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Impact of psychiatric advance directive facilitation on mental health consumers: empowerment, treatment attitudes and the role of peer support specialists.

Publication ,  Journal Article
Easter, MM; Swanson, JW; Robertson, AG; Moser, LL; Swartz, MS
Published in: J Ment Health
October 2021

BACKGROUND: A psychiatric advance directive (PAD) is designed to prevent involuntary mental health interventions by enabling people with serious mental illnesses to plan ahead for their own treatment during a future incapacitating crisis. This study implemented PAD facilitation in assertive community treatment (ACT) teams. AIMS: We examined ACT clients' attitudes toward PAD facilitators, satisfaction with PAD facilitation, the short-term impact of PAD completion on subjective sense of empowerment and attitudes toward treatment, and whether the type of PAD facilitator made a difference. METHODS: Participants were randomly assigned to be offered PAD facilitation by a peer support specialist or non-peer ACT team clinician, and interviewed at baseline (n = 145) and post-facilitation 1-2-month follow-up (n = 116), to assess perceived consumer-directedness of PAD facilitation, empowerment and various treatment attitudes. Mean scores before and after the intervention were compared for PAD-completers, non-completers, and those who completed a PAD with a peer vs. non-peer. The effect of PAD completion was assessed using logistic and linear regression analysis. RESULTS: There was no evidence of bias against peer-facilitators. There was a modest positive impact of PAD facilitation on treatment attitudes and empowerment. CONCLUSIONS: PAD facilitation by peer support specialists and others working in community mental health settings supports recovery.

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Published In

J Ment Health

DOI

EISSN

1360-0567

Publication Date

October 2021

Volume

30

Issue

5

Start / End Page

585 / 593

Location

England

Related Subject Headings

  • Specialization
  • Psychiatry
  • Peer Group
  • Patient Satisfaction
  • Patient Care Planning
  • Mental Health
  • Mental Disorders
  • Humans
  • Health Knowledge, Attitudes, Practice
  • Empowerment
 

Citation

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Easter, M. M., Swanson, J. W., Robertson, A. G., Moser, L. L., & Swartz, M. S. (2021). Impact of psychiatric advance directive facilitation on mental health consumers: empowerment, treatment attitudes and the role of peer support specialists. J Ment Health, 30(5), 585–593. https://doi.org/10.1080/09638237.2020.1714008
Easter, Michele M., Jeffrey W. Swanson, Allison G. Robertson, Lorna L. Moser, and Marvin S. Swartz. “Impact of psychiatric advance directive facilitation on mental health consumers: empowerment, treatment attitudes and the role of peer support specialists.J Ment Health 30, no. 5 (October 2021): 585–93. https://doi.org/10.1080/09638237.2020.1714008.
Easter, Michele M., et al. “Impact of psychiatric advance directive facilitation on mental health consumers: empowerment, treatment attitudes and the role of peer support specialists.J Ment Health, vol. 30, no. 5, Oct. 2021, pp. 585–93. Pubmed, doi:10.1080/09638237.2020.1714008.

Published In

J Ment Health

DOI

EISSN

1360-0567

Publication Date

October 2021

Volume

30

Issue

5

Start / End Page

585 / 593

Location

England

Related Subject Headings

  • Specialization
  • Psychiatry
  • Peer Group
  • Patient Satisfaction
  • Patient Care Planning
  • Mental Health
  • Mental Disorders
  • Humans
  • Health Knowledge, Attitudes, Practice
  • Empowerment