Decision‐making about involuntary psychiatric treatment: An analysis of the principles behind Victorian practice

The author analyses 10 years of published decisions by the Victorian Mental Health Review Board in relation to the involuntary detention for treatment of those with mental illness. He argues that by and large the Board has taken a broad psychosocial approach to assessing whether treatment options that are less restrictive than those which are coerced are feasible. The guiding question has been whether a patient's health or the safety of the community have demanded involuntary provision of treatment However, he argues that although such an approach is enshrined in Victorian mental health legislation, United Nations Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care and the approach propounded by the therapeutic jurisprudence movement, each of these adds little to the other in terms of assisting decision‐makers in individual cases. He maintains that considerable room still exists for decision‐making which is generated by unarticulated “best interests of the patient” ideologies.