Key messages

  • An advance statement sets out a person’s treatment preferences in case they become unwell and need compulsory mental health treatment.
  • A person can make an advance statement at any time if they understand what an advance statement is and the consequences of making one
  • An authorised psychiatrist must have regard to a person’s advance statement when making a treatment decision
  • The authorised psychiatrist may make a treatment decision not in accordance with the advance statement if satisfied the treatment specified in the advance statement is not clinically appropriate or is not a treatment ordinarily provided by the designated mental health service.
Video: How to create an advance statment

Video: How to create an advance statement 

An advance statement sets out a person’s treatment preferences in case they become unwell and need compulsory mental health treatment.

Watch a video on how to create an advance statement

Advance statements are written by a person saying what treatment they would like if they become unwell and need compulsory mental health treatment.

Making an advance statement

A person can make an advance statement at any time provided they understand what an advance statement is and the consequences of making an advance statement.

The authorised psychiatrist must have regard to the views and preferences of the patient about their mental health treatment expressed in their advance statement.

An advance statement must:

  • be in writing
  • be signed and dated by the person making the advance statement
  • be witnessed by an authorised witness
  • include a statement signed by an authorised witness stating that -
    • in their opinion, the person understands what an advance statement is and the consequences of making an advance statement
    • the witness observed the person sign the advance statement
    • the witness is an authorised witness.

An advance statement will be valid if it meets the requirements outlined above.

A template to make an advance statement is available.

The Mental Health Act 2014 does not require that a person make an advance statement in consultation with his or her treating team, carer or family. However, it is good practice for a person’s treating team, family and carers to be involved in the process of making an advance statement so that they are aware of the person’s treatment preferences.

Content of an advance statement

An advance statement sets out a person’s treatment preferences and may include information about:

  • treatment a person finds effective
  • treatment that has been less effective in the past
  • the person’s views and preferences about electroconvulsive treatment.

Non-treatment related preferences can be provided alongside the advance statement for consideration and can be discussed with the person, their nominated person, carer and other support people. However, there is no legal obligation for the authorised psychiatrist to effect these preferences.

An advance statement does not expire unless a new advance statement is made or the person revokes their advance statement.

It is recommended that a person considers whether the preferences expressed in their advance statement remain current. An advance statement cannot be amended. If a person’s treatment preferences have changed, they must make a new advance statement. If a person prepares a new advance statement, they should make relevant people including their treating team aware of the new advance statement.

Using an advance statement

An authorised psychiatrist must have regard to a person’s advance statement whenever they make treatment decisions.

An advance statement will help the authorised psychiatrist make decisions that better align with a patient’s treatment preferences.

Overriding an advance statement

An authorised psychiatrist may make a treatment decision that is not consistent with the patient’s treatment preferences as recorded in the advance statement. The authorised psychiatrist must be satisfied that the treatment specified in the advance statement is not clinically appropriate or is not a treatment ordinarily provided by the designated mental health service.

If the authorised psychiatrist overrides a patient’s advance statement, they must tell the person, explain their reasons and advise the patient that they can request written reasons for the decision.

If requested the authorised psychiatrist must provide written reasons within 10 business days after the request has been made.

Revoking an advance statement

Revocation of an advance statement means that the person’s advance statement has no further effect.

A person can revoke their advance statement at any time provided they understand what an advance statement is and the consequences of revoking it.

A revocation must:

  • be in writing and state that the advance statement is revoked
  • be signed and dated by the person revoking the advance statement
  • be witnessed by an authorised witness
  • include a statement signed by an authorised witness stating that -
    • in their opinion, the person understands what an advance statement is and the consequences of revoking it
    • the witness observed the person revoking the advance statement
    • the witness is an authorised witness.

A revocation will be valid if it meets the above requirements. A template to revoke an advance statement is available.

An advance statement must not be amended. Instead, if a person wants to change his or her preferences expressed in their advance statement they must make a new advance statement.

Making a new advance statement automatically revokes any earlier advance statements made by that person.

The role of the authorised witness

An authorised witness is required to state that the person making or revoking an advance statement understands what the advance statement or revocation is and the consequences of making or revoking the advance statement.

The authorised witness should check the identity of the person making or revoking the advance statement by asking them if they are the person who is making the advance statement.

Accessing a person’s advance statement

A person making an advance statement should ensure that the people involved in their treatment and care know that they have made an advance statement and where that advance statement can be located. A person may wish to give a copy of their advance statement to their nominated person, carer and family.

The mental health service provider is responsible for ensuring that the existence of an advance statement is recorded on the CMI/ODS.