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Advance statements: survey of patients' views and understanding

  • Jane Foy (a1), Alison Macrae (a2), Alex Thom (a3) and Ajay Macharouthu (a4)
Abstract
Aims and Method

A survey of patients was undertaken to determine their knowledge and understanding of advance statements (a new addition to Scottish mental health legislation introduced with the Mental Health (Care and Treatment) (Scotland) Act 2003). Few patients have taken up this facility and this study attempts to identify potential explanations.

Results

A minority of the initial 58 participants had heard of advance statements prior to the survey (5 of 58, 8.6%). After issuing information about advance statements, awareness and understanding increased significantly among those who completed the study, with 59% (16 of 27) now understanding the concept. The types of information that patients wished to be documented in an advance statement fell into two broad groups: treatment preferences and statements regarding loss of control and autonomy. Out of 27 participants 19 (70%) stated they would now consider drawing up an advance statement.

Clinical Implications

A lack of knowledge among patients about the existence of advance statements is highlighted. After a brief intervention, awareness, understanding and interest increased significantly, suggesting that poor uptake could be because of lack of awareness. Most participants would consult mental health professionals when drawing up an advance statement, therefore we have a responsibility to be fully informed about the process.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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HENDERSON, C., FLOOD, C., LEESE, M., et al (2004) Effect of joint crises plans on use of compulsory treatment in psychiatry: single blind randomised controlled trial. BMJ, 329, 136.
Mental Welfare Commission (2006) Summary of Quarterly Statistics Relating to the Mental Health (Care and Treatment) (Scotland) Act – 1 January to 31 March 2006. http://www.mwcscot.org.uk/Rights&TheLaw/Statistics/Statistics.asp
PAPAGEORGIOU, A., KING, M., JANMOHAMED, A., et al (2002) Advance directives for patients compulsorily admitted to hospital with serious mental illness: randomised controlled trial. British Journal of Psychiatry, 181, 513519.
Scottish Executive (2005) The New Mental Health Act. A Guide to Advance Statements. http://www.Scotland.gov.uk/Resource/Doc/26350/0012826.pdf
SWANSON, J., SWARTZ, M., FERRON, J., et al (2006) Psychiatric advance directives among public mental health consumers in five US cities: prevalence, demand and correlates. Journal of the American Academy of Psychiatry and Law, 34, 4357.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Advance statements: survey of patients' views and understanding

  • Jane Foy (a1), Alison Macrae (a2), Alex Thom (a3) and Ajay Macharouthu (a4)
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