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What is an advance decision?
An advance decision, also called an advance decision to refuse treatment, is a legal way to say which medical treatment you do not want in the future. It only applies if you later lose the ability to make or communicate that decision yourself.
It is binding in England and Wales if it is valid and applies to the treatment and situation in question. The decision must be clear, specific, and properly made.
Can it cover mental health treatment?
Yes, an advance decision can sometimes cover mental health treatment. For example, it may refuse certain medicines, such as antipsychotic drugs, if they are being given for a mental health condition.
It can also refuse other treatment used in mental health care, including some forms of physical treatment. However, it must be written carefully so there is no doubt about what is being refused.
Important limits to know
An advance decision cannot be used to demand a particular treatment. It only lets you refuse treatment, not choose or require it.
There are also limits if the Mental Health Act applies. In some situations, treatment for a mental disorder can be given under the Mental Health Act even if you have refused it in an advance decision.
This is especially relevant if you are detained in hospital under the Act. The rules can be complex, so the exact wording and circumstances matter a great deal.
How to make it effective
To be valid, an advance decision must be made by someone who has mental capacity at the time. It should clearly state which treatment is being refused and in what circumstances.
If you want to refuse life-sustaining treatment, the document must say so explicitly and be in writing, signed, and witnessed. Even where life is not at risk, it is still best to put everything in writing.
It is also sensible to share the document with your GP, psychiatrist, and anyone supporting you. Keep copies where they can be found quickly in an emergency.
Advance decisions and mental health planning
Advance decisions are just one part of planning ahead for mental health care. You may also want an advance statement, which records your preferences, and a lasting power of attorney for health and welfare.
These documents can work alongside each other, but they do different things. An advance statement is not usually legally binding, while an advance decision can be.
If you are considering one, it is a good idea to get advice from a solicitor, mental health advocate, or charity such as Mind. That can help make sure your wishes are expressed clearly and legally.
Frequently Asked Questions
An advance decision about treatment UK mental health treatment coverage is a planning tool that lets a person record which medical treatments they do not want to receive in future, if they lose the ability to decide for themselves. In the UK, it is usually used alongside mental health planning and must be followed if it is valid, applicable, and the person has capacity when making it.
Any adult with mental capacity can make an advance decision about treatment UK mental health treatment coverage in the UK. The person must understand the treatment choices being refused and the possible consequences. It is important that the decision is made voluntarily and recorded clearly.
Advance decision about treatment UK mental health treatment coverage in the UK can refuse specific medical treatments, including some treatments used during mental health crises, such as medication, hospital treatment, or other interventions, depending on how it is written. It cannot be used to demand a particular treatment, only to refuse one or more treatments in advance.
Yes, an advance decision about treatment UK mental health treatment coverage in the UK can refuse antipsychotic medication if it is written clearly and applies to the circumstances that arise later. If the refusal relates to life-sustaining treatment, the document must state this explicitly and meet strict legal requirements.
In the UK, an advance decision about treatment UK mental health treatment coverage does not always have to be written down for non-life-sustaining treatment, but writing it down is strongly recommended. If it refuses life-sustaining treatment, it must be in writing, signed, and witnessed, and it should state that it applies even if life is at risk.
An advance decision about treatment UK mental health treatment coverage in the UK is legally binding for refused treatments if valid and applicable. An advance statement is a broader set of preferences and wishes about care, but it is not usually legally binding in the same way. Both can be helpful in mental health planning.
An advance decision about treatment UK mental health treatment coverage in the UK should usually be followed if it is valid and relevant, even in urgent situations. However, if there is doubt about whether it applies, or if emergency treatment is needed for a different reason, clinicians may act to protect the person while checking the document.
To be legally valid, advance decision about treatment UK mental health treatment coverage in the UK must be made when the person has capacity, be specific about the treatments refused, and show that the person understood the consequences. If it covers life-sustaining treatment, it must be written, signed, and witnessed, and include the required statement.
Yes, advance decision about treatment UK mental health treatment coverage in the UK can be changed or withdrawn at any time while the person has capacity. The person should destroy old copies, create a new version, and tell family, carers, and healthcare professionals about the update.
A person should tell their GP, mental health team, family members, carers, and anyone likely to be involved in a crisis about their advance decision about treatment UK mental health treatment coverage in the UK. This helps make sure the document is available and used if needed.
If a mental health crisis occurs, clinicians must check whether advance decision about treatment UK mental health treatment coverage in the UK is valid and applicable to the treatment being considered. If it is, the refusal should be respected. If it is unclear or does not cover the situation, the care team may need to use their best judgment.
Advance decision about treatment UK mental health treatment coverage in the UK can refuse treatments that might otherwise be offered, but compulsory treatment under mental health law may sometimes follow separate legal rules. Whether it applies depends on the situation, the treatment, and the relevant legal framework.
An advance decision about treatment UK mental health treatment coverage in the UK may still be relevant for someone who is sectioned, but it does not automatically override all treatment powers under mental health law. The exact effect depends on the treatment, the law being used, and whether the refusal is legally valid and applicable.
An advance decision about treatment UK mental health treatment coverage in the UK is mainly about refusing medical treatment, so it is not usually the right document for refusing restraint or seclusion. Those issues are better addressed in care planning, advance statements, or other safety planning documents.
Advance decision about treatment UK mental health treatment coverage in the UK should be as specific as possible about which medication is being refused and why, including concerns about side effects if relevant. Clear wording helps doctors know exactly what the person wanted if the document is used later.
Family members cannot create or change advance decision about treatment UK mental health treatment coverage in the UK unless they have legal authority to act in another capacity, such as a health and welfare lasting power of attorney. They can, however, help the person write, store, and share the document.
Advance decision about treatment UK mental health treatment coverage in the UK should be stored in a safe but accessible place, with copies given to the GP, mental health team, and trusted supporters. Some people also carry a card or note saying they have an advance decision and where it can be found.
Yes, advance decision about treatment UK mental health treatment coverage in the UK can be used alongside a health and welfare lasting power of attorney, but they must be consistent. If there is a conflict, the legal status of each document and the specific powers granted may affect which decision applies.
Advance decision about treatment UK mental health treatment coverage in the UK stops applying if it is withdrawn, replaced, found to be invalid, or does not cover the treatment or situation at hand. It also stops if the person later gives valid consent to the treatment in the moment.
A person can get help with advance decision about treatment UK mental health treatment coverage in the UK from a GP, psychiatrist, community mental health team, solicitor, advocacy service, or mental health charity. Professional advice is especially useful if the person wants to refuse life-sustaining treatment or is unsure about the legal wording.
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