Strengthening rights and reducing Restrictive Interventions: analysis of the uptake of Advance Statements and Nominated Persons within the Victorian Mental Health Act 2014.

Ms Frances Sanders1
1Department Of Health And Human Services Victoria Office Of The Chief Psychiatrist, Melbourne, Australia

With the release of the Victorian Mental Health Act in 2014, the Victorian Government set out to lead a reform agenda for Victoria in upholding the human rights and recovery goals of people utilising mental health services; and their families and carers. The Mental Health Act 2014 introduced various ways to uphold the rights of people with a mental illness, including a statements of rights, inclusion of recovery principles and formal mechanisms for supported decision making. A central tenent of the Act is the presumption that people have capacity to make decisions about their treatment and to give informed consent. The inclusion of Advanced Statements and the right to elect a Nominated Person were designed to provide support and to help protect consumers interests by ensuring people were able to exercise their rights and have their views and preferences about their treatment and recovery taken into account.

The uptake of these mechanisms ranges from 1 – 15.5% across Victorian cohorts (DHHS, 2018). As part of a broader focus of the Office of the Chief Psychiatrist on consumer rights, this project reviewed the uptake and impacts of Advances Statements and the provision for a Nominated Person, including improving the understanding of the enablers and barriers to implementation.

Findings reveal legislative literacy, communication skills, clinical commitment and performance culture impact the uptake of Advanced Statement and Nominated Person provisions.

The commitment to supported decision making and opportunities to communicate preferences improved consumer outcomes including reducing the need for restrictive interventions


Frances Sanders is the Senior Carer Adviser with the Office of the Chief Psychiatrist in Victoria. Prior to this she worked leading NDIS business development and implementation which focused on the development of person centered services that respond to customer choice and need. She has led consumer and carer services and statewide engagement strategy’s and has held executive roles in the mental health and psychiatric employment sectors since 1995. Her project management and operational oversight includes eating disorder services, sub acute and complex care programs and a broad range of residential and community outreach programs.


TERP focuses on identifying, avoiding and reducing harm across all environments in which the care of people with mental ill health is provided. TERP inforces Australia’s commitment to reduce the use of, and eliminate restrictive practices as a priority for action. Each jurisdiction, in conjunction with the Safety and Quality Partnership Standing Committee and the Commonwealth Government, works towards this vision by holding a series of forums providing an opportunity to learn and grow from local and national initiatives to eliminate restrictive practices and create a dialogue for future care.

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