A Survey of Stakeholder Knowledge, Experience, and Opinions of Advance Directives for Mental Health in Virginia (original) (raw)
Related papers
Commentary: Psychiatric advance directives as tools for enhancing treatment of the mentally ill
The journal of the American Academy of Psychiatry and the Law, 2006
In this issue of the Journal, Swanson et al. explore the demand for and utilization of psychiatric advance directives (PADs), and discuss some of the barriers to their greater acceptance. This author suggests that PADs may be more widely accepted and utilized if they are viewed as tools for maximizing individual autonomy, with an emphasis on optimizing rather than merely restricting care.
Administration and Policy in Mental Health and Mental Health Services Research, 2010
The aim of this study was to measure expert consensus on the implementation of Psychiatric Advance Directives (PADs) within the Veterans Health Administration. We conducted a two-round Delphi study with 55 panelists including consumers, caregivers, mental health providers and researchers. For a number of items where no positive or negative consensus was reached we found differences between the views of consumers and non-consumers, reflecting consumer's preferences for nonmedical settings for completion and assistance with completion independent of the treatment team. Thus, the principle of consumer choice that applies to MHAD content should also be applied to the process of completion offered.
Issues in the development of advance directives in mental health care
Journal of Mental Health, 2003
Background: Interest in advance directives in mental health care is growing internationally. There is no clear universal agreement as to what such an advance directive is or how it should function. Aim: To describe the range of issues embodied in the development of advance directives in mental health care. Method: The literature on advance directives is examined to highlight the pros and cons of different versions of advance directive. Results: Themes emerged around issues of terminology, competency and consent, the legal status of advance directives independent or collaborative directives and their content. Opinions vary between a unilateral legally enforceable instrument to a care plan agreed between patient and clinician. Conclusion: There is immediate appeal in a liberal democracy that values individual freedom and autonomy in giving weight to advance directives in mental health care. They do not, however, solve all the problems of enforced treatment and early access to treatment. They also raise new issues and highlight persistent problems.
Psychiatric Advance Directives: An Understanding
Zenodo (CERN European Organization for Nuclear Research), 2019
Undoubtedly, 2017 is a watershed year for mental health professionals and sufferers; this year witnessed the historic moment of the advance of Mental Health Care Act (MHCA). The importance of this Act cannot be underestimated as it has come as a ray of hope as few rights have been given to the persons with mental illness, first time, like the right to make advance directives. Hence, it can be said that its coming is a tremendous achievement and a beacon of hope for the millions of people. It is a pivotal Act in the battle against the mental illness that also directs the public's attention toward the ongoing pandemic. Efforts to implement it will cause many challenges as well as renewed optimism. Understanding of concepts related to ADs is essential for mental health professionals as they have an important role to play with severe, persistent, mental illnesses. The purpose of this article is to collect the blinding flashes of insight, as well as the mundane aspects of ADs to begin to understand its benefits and prediction of barriers in its implementation and their possible solution.
2007
Psychiatric advance directives (PADs) are legal tools that allow competent individuals to declare preferences for future mental health treatment when they may not be capable of doing so as a result of a psychiatric crisis. PADs allow individuals to maintain self-determination during times when they are most vulnerable to loss of autonomy and in need of assistance to make their preferences known and honored. This article describes the content of twenty-eight open-ended, semi-structured qualitative interviews of adults with PADs who have experienced psychiatric crises. The qualitative analysis revealed three major themes from the interviews: (1) PADs as tools for empowerment and self-determination, (2) limited knowledge of PADs among service providers; and (3) difficulties communicating PADs to inpatient staff. In general, many participants expressed enthusiasm of the implementation of PADs but concern regarding clinicians' general lack of awareness about them. Additionally, some consumers discussed discomfort in even mentioning that they had a PAD to clinicians for fear of a negative response from them, or some type of involuntary treatment during their hospitalization. However, participants consistently viewed PADs as a positive tool to promote autonomy with the potential to facilitate stronger patient-provider relationships. Therefore, when working with individuals in psychiatric crisis who have a PAD, and who have never before experienced a sense of control over their own treatment, clinicians must recognize the potential troubling disequilibrium this sense of control may engender. In sum, though the most significant challenges facing the implementation of PADs involve clinicians' familiarity with and education about PADs, much promise for the future growth of PADs lies in the benefits perceived by the patients. Kim et al.