Narratives of individuals concerning psychiatric advance directives: Qualitative study (original) (raw)

Little is known about the values individuals living with specifi c mental disorders that complete psychiatric advance directives (PADs) hold. The aim of this study is to explore how individuals narrate their experiences with mental illness and PADs in relation to autonomy, mental capacity, medications, involuntary treatment, the doctor-patient relationship, substitute decision-makers, and recovery. Semi-structured interviews were conducted with individuals living in the community with schizophrenia, depression, or bipolar disorder (N=12). Transformation methods were used to yield new and emergent themes. The quality and quantity of trust one has in family members and friends are two important factors to explain why some individuals choose a particular substitute decision-maker when mentally incapable. Individuals perceive PADs as useful for themselves to improve communication with doctors, avoid side eff ects, and prevent involuntary treatment. PADs could be off ered as documents that promote trust in the doctor-patient relationship.