If you have previously had, or currently have, a mental illness, you can document:
- your preferences and values for any treatment for mental illness in either or both:
- an advance statement
- advance care directive
- who you would like to make medical treatment decisions for you
- who you would like to support you.
Under the Mental Health Act, you can make an advance statement, which is a document that sets out your preferences in relation to treatment in the event that you become subject to compulsory treatment.
You can make an advance statement at any time by writing it down, and signing and dating it. Your advance statement must be signed by a witness who says you understand what it is and what it means to make the advance statement. The witness must be a doctor, a member of your treating team, or someone who is allowed to witness statutory declarations.
An authorised psychiatrist can only override your preferences if they are satisfied that the preferred treatment specified in the advance statement is not clinically appropriate or is not a treatment ordinarily provided by the mental health service. You can request written reasons from the authorised psychiatrist.
You can also choose someone to represent your interests and be a support, should you become a compulsory patient, This person is known as your nominated person.
Your nominated person gets information about your mental health treatment. Because of this, you should choose someone who knows you well and who you can trust.
You can make a nomination by writing it down, and signing and dating your nomination. The person needs to agree to be your nominated person.
Your nomination must be signed by a witness who says you understand what the nomination is and what it means to make a nomination. The witness must be a doctor, a member of your treating team, or someone who is allowed to witness statutory declarations. The witness cannot be the person you choose to be the nominated person.
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.
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.
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 Act
If you become a patient under the Mental Health Act, then the authorised psychiatrist in making any treatment decision (that is, treatment for mental illness) must have regard to your views and preferences about treatment of your mental illness.
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.
Medical treatment decision maker
If you have decision-making capacity to do so, you can appoint a medical treatment decision maker who can make medical treatment decisions for you if, in the future, you do not have decision-making capacity to make the medical treatment decision.
If you do not appoint someone to be your medical treatment decision maker, the Medical Treatment Planning and Decisions Act sets out who can make a decision for you.
Your medical treatment decision maker cannot make any decisions in relation to treatment for mental illness if you are a patient under the Mental Health Act (that is, a person who is subject to compulsory treatment under the Mental health Act).
However, a medical treatment decision maker can make decisions in relation to medical treatment, including treatment for mental illness, for a person who is not a patient under the Mental Health Act.
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.