Use of advance directives to promote supported decision-making in mental health care: Implications of international trends for reform in New Zealand

Aust N Z J Psychiatry. 2023 May;57(5):636-641. doi: 10.1177/00048674221079225. Epub 2022 Feb 15.

Abstract

Advance directives are advocated, in many jurisdictions, as a way to promote supported decision-making for people who use mental health services and to promote countries' compliance with their obligations under the United Nations Convention on the Rights of Persons with Disabilities. The United Nations Convention on the Rights of Persons with Disabilities promotes the use of tools to further personal autonomy which would include integrating the use of advance directives into mental health law, to clarify the effect (or force) an advance directive carries when its maker comes under the relevant mental health legislation. In addition, securing the active use of advance directives requires adoption of certain supportive practices and policies within health services. Here, we discuss a number of approaches taken to advance directives in revised mental health legislation, and the associated practices we think are required.

Keywords: Advance directives; Mental Health Act; disability rights; law reform; supported decision-making.

MeSH terms

  • Advance Directives
  • Decision Making
  • Human Rights
  • Humans
  • Mental Health Services*
  • Mental Health*
  • New Zealand