Sex) problems and (Surname) has so been of (address) .......................................................................................... appointed by .......................................................................................... the Minister in terms of the Mental Health (b) The criteria for involuntary admission to a licensed mental health facility of the said Act apply to this minor Act. (c) Treatment can not be safely given in the community. ................................. (Official Stamp) To be filled by Commissioner ........................... (Signature) .......................... (Reg. No) ................................. ................................ (Date) (Time) Notification received on (date) ....................... at (time) ......................</p>\n<p class=\"lf-p\">Comments ................................. (Signature) ............................ (Date) ........................ (Time) MENTAL HEALTH FOURTEENTH SCHEDULE [Article 33(1)]</p>\n<h3 class=\"lf-part\">Part I</h3>\n<p class=\"lf-p\">Amended by:</p>\n<p class=\"lf-p\">L.N. 206 of 2017.</p>\n<p class=\"lf-p\">Mental Health Act SPECIAL TREATMENT LIST Only the following therapeutic invasive or irreversible interventions for mental illness, as determined by the Minister, may be carried out on a patient with a mental disorder: - Stereotactic Ablative Anterior Capsulotomy for severe refractory Major Depressive Disorder - Stereotactic Ablative Anterior Capsulotomy for severe refractory Obsessive Compulsive Disorder - Stereotactic Ablative Anterior Cingulotomy for severe refractory Major Depressive Disorder - Stereotactic Ablative Anterior Cingulotomy for severe refractory Obsessive Compulsive Disorder MENTAL HEALTH FOURTEENTH SCHEDULE [Article 33(2)(b)]</p>\n<h3 class=\"lf-part\">Part II</h3>\n<p class=\"lf-p\">Mental Health This application shall be submitted to the Commissioner.</p>\n<p class=\"lf-p\">Act IIT Ref No:</p>\n<p class=\"lf-p\">APPLICATION FOR INVASIVE OR IRREVERSIBLE TREATMENT To the Commissioner for the Promotion of Rights of Persons with Mental Disorders.</p>\n<p class=\"lf-p\">To be filled by (1) Please approve my request in respect of: responsible M/F specialist in ................. ................. ................ .............. ........... ............ mental health. (Surname) (Name) (ID No) (D.O.B.) (Sex) (Ward) of (address) ......................................................................................... to undergo invasive or irreversible treatment for his/her mental disorder.</p>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">(2)</span>If applicable, indicate if person is: a voluntary patient ............................. an involuntary patient under an Involuntary Admission for Observation IAO Ref No .............. an involuntary patient under an Involuntary Admission for Treatment Order IATO Ref No ............. an involuntary patient under an Extension of Involuntary Admission for Treatment Order EIATO Ref No .......... an involuntary patient under a Continuing Detention Order CDO Ref No .............. an involuntary patient under a Community Treatment Order CTO Ref No ..............</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">(3)</span>Specify treatment to be given ........................................................</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">(4)</span>Treatment is to be performed by .................................................</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">(5)</span>I certify that:</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>the patient has the mental capacity to give, and has given, informed consent to undergo such treatment;</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>the consent is in writing and signed by the person (copy attached);</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>there is sufficient evidence-based knowledge about this treatment;</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>the treatment benefits the health needs of the patient;</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>every available alternative treatment that could reasonably be regarded as likely to produce a sufficient and lasting benefit has been given to this patient without a sufficient and lasting benefit.</div>\n<p class=\"lf-p\">MENTAL HEALTH</p>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">(6)</span>Attached is a clinical report on the recommended treatment including the:</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>patient’s treatment history;</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>proposed treatment;</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>reasons for such treatment;</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>evidence-based knowledge about this treatment; and</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">•</span>benefits for this patient. .................................. (Official Stamp) To be filled by Commissioner .......................... (Signature) ......................... (Reg. No) ................................... .............................. (Date) (Time) Application received on (date) ............................</div>\n<p class=\"lf-p\">Action Comments Decision Treatment approved Treatment not approved My decision was communicated in writing to the responsible specialist on (date) ..................... ....................... (Signature) .......................... (Official Stamp) ...................... (Date) ........... (Time) MENTAL HEALTH FIFTEENTH SCHEDULE [Article 37(1)] Mental Health This application shall be submitted to the Minister responsible for Act Justice.</p>\n<p class=\"lf-p\">APPLICATION FOR LEAVE UNDER ARTICLE 37 FOR A PERSON DETAINED UNDER COURT ORDER To the Minister of Justice.</p>\n<p class=\"lf-p\">To be filled by (1) I the undersigned, a specialist in mental health, request that responsible M/F specialist in .................. ................. ................... ............... .............. mental health. (Surname) (Name) (ID No) (D.O.B.) (Sex) of (address) ......................................................................................... ......................................................................................... who is an involuntary patient under the Mental Health Act and is subject to a court order issued on .............................., be allowed to leave this facility on special leave from (date) ........................ to (date) .............................. as part of his care plan.</p>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">(2)</span>Give reasons why special leave is recommended: .................................................................................... .................................................................................... ....................................................................................</div>\n<div class=\"lf-abs\"><span class=\"lf-abs-num\">(3)</span>The following conditions shall apply if special leave is approved: .................................................................................... .................................................................................... .................................................................................... ................................. (Official Stamp) .................................. (Date) ............................ (Signature) .......................... (Reg. No) ............................... (Time) To be filled by Minister responsible for Justice MENTAL HEALTH Special leave is not granted  Special leave is granted  Special leave is granted subject to the following conditions: .................................................................................... .................................................................................... .................................................................................... ................... (Signature) .......................... (Official Stamp) ........................ (Date) ........... (Time)</div></div>", "next": 0}