Definitions
The definition of medical treatment includes treatment for mental illness.
Treatment for mental illness means things done in the course of the exercise of professional skills to remedy a person’s mental illness or to alleviate the symptoms and reduce the ill effects of a person’s mental illness.
Mental illness is a medical condition that is characterised by a significant disturbance of thought, mood, perception or memory.
Advance care directives
If you have decision-making capacity you can make an advance care directive in relation to medical treatment and medical research procedures. An advance care directive can include either or both an instructional directive and values directive.
Instructional directive
You can include an instructional directive in an advance care directive in which you either consent to, or refuse medical treatment. This can include treatment for mental illness.
If you consent to or refuse the medical treatment in an advance care directive, your health practitioner must give effect to your instruction, unless there are permissible circumstances for the health practitioner to refuse to comply.
Values directive
You can include a values directive stating your preferences and values for medical treatment, including treatment for mental illness, which your medical treatment decision maker would have to consider in making any medical treatment decision.
Advance care directives and the Mental Health and Wellbeing Act
If you become a patient under the Mental Health and Wellbeing Act, the authorised psychiatrist must have regard to your views and preferences about treatment when making any treatment decision (both treatment for mental illness and other medical treatment).
Therefore, an authorised psychiatrist could take into account your views and preferences expressed in an advance care directive.
However, an authorised psychiatrist does not have to give effect to medical treatment decisions in an advance care directive.
Support Person
If you have decision-making capacity to do so, you can appoint a support person who can support you to make, communicate and give effect to your medical treatment decisions.
Your support person can also represent your interests in relation to your medical treatment, including when you do not have decision-making capacity in relation to medical treatment decisions.
Electroconvulsive Therapy (ECT) for non-patients
ECT is treatment for mental illness, which falls within the definition of medical treatment under the Medical Treatment Planning and Decisions Act. However, ECT can only be performed in accordance with the Mental Health and Wellbeing Act.
If you are not subject to compulsory treatment under the Mental Health and Wellbeing Act, and you have decision-making capacity, you can consent to, or refuse, ECT. If you are under 18 years old, the Mental Health Tribunal would still need to make an order authorising ECT on the basis of your informed consent, before ECT could be performed on you.
If you do not have decision-making capacity regarding ECT, then a psychiatrist can make an application to the Mental Health Tribunal for an order authorising ECT.
The Mental Health Tribunal will make an order authorising ECT if satisfied as to all of the following:
- you do not have decision-making capacity to give informed consent
- there is no less restrictive way for you to be treated and
- either:
- you have an instructional directive giving informed consent to ECT (if you are an adult), or
- your medical treatment decision maker has given informed consent in writing to ECT.