Skip to main content
×
×
Home

National survey of training of psychiatrists on advance directives to refuse treatment in bipolar disorder

  • Richard Morriss (a1), Mohan Mudigonda (a1), Peter Bartlett (a1), Arun Chopra (a2) and Steven Jones (a3)...
Abstract
Aims and method

To determine features associated with better perceived quality of training for psychiatrists on advance decision-making in the Mental Capacity Act 2005 (MCA), and whether the quality or amount of training were associated with positive attitudes or use of advance decisions to refuse treatment (ADRTs) by psychiatrists in people with bipolar disorder. An anonymised national survey of 650 trainee and consultant psychiatrists in England and Wales was performed.

Results

Good or better quality of training was associated with use of case summaries, role-play, ADRTs, assessment of mental capacity and its fluctuation. Good or better quality and two or more sessions of MCA training were associated with more positive attitudes and reported use of ADRTs, although many psychiatrists would never discuss them clinically with people with bipolar disorder.

Clinical implications

Consistent delivery of better-quality training is required for all psychiatrists to increase use of ADRTs in people with bipolar disorder.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      National survey of training of psychiatrists on advance directives to refuse treatment in bipolar disorder
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      National survey of training of psychiatrists on advance directives to refuse treatment in bipolar disorder
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      National survey of training of psychiatrists on advance directives to refuse treatment in bipolar disorder
      Available formats
      ×
Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Richard Morriss (richard.morriss@nottingham.ac.uk)
Footnotes
Hide All

Declaration of interest

None.

Footnotes
References
Hide All
1 Department for Constitutional Affairs. Mental Capacity Act (2005): Code of Practice. TSO (The Stationery Office), 2007.
2 Bartlett, P, Morriss, R, Mudigonda, M, Chopra, A, Jones, S. Advance decisions under the Mental Capacity Act 2005 in cases of bipolar disorder. J Soc Welfare Fam Law 2016; 38: 263–86.
3 House of Lords. Mental Capacity Act 2005: Post-Legislative Scrutiny. TSO (The Stationery Office), 2014.
4 Department of Health. Valuing Every Voice, Respecting Every Right: Making the Case for the Mental Capacity Act. Department of Health, 2014.
5 National Institute of Health and Clinical Excellence. Bipolar Disorder: The Assessment and Management of Bipolar Disorder in Adults, Children and Young People in Primary and Secondary Care (Clinical Guideline number 185). British Psychological Society and Royal College of Psychiatrists, 2014.
6 Dunlop, C, Sorinmade, O. Embedding the Mental Capacity Act 2005 in clinical practice: an audit review. Psychiatr Bull 2014; 38: 291–3.
7 Lepping, P, Stanly, T, Turner, J. Systematic review on the prevalence of lack of capacity in medical and psychiatric settings. Clin Med (Lond) 2015; 15: 337–43.
8 Swanson, JW, Swartz, MS, Elbogen, EB, Van Dorn, RA, Ferron, J, Wagner, HR, et al. Facilitated psychiatric advance directives: a randomized trial of an intervention to foster advance treatment planning among persons with severe mental illness. Am J Psychiatry 2006; 163: 1943–51.
9 Academy of Medical Royal Colleges. Mental Capacity Act. Academy of Medical Royal Colleges, 2017. Available at: http://www.aomrc.org.uk/quality-policy-delivery/improving-quality-and-standards/mental-capacity-act/ (accessed 6 Jun 2017).
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 1
Total number of PDF views: 32 *
Loading metrics...

Abstract views

Total abstract views: 113 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 16th August 2018. This data will be updated every 24 hours.

National survey of training of psychiatrists on advance directives to refuse treatment in bipolar disorder

  • Richard Morriss (a1), Mohan Mudigonda (a1), Peter Bartlett (a1), Arun Chopra (a2) and Steven Jones (a3)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *