Janey's plain language summary blog: Advance treatment directives for people with severe mental illness
The interesting thing about the two studies in the Cochrane review on advance directives (and this is something the review cannot tell you) is that of all the people asked if they would like to take part in them, only about a third did...
And interestingly, a study done in Bradford where there was an attempt to allow all mental health service users to make an advance directive, very few did there too. This contrasts with Scotland where there is good take-up. But there, an advance directive is a legal part of their Mental Health Act; and if a doctor ignores it, he or she has to document in the patient’s notes why this was so. It’s a bit more complicated to set up a directive north of the border because someone has to sign to say you had the mental ability to make the decisions you’ve made (have capacity).
The two studies in the Cochrane review were done before the 2007 amendment to the (English and Welsh) Mental Health Act and advance directives are now in the code of practice. Maybe the thinking that psychiatrists won’t take any notice of them because they have no legal clout, no longer applies. I have one on my local mental health computer system saying how I would like to be treated in a crisis and it seems to work quite well most of the time.
Read my summary on Advance treatment directives for people with severe mental illness
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