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Backlar, Patricia; McFarland, Bentson H.; Swanson, Jeffrey W.; Mahler, Jo

doi:10.1023/a:1012214807933

Cited by 81 publications

(11 citation statements)

References 14 publications

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“…The specification of persons to be notified upon hospitalization, preferences for cultural support and methods of escalation in emergencies were items rated most highly across both groups. Similar to other studies in this area (Atkinson et al 2004;Backlar & McFarland 1996;Backlar et al 2001;Swanson et al 2003;2007;Swartz et al 2005;Wilder et al 2012), service users and clinicians varied in opinions when it came to the consideration of coercive measures used in mental health services. Only a third of clinicians, for example, agreed that service users should be able to refuse seclusion via their advance directives.…”

Section: Discussionsupporting

confidence: 53%

“…Other studies suggested that advance care planning gave service users an increased perception of empowerment. Henderson et al (2009) reported that service users showed an increase in perceived hope and self-determination upon completing a joint crisis plan and Backlar et al (2001) reported similar findings, whereby service users reported a feeling of empowerment upon completion of a PAD. Both of these studies found, however, that the initial sense of increased empowerment was often followed by less positive feelings, which may be indicative of the powerlessness service users felt in relation to compulsory treatment.…”

Section: Literature Reviewmentioning

confidence: 75%

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Service user and clinical perspectives of psychiatric advance directives in New Zealand

Thom

O’Brien

Tellez

2015

Int J Mental Health Nurs

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Advance care planning is becoming an increasingly important feature of health service provision. Although the New Zealand Mental Health Commission has advocated strongly for the provision of advance directives in mental health services, little is known about clinician or service user views on advance directives. The aim of the study was to survey the perspectives of service users and clinicians on the use of psychiatric advance directives. The study used an anonymous online survey to collect data from 110 mental health service users and 175 clinicians. Survey items included existing knowledge, preferred content and potential benefits of advance directives. Descriptive statistics and intergroup comparisons were conducted. Over 90% of service users and clinicians agreed that they support advance directives in mental health. There were similarities in the preferred content of an advance directive across the two groups, particularly regarding the notification of support persons, cultural support and preferred methods of de-escalation. Significant differences in opinion were found regarding the use of coercive measures and the ability of mental health legislation to override advance directives. The results indicate strong support for the use of advance directives within New Zealand mental health services, as well as for further research in the area.

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Section: Discussionsupporting

confidence: 53%

Section: Literature Reviewmentioning

confidence: 75%

Service user and clinical perspectives of psychiatric advance directives in New Zealand

Thom

O’Brien

Tellez

2015

Int J Mental Health Nurs

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“…Home treatment team care had the benefit of allowing service users to retain a sense of control and enabling participation in ‘normal’ activities. In contrast to clinicians’ concerns described in the literature [14, 19–22], less than half of the service users made a refusal and where there were refusals, valid alternatives were usually presented. Furthermore, while there were some refusals relating to medication and hospitalisation, these treatments were amongst the preferences for some service users, usually at specified stages of relapse.…”

Section: Discussionmentioning

confidence: 96%

“…However, service users have expressed doubts regarding the implementation of their statements [18], and studies suggest that clinicians are concerned that service users will refuse all treatment, or make choices counter to good practice guidelines [14, 19–22]. …”

Section: Introductionmentioning

confidence: 99%

What service users with psychotic disorders want in a mental health crisis or relapse: thematic analysis of joint crisis plans

Farrelly

Brown

Rose

et al. 2014

Soc Psychiatry Psychiatr Epidemiol

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PurposeRecent legislation and guidance in England emphasises the importance of service user choice in care planning. However, it is not obvious how best to facilitate choices in care planning, and some clinicians are concerned that service users may make ‘unwise’ decisions. This study aimed to examine mental health service users’ preferences and priorities in the event of a future mental health crisis or relapse.MethodThematic analysis of 221 joint crisis plans (JCP) developed by service users and their clinical team as part of the CRIMSON randomised controlled trial. Participants had a diagnosis of a psychotic disorder, at least one psychiatric admission in the past 2 years, contact with a community mental health team, and complex care needs.ResultsTwo major categories of preferences were identified: first the manner in which crisis care would be delivered; and second, specific treatment interventions. Most service users requested full involvement in decisions about their care, clear and consistent treatment plans, access to familiar clinicians who knew them well, and to be treated with respect and compassion. Some service users requested hospitalisation, but the majority preferred alternatives. The most frequently preferred intervention was care by a home treatment team. Just under half made a treatment refusal, the majority being for specific medications, alternatives were offered.ConclusionsJoint crisis planning resulted in service users making choices that were clinically reasonable. The technique employed by JCPs appeared to empower service users by engaging them in a productive dialogue with their clinicians.

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“…Arising from the recovery movement, empowerment in mental health services (Anthony, 1993) remains an integral part of the rationale for PADs (Backlar, McFarland, Swanson, & Mahler, 2001). In this context, empowerment is viewed as exerting control over multiple domains of one’s life (Rappaport, 1987).…”

Section: Historical Context Of the Development Of Padsmentioning

confidence: 99%

Psychiatric Advance Directives and Social Workers: An Integrative Review

et al. 2010

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Psychiatric Advance Directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and to authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs are viewed as an alternative to the coercive interventions that sometimes accompany mental health crises for persons with mental illness. Insofar as coercive interventions can abridge clients' autonomy and self-determination --values supported by the Profession's Code of Ethics --social workers have a vested interest in finding ways to reduce coercion and increase autonomy and self-determination in their practice. However, PADs are also viewed as having the potential to positively affect a variety of other clinical outcomes, including but not limited to treatment engagement, treatment satisfaction, and working alliance. This article reviews the clinical and legal history of PADs and empirical evidence for their implementation and effectiveness. Despite what should be an inherent interest in PADs, and the fact that laws authorizing PADs have proliferated in the past decade, there is little theoretical or empirical research in the social work literature.

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Untitled

Cited by 81 publications

References 14 publications

Service user and clinical perspectives of psychiatric advance directives in New Zealand

Service user and clinical perspectives of psychiatric advance directives in New Zealand

What service users with psychotic disorders want in a mental health crisis or relapse: thematic analysis of joint crisis plans

Psychiatric Advance Directives and Social Workers: An Integrative Review

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