Under the Mental Healthcare Act (MHCA) 2017, an Advanced Directive allows a person with mental illness to make decisions about their treatment. Which of the following statements about Advanced Directives under MHCA 2017 is CORRECT?

• A It can direct that a specific treatment (e.g., ECT) be administered even against the treating psychiatrist's clinical judgment
• B It can specify treatment preferences and persons to be consulted, but cannot override a treating psychiatrist's clinical recommendation during an emergency ✓
• C It must be registered with the appropriate authority and can be revoked only by court order
• D It applies only to in-patient admissions and has no relevance for outpatient treatment

Explanation

Under MHCA 2017 (India), an Advanced Directive (Section 5–11) allows a person with mental illness to give instructions about their desired treatment or refusal of specific treatments during future episodes. However, it has important limitations: it cannot mandate treatment against the treating psychiatrist's clinical judgment; in emergency situations threatening life, the clinician may depart from the directive with documented justification; and it can be challenged by the treating psychiatrist or nominated representative through the Mental Health Review Board. It does NOT require court order for revocation — it can be revoked at any time by the person when they have capacity.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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