Guidelines, process and ethics with the New Zealand Mental Health (compulsory assessment and treatment) Act: striking a balance

The New Zealand Mental Health (compulsory assessment and treatment) act [1] was amended to mandate the consultation of family and care-givers in every stage of civil committal. Although the use of committal has been seen by clinicians as an impediment to care [2] and clinicians continue to have concerns about the timing of discharge from the act [3], many people with serious mental illness have experienced the act as beneficial [4]. A recent review of the regulations has increased the length and detail of the reports clinicians have to provide to the court. This, combined with a clear directive that an advocate who is not part of the clinical care process must be present during the clinical interview to commence committal, may be causing a conflict between the provision of care in a timely manner when patients are at risk and complying with the requirements of the court.