Advance statements in mental healthcare: time to close the evidence to practice gap
This article discusses advance statements in mental health care, which allow individuals with mental disorders to express their preferences for treatment during mental health crises. Despite the evidence supporting their effectiveness, their implementation in clinical practice remains limited. This...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-01-01
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| Series: | Epidemiology and Psychiatric Sciences |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2045796023000835/type/journal_article |
| _version_ | 1797403346027413504 |
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| author | Antonio Lasalvia Sara Patuzzo Esther Braun Claire Henderson |
| author_facet | Antonio Lasalvia Sara Patuzzo Esther Braun Claire Henderson |
| author_sort | Antonio Lasalvia |
| collection | DOAJ |
| description | This article discusses advance statements in mental health care, which allow individuals with mental disorders to express their preferences for treatment during mental health crises. Despite the evidence supporting their effectiveness, their implementation in clinical practice remains limited. This article explores variations among advance statements, such as psychiatric advance directives (PADs), joint crisis plans (JCPs) and self-binding directives (SBDs), highlighting their content, development process and legal status. We outline the benefits of advance statements, including empowerment, early intervention, improved therapeutic relationships and reduced compulsory admissions. We then draw attention to the challenges that may contribute to their lack of implementation, including legal complexities, communication issues, cultural factors, potential inequities, healthcare provider knowledge, changing preferences, resource constraints, crisis responses, data privacy, family involvement, and long-term evaluation. In conclusion, advance statements offer significant benefits but require addressing these critical aspects to ensure ethical and effective use. Bridging the evidence-to-practice gap is essential, with a focus on implementation science. Integrating these tools into routine clinical practice can significantly benefit individuals with severe mental disorders and mental health systems. |
| first_indexed | 2024-03-09T02:37:24Z |
| format | Article |
| id | doaj.art-57769da3807e4ad196bcc9f7df0776fc |
| institution | Directory Open Access Journal |
| issn | 2045-7960 2045-7979 |
| language | English |
| last_indexed | 2024-03-09T02:37:24Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Epidemiology and Psychiatric Sciences |
| spelling | doaj.art-57769da3807e4ad196bcc9f7df0776fc2023-12-06T08:13:01ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792023-01-013210.1017/S2045796023000835Advance statements in mental healthcare: time to close the evidence to practice gapAntonio Lasalvia0https://orcid.org/0000-0001-9963-6081Sara Patuzzo1Esther Braun2Claire Henderson3https://orcid.org/0000-0002-6998-5659Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, ItalyDepartment of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, ItalyInstitute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany Department of Philosophy, University of Oxford, Oxford, UKHealth Service and Population Research Department P029, David Goldberg Centre, King’s College London Institute of Psychiatry, London, UKThis article discusses advance statements in mental health care, which allow individuals with mental disorders to express their preferences for treatment during mental health crises. Despite the evidence supporting their effectiveness, their implementation in clinical practice remains limited. This article explores variations among advance statements, such as psychiatric advance directives (PADs), joint crisis plans (JCPs) and self-binding directives (SBDs), highlighting their content, development process and legal status. We outline the benefits of advance statements, including empowerment, early intervention, improved therapeutic relationships and reduced compulsory admissions. We then draw attention to the challenges that may contribute to their lack of implementation, including legal complexities, communication issues, cultural factors, potential inequities, healthcare provider knowledge, changing preferences, resource constraints, crisis responses, data privacy, family involvement, and long-term evaluation. In conclusion, advance statements offer significant benefits but require addressing these critical aspects to ensure ethical and effective use. Bridging the evidence-to-practice gap is essential, with a focus on implementation science. Integrating these tools into routine clinical practice can significantly benefit individuals with severe mental disorders and mental health systems.https://www.cambridge.org/core/product/identifier/S2045796023000835/type/journal_articlecommunity mental healthdiscriminationethicsrights of persons with disabilitiessocial and political issues |
| spellingShingle | Antonio Lasalvia Sara Patuzzo Esther Braun Claire Henderson Advance statements in mental healthcare: time to close the evidence to practice gap Epidemiology and Psychiatric Sciences community mental health discrimination ethics rights of persons with disabilities social and political issues |
| title | Advance statements in mental healthcare: time to close the evidence to practice gap |
| title_full | Advance statements in mental healthcare: time to close the evidence to practice gap |
| title_fullStr | Advance statements in mental healthcare: time to close the evidence to practice gap |
| title_full_unstemmed | Advance statements in mental healthcare: time to close the evidence to practice gap |
| title_short | Advance statements in mental healthcare: time to close the evidence to practice gap |
| title_sort | advance statements in mental healthcare time to close the evidence to practice gap |
| topic | community mental health discrimination ethics rights of persons with disabilities social and political issues |
| url | https://www.cambridge.org/core/product/identifier/S2045796023000835/type/journal_article |
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