Core Forensic Model

On the first day the consumer gets a plan, and we talk with them about where their care is heading.

What happens

• Forensicare may first meet the consumer in prison, in the community, or in a high, medium or low secure hospital. The model starts there.
• The team completes a START, a short, structured check of risk and of what treatment is likely to help. The primary nurse is accountable for it, the rest of the team contributes, and the consultant psychiatrist is informed.
• A first care plan is written from the START, so risks are addressed from day one, before the team knows the consumer well.
• The Master Report opens. Clinical review starts, at the frequency set for the setting.
• DASA, a daily or more frequent check on the risk of aggression, begins where it is used, mainly in acute settings.
• The team talks with the consumer, and their family and carers where possible, about the likely pathway to the community.
• Any other consumer- or family-specific assessments are identified and started.
• Most consumers are on a custodial supervision order, made by a court under the CMIA. Someone moved from prison is on a secure treatment order, made by the Justice Secretary and heard by the Mental Health Tribunal within 28 days.

What comes out of it

• A first care plan.
• An open Master Report.
• A shared understanding of the likely pathway.

Who does what

• Primary nurse: accountable for the START and for DASA.
• Consultant psychiatrist: informed.
• Consumer, registrar, psychologist, social worker, occupational therapist and peer worker: contribute.

Open question. Is the first plan the Consumer Pathway Plan (CPP), the Mental Health Recovery Plan (MHRP), or both?

Settled since September: who is accountable for the START, and that the Master Report opens at admission.

Over the first three months the team learns the consumer’s history and records it in the draft Master Report.

What happens

• Clerking and interviews with the consumer.
• Occupational therapy and social work interviews with the consumer and, where possible, their family and carers.
• Everything learned goes into the draft as it is gathered.
• Clinical review keeps the care plan up to date: weekly in acute and high secure, fortnightly in medium secure, monthly in low secure and the community.
• DASA continues where used, guiding day-to-day decisions such as freedom to move around the unit.
• Other assessments are phased in as needed, such as neuropsychological testing, a family violence risk assessment or an NDIS assessment. They support the model but are not part of its core.

What comes out of it

• A draft Master Report for the first review, covering background, mental health, physical health, forensic history, drug and alcohol history, and progress so far.

Open question. Does the month-3 review happen when the date arrives, or when the draft is ready?

The whole team meets with the consumer to agree what the risks are and what to do about them.

What happens, in order

• The consultant psychiatrist chairs. The consumer takes part as far as their mental state allows.
• The team reads the draft Master Report together. It becomes the agreed account of the consumer’s history.
• The team rates the HCR-20 v3 together, item by item, for presence and relevance, then agrees a summary risk judgement. The detail is already in the report, so rating takes less time.
• The team rates DUNDRUM 3, which programs the consumer has completed, and DUNDRUM 4, their stage of recovery.
• The team tests the likely scenarios and writes a brief risk formulation.
• The team writes a SMART care plan, with each task given a named owner and discussed with the consumer.
• The report is mastered. It is locked as one dated version and becomes the single source of truth at that point.
• It is shared with the consumer in full, apart from information about other people that legally cannot be shared. Lived experience colleagues will help shape how this is done.

What comes out of it

• Master Report v1, then v2, v3 and so on, one at each review.
• An updated care plan with named owners.
• A new draft, started from the mastered version.

Each later review is the same meeting, held six months after the last. The historical items rarely change, so the team can concentrate on the clinical and risk management items, and the meeting gets quicker.

For decision. Should a review also be held before a leave application or renewal, a move between units or security levels, or a court or Tribunal report, and after a serious incident, a leave suspension or sustained high DASA scores? And should reviews be scheduled at least six weeks before a leave grant expires, so the locked report can inform the Tribunal’s leave profile?

Who does what

• Consultant psychiatrist: chairs, and is accountable for the Master Report, HCR-20 v3, DUNDRUM, CPP and MHRP.
• Consumer, registrar, psychologist, primary nurse, social worker, occupational therapist and peer worker: contribute.

Between reviews, named team members carry out the plan and keep adding to the draft.

What happens

• Each task in the care plan has a named owner and is worked through with the consumer, and with their family and carers where possible.
• Clinical reviews revise the care plan at the frequency set for the setting. DASA continues where used.
• New information, such as school reports or newly found history, goes straight into the new draft.
• Criminogenic, educational, occupational and clinical recovery programs run alongside, on and off the unit. They are aligned to the seven DUNDRUM recovery pillars, including mental health, physical health, education, occupation, and family and community support. Their outcomes inform the next DUNDRUM rating and the care plan.
• Graduated leave, linked to risk and the care plan, opens up in steps. Early leave helps the consumer get to know the community. Later leave lets them visit where they will live, work or study.
• Since 1 September 2026 the Mental Health Tribunal decides limited off-ground leave, for up to six months a grant. Its orders generally leave the details of where, how often and how long to the treating team, which steps leave up from escorted to accompanied to unescorted. The Leave Review Committee says whether it supports an application. The person can apply even if it does not. The authorised psychiatrist grants special leave, and the Chief Psychiatrist can suspend leave.
• Court reports, referrals and risk summaries are drawn from the record.

What comes out of it

• An updated draft with a six-month addendum, ready for the next review.
• No repeated assessments.

Settled since September: the primary nurse is accountable for DASA.

A meaningful life, lived safely, in the community.

The Core Forensic Model does not yet describe this stage, so the sheets leave it unfinished. The clinical points below come from the Model of Care 2021–26. The legal steps come from public guidance. Could Forensicare’s legal advisers check them before printing?

What the Model of Care says

• Consumers reintegrate gradually, using the skills they developed in rehabilitation.
• This applies to people leaving a secure hospital, people leaving prison (supported by the Community Integration Program), and people already living in the community who may be isolated.
• Referrals link consumers with mental health and wellbeing services and other community services: housing, employment, education and substance use, and benefits such as the NDIS.
• Recovery means somewhere to live, something to do and someone to love.

What the law already defines

• The Supreme or County Court grants extended leave, for up to 12 months living in the community.
• After 12 months of extended leave, the court can vary a custodial supervision order to a non-custodial one.
• The court reviews the order three months before the nominal term ends, and at least every five years after that.
• People on a secure treatment order return to prison when it ends, with release planning through the Community Integration Program. Community leave is available to them only in extreme circumstances.