Self‐binding directives for mental health treatment: when advance consent is not effective consent

Variation in Australian law concerning self‐binding directives for mental illness is unnecessarily complex for clinicians

Self‐binding directives (SBDs, also referred to as Ulysses directives)1 are a type of advance health directive used by people with mental illness to bind themselves to future treatment that is likely to be resisted at the time when it is needed. SBDs offer the potential to use the individual's past experience of illness to describe early indicators of the onset of another acute phase of illness,2 and give advance consent to specified forms of mental health treatment. This treatment is intended to occur at a time when the person considers their functioning will have become severely affected by illness, which may be before they meet the criteria for involuntary treatment under mental health laws.