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

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.

Crisis plans in mental health: A scoping review

“…Finally, decision‐making in partnership is found in most crisis plans. On one hand, the joint crisis plan and the safety plan seem to focus on promoting active service user participation by building on their experiential knowledge to prevent and respond to crisis situations (Flood et al, 2006; Gumley et al, 2021; Henderson et al, 2009; Lenagh‐Glue et al, 2018; Perkins & Repper, 2016). On the other hand, with advance directives, it is more a question of relying on the expertise of the professionals involved in the creation of the plan to support the service user's decision‐making (Henderson et al, 2008; Jankovic et al, 2010; Lenagh‐Glue et al, 2020; Maître, 2018; Nicaise et al, 2013; Srebnik et al, 2005).…”