Advance Directives One way to assert your rights…. Vivienne Topp Policy Coordinator / Lawyer

Charter Rights All Victorians have the right to: – Recognition and equality before the law, this includes freedom from discrimination because of having a psychiatric disability and freedom to make decisions.

Section 10 A person must not be— (a) subjected to torture; or (b) treated or punished in a cruel, inhuman or degrading way; or (c) subjected to medical or scientific experimentation or treatment without his or her full, free and informed consent.

Limitations The Charter also says: Those rights can be limited by other Acts/pieces of legislation, by “reasonable limits that can be demonstrably justified in a free and democratic society based on human dignity, equality and freedom, and taking into all relevant factors.” Section 7(2)

Any attempt to limit an individual’s rights must be demonstrably: reasonable, and necessary, and justified, and proportionate Vic EOCHRC But only when……….

Standing up for your rights Without mechanisms to assert these rights, they are hollow………..they are just words

MHLC Advance Directive Project At a community forum people living with mental illness, family, carers, and mental health professionals identified advance directives (AD’s) as a critically under-utilized human rights tool. AD’s have the potential to achieve and retain independence, self-determination and non-discrimination for people living with mental illness. ‘Advance Directives’, Hotel Y, June 22nd, 2006.

What are ‘Advance Directives’? A type of document created by people living with mental illness while they are well Typically documents contain special information outlining a person’s unique circumstance, personal preferences regarding treatment choices, and information about practical life management arrangements in the event they become unwell They are not legally enforceable in Victoria

Types of Advance Directive Instructional Proxy Hybrid

What can you put in an Advance Directive? Treatment preferences Who to notify / Who not to notify Arrangements for the care of - children - pets - accommodation - financial matters

What does an Advance Directive look like? scroll down to CAPS and Advocard advance statement form.pdf

What are the Benefits? “ Nothing about us without us” Valuing the consumer in all aspects of their lives Encourages discussion between parties Better clinical outcomes

Consumer Experience : Problems with inappropriate diagnosis Potential re traumatisation especially under involuntary status: treatments/detention Underlying issues can remain unattended Diagnosis….. Risk of history of ‘bad’ interactions with ‘helping’ professions

Can they make a difference? Women diagnosed with mental illness are often women with a history of childhood trauma, emotional, physical and sexual abuse and/or neglect as well as women living in situations of recurrent male violence Experiences retriggered during acute unit admissions where they again experience violence and fear –

Advance Directives are not Treatment Plans TP – imbalance in power relations between clinician and consumer TP are about treatment alone. ~ AD – consumers frame the content AD are about treatment and practical measures

Overseas Research Findings AD Not used to refuse all treatment People are well-informed about latest treatments People choose feasible alternatives

The Mental Health Legal Centre Project - Aims 1.To represent the consumer as an ‘active voice’ in formal research

The Mental Health Legal Centre Project - Aims 2.To understand the difficulties and opportunities faced by consumers, family carers and clinicians in articulating, producing and implementing advance directives

The Mental Health Legal Centre Project - Aims 3.To provide community based resources and information

The Mental Health Legal Centre Project - Aims 4.To identify law reform necessary to enable legal recognition and respect of advance directives ~ Contact: MHLC or Vivienne