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How Should we Implement Psychiatric Advance Directives? Views of Consumers, Caregivers, Mental Health Providers and Researchers

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Abstract

The aim of this study was to measure expert consensus on the implementation of Psychiatric Advance Directives (PADs) within the Veterans Health Administration. We conducted a two-round Delphi study with 55 panelists including consumers, caregivers, mental health providers and researchers. For a number of items where no positive or negative consensus was reached we found differences between the views of consumers and non-consumers, reflecting consumer’s preferences for nonmedical settings for completion and assistance with completion independent of the treatment team. Thus, the principle of consumer choice that applies to MHAD content should also be applied to the process of completion offered.

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Acknowledgments

We wish to thank Andrea Jamison, PhD, James J Peters VA Medical Center; Antonette Zeiss, PhD, VA Central Office; Robert A. Pearlman, MD, MPH, Chief, Ethics Evaluation, National Center for Ethics in Health Care (VHA) and Ruth Cecire, PhD, Policy Analyst, National Center for Ethics in Health Care for providing the draft worksheets and information on the plans for implementation of the VA MHAD; Daniel Herman, PhD, and Helen Rasmussen, M.S.W., for comments on drafts of the questionnaire. Michaela Amering, Patricia Backlar, Toni Beard, Tom Berger, Daniel Bradford, Loretta Braxton, Roy Brown, Jennifer Bucci, William Crandell, Deb Define, Dianna Dragatsi, Eric Elbogen, Ann Feder, Chris Flood, Mary Ellen Foti, Bert Harvey, John Hendershot, Peggy Henderson, Scott Hicks, Shirley Holland, Teresa Isner, Thomas Kallert, Miriam Keith, Mimi Kim, Lona King, Doreen Krodel, Rufina Lee, Stephanie LeMelle, Miklos Losonczy, David Lowenthal, James McDonagh, Hunter McQuistion, Susan Mirch-Kertschmann, Mary Nettle, Maria O’Connell, consumer advocate (name withheld), Melody Riefer, Diana Rose, Jana Spalding, Kim Sutherby, Jeffrey Swanson, Marvin Swartz, George Szmukler, John Tatarakis, Gaila Taylor, Crescent Terry, Graham Thornicroft, Richard van Dorn, Colleen Vaughan, Kendra Weaver, Jacqueline Woo, Carol Youtz, Laura Ziegler, Martin Zinkler. The views expressed in this article are those of the authors and do not necessarily reflect the positions or policies of affiliated institutions. This study was supported by the Department of Veterans Affairs Health Services Research and Development Service # SHP-08-163 and by a Department of Veterans Affairs Research Career Development Award to the last author #RCD-06-020. James J. Peters in VA Medical Center at that time the study was conducted.

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Author notes

  1. Carlos Jackson

    Present address: New York State Psychiatric Institute, Columbia University, New York, NY, USA

Authors and Affiliations

  1. P029, Health Service and Population Research Department, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, UK

    Claire Henderson & Mike Slade

  2. James J. Peters VA Medical Center, Bronx, NY, USA

    Claire Henderson & Carlos Jackson

  3. Greater Los Angeles VA and University of California Los Angeles, Los Angeles, CA, USA

    Alexander S. Young

  4. Durham VA and Duke University Medical Centers, Durham, NC, USA

    Jennifer L. Strauss

Authors
  1. Claire Henderson
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  2. Carlos Jackson
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  3. Mike Slade
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  4. Alexander S. Young
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  5. Jennifer L. Strauss
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Corresponding author

Correspondence to Claire Henderson.

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Henderson, C., Jackson, C., Slade, M. et al. How Should we Implement Psychiatric Advance Directives? Views of Consumers, Caregivers, Mental Health Providers and Researchers. Adm Policy Ment Health 37, 447–458 (2010). https://doi.org/10.1007/s10488-010-0264-5

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  • DOI: https://doi.org/10.1007/s10488-010-0264-5

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