Evaluation of California's Multi-County Psychiatric Advance Directives Innovation Project: Early Implementation and...

Area of Science:

• Psychiatry
• Health Services Research
• Mental Health Policy

Background:

• Psychiatric advance directives (PADs) are crucial for individuals with mental health conditions to articulate care preferences during crises.
• Seven California counties collaborated on a Mental Health Services Act Innovation Project to boost PAD availability and usage.
• Peer worker outreach and facilitation were integral components of the project.

Purpose of the Study:

• To evaluate the outcomes and experiences of PAD facilitation facilitated by peer workers.
• To assess PAD creation rates and user outcomes across participating California counties.
• To gather insights from county implementation staff on the project's beta testing and overall implementation.

Main Methods:

• Surveys and interviews with peer workers to assess post-training outcomes and real-world facilitation experiences.
• Analysis of administrative metadata, user surveys, and follow-up interviews/surveys with PAD creators to determine creation rates and outcomes.
• Interviews with county implementation staff to gather reflections on the project's implementation process.

Main Results:

• Peer worker facilitation showed positive post-training outcomes and real-world experiences.
• The project demonstrated varying PAD creation rates and outcomes across the seven participating counties.
• County staff provided valuable feedback on the implementation and beta testing phases.

Conclusions:

• The PADs Innovation Project successfully increased PAD availability and uptake through peer support.
• Recommendations for future PAD implementation were derived from project findings and staff feedback.
• The study highlights the importance of peer workers in supporting individuals with mental health needs to utilize PADs.