This project will look at the implementation of Virginia’s newly-enacted Health Care Decisions Act (HCDA) and identify the key barriers and enabling factors that will determine the law’s ultimate impact on health outcomes, safety, and quality of life for persons with severe mental illness.

The study’s findings will be used to develop specific recommendations to improve the implementation and positive impact of the HCDA in Virginia and will also be disseminated nationally to inform policymaking in other states. The NCDA provides a legal mechanism for persons with chronic, disabling health conditions — including serious mental health disorders such as schizophrenia or bipolar disorder — to document, while competent, their advance consent to treatment and to authorize a health care proxy to make treatment decisions for them during periods of incapacity. Whether and how these types of advance directives will work in practice is unknown.

The Research Network on Mandated Community Treatment has awarded a matching grant for this research. Funded by the John D. and Catherine T. MacArthur Foundation, the Research Network on Mandated Community Treatment seeks to elaborate a new and broader conceptual framework to encompass all forms of mandated treatment.