title: New Zealand's mental health legislation needs reform to avoid discrimination.
abstract: New Zealand's Mental Health (Compulsory Assessment and Treatment) Act (the Act) is now over 20 years old. As has occurred historically our conceptualisation of humane treatment of people with mental illness has altered significantly over the period in which the Act has been in force. The emergence of the philosophy of recovery, and its subsequent policy endorsement, has seen a significant shift in mental health service delivery towards a greater emphasis on autonomy. Human rights developments such as New Zealand's ratification of the 2006 United Nations Convention on the Rights of Persons with Disabilities have resulted in compulsory treatment, where it is justified in whole or part by a person's mental illness, now being considered antithetical to best practice, and discriminatory. However the number of people subject to the Act is increasing, especially in community settings, and it is questionable how effective the mechanisms for challenging compulsion are in practice. Moreover, monitoring of the situation at the systemic level lacks critical analysis. Complacency, including no indication that review and reform of this now antiquated legislation is nigh, continues a pattern of old where the situation of people with experience of mental illness is largely ignored and neglected.
authors.affiliation: Department of Psychological Medicine, University of Otago Wellington, PO Box 7343, Wellington 6242, New Zealand. sarah.e.gordon@otago.ac.nz.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Gordon
authors.forename: Anthony
authors.initials: A
authors.lastname: O'Brien
mesh_terms: D002961:Civil Rights; D003068:Coercion; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006801:Humans; D007258:Informed Consent; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence* / Q000523:psychology; D009520:New Zealand; D011287:Prejudice / Q000517:prevention & control*