Mental health nurses’ perspectives on psychiatric advance directives
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Mental health nurses’ perspectives on psychiatric advance directives

Conor Quinlan Member of the assertive outreach team of South Lee Mental Health Services, University College Cork, Ireland
Alice Coffey Lecturer, School of Nursing and Midwifery, University College Cork, Ireland

Conor Quinlan and Alice Coffey found participants in a study welcomed the empowerment of service users in their own care, but staff need appropriate training to cover the legal implications

Background Psychiatric advance directives (PADs) are written statements that allow people with mental illness to state their treatment preferences and exercise control over future health interventions.

Aim To explore mental health nurses’ perspectives on psychiatric advance directives in Ireland.

Methods A qualitative design comprising individual interviews supported by an interview guide, conducted with seven mental health nurses in Ireland. Data were subjected to thematic analysis.

Findings Themes identified were perceived benefits, perceived risks and barriers to implementation of PADs. Participants were supportive of PADs particularly as related to client autonomy. However, lack of training, risks of legal liability and service users’ competence were of concern.

Conclusions Mental health nurses in Ireland welcome PADs but report inadequate knowledge and confidence. Training is needed and clear guidelines, policy and legal basis for implementation of PADS. Service users, their families, carers and advocates should be involved in the process as well as related healthcare professionals.

Mental Health Practice. 18, 7, 25-30. doi: 10.7748/mhp.18.7.25.e984


Peer review

This article has been subject to double blind peer review

Conflict of interest

None declared

Received: 29 March 2014

Accepted: 04 July 2014

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