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Implementing psychiatric advance directives: service provider issues and answers
1Department of Psychiatry and Behavioral Sciences, University of Washington, Box 359911, 325-9th Ave, Seattle, WA 98104, USA. srebnik@u.washington.edu
The Journal of Behavioral Health Services & Research
|July 24, 2003
Summary
Psychiatric advance directives (PADs) empower adults with serious mental illness to document future treatment choices. This guide addresses service provider concerns for effective PAD implementation and utilization.
Area of Science:
- Psychiatry
- Mental Health Law
- Healthcare Policy
Background:
- Psychiatric advance directives (PADs) are an emerging tool for individuals with serious and persistent mental illness.
- PADs allow patients to document treatment preferences during periods of capacity for future use during incapacity.
Purpose of the Study:
- To identify and address frequently raised issues by service providers regarding PAD implementation.
- To provide recommendations for overcoming barriers to effective PAD utilization.
Main Methods:
- The study synthesized common concerns and questions from service providers involved in PAD planning.
- A review of legal, ethical, and practical considerations for PAD execution and enforcement was conducted.
Main Results:
- Key issues include access, competency, legal enforceability, agent roles, and information sharing.
- Service provider concerns range from the complexity of PADs to liability issues.
Conclusions:
- Effective PAD implementation requires staff and consumer training, potential statute development, and addressing logistical, attitudinal, and systemic barriers.
- Addressing these issues is crucial for maximizing the benefits of PADs for individuals with serious mental illness.