Advance Statements within the Victorian Mental Health Setting: A Contextual and Legislative Global Comparison

James, Russell; Maude, Phil; McGrath, Ian

doi:10.1080/01612840.2019.1652871

Cited by 8 publications

(7 citation statements)

References 42 publications

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“…In the state of Victoria, Australia, advance statements were implemented as part of a suite of reforms introduced in new mental health legislation (the Mental Health Act) in 2014, with several principles of this act incorporating person-centred practices such as reducing restrictive interventions and enabling mental health services to include recovery-focussed care in their service delivery. Advance statements allow for the opportunity for mental health service users to document their preferences and goals in receiving care and have been hailed as a paradigm shift in the delivery of compulsory care under law (James et al 2020). Since then, several other jurisdictions in Australia have followed, with both the Australian Capital Territory and Queensland implementing legally binding advanced statements under their respective mental health acts (Ouliaris et al 2017;Saraf 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Advance statements allow for the opportunity for mental health service users to document their preferences and goals in receiving care and have been hailed as a paradigm shift in the delivery of compulsory care under law (James et al . 2020). Since then, several other jurisdictions in Australia have followed, with both the Australian Capital Territory and Queensland implementing legally binding advanced statements under their respective mental health acts (Ouliaris et al .…”

Section: Introductionmentioning

confidence: 99%

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Mental health clinician training and experiences with utilization of advance statements in Victoria, Australia

James

Maude

Searby

2021

Int J Mental Health Nurs

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Advance statements, advance directives, or psychiatric wills are a key component of a shift to mental healthcare that promotes autonomy and choice and aims to reduce restrictive and coercive care practices in mental health treatment settings. The use of advance statements has gained momentum to provide a means for individuals to detail clear preferences for mental health treatment. This paper uses a qualitative descriptive design to explore the experiences of clinicians (n = 15) implementing advance statements in the state of Victoria, Australia, a region that introduced advance statements as part of an overhaul of mental health legislation in 2014. The study, reported using the COREQ framework, found two key themes after analysis: experiences of advance statement training, with the availability and quality of training and training as a driver of change emerging as sub-themes, and experiences of advance statements in practice, with participants providing narratives of the barriers and facilitators to successful advance statement implementation. We recommend that clinician and service user experiences of advance statement implementation are further explored to identify existing and emerging barriers to implementation of these tools, which are crucial to achieve autonomy and choice for individuals receiving mental healthcare.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mental health clinician training and experiences with utilization of advance statements in Victoria, Australia

James

Maude

Searby

2021

Int J Mental Health Nurs

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“…Other approaches involving clients were discussed by client participants in phase one, namely the use of advance statements and nominated person forms. These forms represent legal mechanisms designed to uphold the rights of people to make decisions about their own mental health care ( 57 ). However, participants felt that the utility of these were limited in early intervention services where young people may experience being acutely unwell for the first time, so aren't able to express their preferences in advance or make informed experience-based choices.…”

Section: Discussionmentioning

confidence: 99%

Shared Decision Making With Young People at Ultra High Risk of Psychotic Disorder

et al. 2021

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Introduction: While the majority of young people who meet the criteria for being considered at increased risk of psychosis do not go on to develop a psychotic disorder, young people are currently being identified and treated in early intervention services. Ethical concerns have been raised concerning the decision about whether or not to provide treatment, and if so, what type of treatment. This study sought to support young people themselves to make these decisions with support from their clinician through a shared decision-making approach, facilitated by an online decision aid.Methods: This project used the International Patient Decision Aid Standards (IPDAS) to guide the development and piloting of an online decision aid across two phases: (1) qualitative, semi-structured focus groups with young people who were past clients and clinicians from an early psychosis service; and (2) pilot testing of the decision aid with clinicians and young people who were current clients to finalize the development.Results: Issues discussed by clinicians in the focus group were grouped into three main areas: (1) engagement phase; (2) assessment and priorities for treatment; and (3) initial and ongoing decision making. Clients focused on the context in which the decisions were made, including as they experienced initial feelings of resistance, and then acceptance of efforts made to describe and treat their mental health challenges. Clients highlighted the need for collaboration between themselves and their clinician, and the need to be equipped with the knowledge and tools to take care of themselves. These focus group data were used to refine the online decision aid. Pilot testing revealed that while it was overall useful and relevant, important limitations were noted by both clients and clinicians.Discussion: The use of a decision aid to facilitate shared decision making (SDM) in this area is feasible and has utility for both clients and clinicians. Use of such a tool can help to address the need to uphold the rights of young people as decision makers about their own care. Future efforts should embed decision aids within complex SDM interventions, and research to understand issues relating to implementation of these interventions.

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“…proxy decision-maker) within the legislation was a first for Australia and was a paradigm shift from State-directed substitute decision-making when a compulsory treatment order has been applied to an individual (Turton-Lane & Clarke 2014). The inclusion of advance statements within mental health legislation is acknowledged as a practice change that recognizes how mental health providers engage individuals who encounter mental health services, and value their preferences to care received (James et al 2019). However, the familiarity and knowledge mental health clinicians have of advance statements greatly affects their implementation within the mental health setting (James et al 2022).…”

Section: Introductionmentioning

confidence: 99%

“…The inclusion of advance statements within mental health legislation is acknowledged as a practice change that recognizes how mental health providers engage individuals who encounter mental health services, and value their preferences to care received (James et al . 2019). However, the familiarity and knowledge mental health clinicians have of advance statements greatly affects their implementation within the mental health setting (James et al .…”

Section: Introductionmentioning

confidence: 99%

Clinician knowledge and attitudes of mental health advance statements in Victoria, Australia

James

Maude

Searby

2022

Int J Mental Health Nurs

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Seclusion is used in forensic and general mental health settings to protect a person or others from harm. However, seclusion can result in trauma‐related harm and re‐traumatization with little known about the experience of seclusion for consumers in forensic mental health settings from their perspectives. This article explores consumer experiences of seclusion in forensic mental health settings and explores the differences between female and male experiences of seclusion. Five electronic databases were systematically searched using keywords and variations of experience, attitude, seclusion, coercion, forensic mental health, and forensic psychiatry. Inclusion criteria were original peer‐reviewed studies conducted in adult forensic mental health settings reporting data on the experiences of or attitudes towards seclusion. Seven studies met the criteria for inclusion and a quality assessment was undertaken. Results found consumers in forensic mental health settings perceive seclusion to be harmful, a punishment for their behaviour, and largely a negative experience that impacts their emotional health. Some consumers report positive experiences of seclusion. Differences in the experience of seclusion for females and males are unclear. Further research is required to understand the experience of seclusion for women in forensic mental health settings. Identification and consideration of differences in the experience of seclusion for males and females may assist in identifying sex‐specific interventions and may inform policy and practices to eliminate or reduce the trauma associated with seclusion use.

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Advance Statements within the Victorian Mental Health Setting: A Contextual and Legislative Global Comparison

Cited by 8 publications

References 42 publications

Mental health clinician training and experiences with utilization of advance statements in Victoria, Australia

Mental health clinician training and experiences with utilization of advance statements in Victoria, Australia

Shared Decision Making With Young People at Ultra High Risk of Psychotic Disorder

Clinician knowledge and attitudes of mental health advance statements in Victoria, Australia

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