Journal ArticleDOI
Interest in Psychiatric Advance Directives Among High Users of Crisis Services and Hospitalization
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TLDR
Substantial interest in psychiatric advance directives was shown among individuals with serious and persistent mental illness and the results strongly suggested that attitudes of clinicians about Psychiatric advance directives are associated with interest in the directives among these individuals.Abstract:
Objectives: This study examined rates of interest in creating psychiatric advance directives among individuals at risk of psychiatric crises in which these directives might be used and variables associated with interest in the directives. Methods: The participants were 303 adults with serious and persistent mental illnesses who were receiving community mental health services and who had experienced at least two psychiatric crises in the previous two years. Case managers introduced the concepts of the directives and assessed participants’ interest. The associations between interest in the directives and demographic characteristics, psychiatric symptoms, level of functioning, diagnosis, history of hospitalizations, history of outpatient commitment orders, support for the directives by case managers, and site differences were examined. Results: Interest in creating a directive was expressed by 161 participants (53 percent). Variables significantly associated with interest were support for the directives by a participant’s case manager and having no outpatient commitment orders in the previous two years. Reasons for interest included using the directives in anticipation of additional crises and as a vehicle to help ensure provision of preferred treatment. Conclusions: Substantial interest in psychiatric advance directives was shown among individuals with serious and persistent mental illness. The results strongly suggested that attitudes of clinicians about psychiatric advance directives are associated with interest in the directives among these individuals. Therefore, it is important to educate clinicians and address their concerns about the directives so that they can more comfortably support creating the documents. A shift in values may also be necessary to more consistently recognize and honor patients’ treatment preferences as specified in the directives. (Psychiatric Services 54:981–986, 2003)read more
Citations
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Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among Persons with Severe Mental Illness
Jeffrey W. Swanson,Marvin S. Swartz,Eric B. Elbogen,Richard A. Van Dorn,M.S.W. Joelle Ferron,H. Ryan Wagner,Barbara J. McCauley,Mimi Kim +7 more
TL;DR: The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients' treatment preferences, and enabling system-level policies to embed facilitation of these instruments in usual-care care settings.
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Transforming systems of care: the American Association of Community Psychiatrists Guidelines for Recovery Oriented Services.
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A Typology of Advance Statements in Mental Health Care
TL;DR: There is recent convergence between the United Kingdom and the United States with respect to research interventions that facilitate the production of advance statements, as evidence emerges for the effectiveness of facilitated psychiatric advance directives and joint crisis plans.
References
More filters
Journal ArticleDOI
The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance.
TL;DR: The relative simplicity, reliability, and validity of the GAS suggests that it would be useful in a wide variety of clinical and research settings.
Journal ArticleDOI
Effectiveness, Transportability, and Dissemination of Interventions: What Matters When?
TL;DR: The authors identify and define key aspects of the progression from research on the efficacy of a new intervention to its dissemination and illustrate key conceptual and design features that differentiate efficacy, effectiveness, and dissemination research.
Journal ArticleDOI
Housing choice and community success for individuals with serious and persistent mental illness
TL;DR: Assessment of level of housing choice and the relationship of choice to community success in supported housing demonstration projects in five states demonstrated that choice was positively related to housing satisfaction, residential stability, and psychological well-being.
Journal ArticleDOI
Advance Directives for Mental Health Treatment
Debra Srebnik,John Q. La Fond +1 more
TL;DR: Issues to be clarified in future research and practice include strategies for increasing awareness of advance directives in mental health, barriers to execution of legally and clinically effective directives, practitioners' concerns, providers' compliance with directives, effects of directives on consumers and providers, results of managed care on implementation of directives, and stakeholders' perceptions of the value of directives.
Journal ArticleDOI
Psychiatric advance directives: an alternative to coercive treatment?
TL;DR: According to the model proposed here, PADs might provide an effective tool for managing psychiatric crises but might also help to improve participation in regular outpatient treatment.