The future of Advance Decision Making in the Mental Health Act

2019 | Advance Directives | Output
13 May, 2019

‘Advance decision making’ refers to people planning for a future when they may become unwell. At present, people living with mental illness in England and Wales have little reassurance that advance decisions they make about their own future mental health treatment will be respected, even those decisions made during times when they are well, which are supported by professionals and family. This is in sharp contrast to those making advance decisions about treatment for physical health problems.

In this case the Mental Capacity Act 2005 ensures all valid and applicable advance decisions to refuse medical treatments are respected and preferences are acknowledged. This inequality was highlighted and addressed by the Independent Review of the Mental Health Act, which formulated a recommendation for statutory provision for mental health advance decision-making in the form of ‘Advance Choice Documents’. This recommendation has been accepted by government.

Plans for Advance Choice Documents were drawn from a report submitted by the Mental Health and Justice Project. This report argued that legal reform should enable a culture shift towards mental health advance decision-making which is collaborative, encourages treatment requests, as well as appropriate treatment refusal, and respects service user expertise borne of lived experience. Outlined in the new policy briefing is the rationale for implementing Advance Choice Documents, answers to some of the concerns around creating statutory provision, and implementation suggestions for those involved in law reform.

Access the policy briefing in full here:

With support from The Policy Institute at King’s College London