Dr Katrine Del Villar
1Australian Centre for Health Law Research, QUT, Australia
Biography:
Katrine researches and teaches in the areas of medical law and ethics, with mental health law a principle area of research. Prior to joining QUT, Katrine worked as an associate to Justice Gaudron of the High Court, as a solicitor for Blake Dawson Waldron, and a research officer for the Commonwealth Parliamentary Library. Katrine obtained a PhD from QUT in 2020, a BA (Hons)(Russian) from the ANU in 1995, and an LLB(Hons) from the ANU in 1997. She is admitted to practice as a Barrister and Solicitor of the Supreme Court of the ACT and of the High Court.
Abstract:
Compulsory treatment for mental illness can be long-lasting, is often experienced as invasive and coercive, and can cause significant damage to the therapeutic relationship. However, untreated mental illness can itself have very serious consequences. This paper considers the potential for mental health advance directives (MHADs) to play an important role in allowing people with mental illness to receive treatment in accordance with their own desires and instructions, rather than under coercion, during acute or crisis situations.
The paper examines MHADs primarily from a legal perspective, considering whether general legislation which applies to advance directives in Australia is appropriately tailored to advance directives for mental illness. It also considers examples of international best practice in legislation governing MHADs. The focus is on the circumstances in which MHADs may be binding, or may be overridden, as well as the interaction with involuntary treatment laws. It identifies options for law reform to promote the uptake of MHADs, and to minimise exceptions which can undermine the utility of MHADs.
The paper also considers the current empirical evidence on the potential of MHADs to further individual autonomy and reduce coercion in the mental health system, including surveys of the wishes and preferences of people with mental illness, and some controlled trials of utilization of MHADs in practice to express mental health treatment preferences.