Psychiatric advance directives facilitated by peer workers among people with mental illness: economic evaluation of a randomized controlled trial (DAiP study)

Loubière, Sandrine; Loundou, Anderson; Auquier, Pascal; Tinland, Aurélie

doi:10.1017/s2045796023000197

Cited by 3 publications

(2 citation statements)

References 56 publications

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“…Peers with personal experiences of mental illness and recovery can provide unique insights, empathy and understanding of the developmental process. Peer support contributes to a more trusting and compassionate environment, which positively affects the mental health outcomes of service users (Loubière et al, 2023;Tinland et al, 2022).…”

Section: Facilitation By Peer Workersmentioning

confidence: 99%

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Advance statements in mental healthcare: time to close the evidence to practice gap

Lasalvia,

Patuzzo,

Braun

et al. 2023

Epidemiol Psychiatr Sci

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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.

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Section: Facilitation By Peer Workersmentioning

confidence: 99%

“…Peer support contributes to a more trusting and compassionate environment, which positively affects the mental health outcomes of service users (Loubière et al. , 2023 ; Tinland et al. , 2022 ).…”

Section: Benefits and Opportunitiesmentioning

confidence: 99%

Advance statements in mental healthcare: time to close the evidence to practice gap

Lasalvia,

Patuzzo,

Braun

et al. 2023

Epidemiol Psychiatr Sci

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Supported Decision‐Making Interventions in Mental Healthcare: A Systematic Review of Evidence on the Outcomes for People With Mental Ill Health

Francis,

Hazelton,

Wilson

2024

Health Expectations

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BackgroundMost people with mental ill health want to be involved in decision‐making about their care, many mental health professionals now recognise the importance of this (at least in‐principle) and the Convention on the Rights of Persons with Disabilities enshrines the ethical imperative to support people in making their own treatment decisions. Nonetheless, there are widespread reports of people with mental ill health being excluded from decision‐making about their treatment in practice.ObjectivesWe conducted a systematic review of quantitative, qualitative and mixed method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning. We sought to consolidate and understand the evidence on the outcomes of shared and supported decision‐making for people with mental ill health.MethodsSeven databases were searched and 5137 articles were screened. Articles were included if they reported on an intervention for adult service users, were published between 2008 and October 2023 and were in English. Evidence in the 140 included articles was synthesised according to the JBI guidance on Mixed Methods Systematic Reviews.ResultsThere was evidence relating to the effects of these interventions on a range of outcomes for people with mental ill health, including on: suicidal crisis, symptoms, recovery, hospital admissions, treatment engagement and on the use of coercion by health professionals. There is favourable evidence for these types of interventions in improving some outcomes for people with mental ill health, more so than treatment‐as‐usual. For other outcomes, the evidence is preliminary but promising. Some areas for caution are also identified.ConclusionsThe review indicates that when the involvement of people with mental ill health in treatment planning is supported, there can be improved outcomes for their health and care. Areas for future research are highlighted.Patient or Public ContributionThis systematic review has been guided at all stages by a researcher with experience of mental health service use, who does not wish to be identified at this point in time. The findings may inform organisations, researchers and practitioners on the benefits of implementing supported decision‐making, for the greater involvement of people with mental ill health in their healthcare.

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Joint Crisis Plan in Mental Health Settings: A Reflective Process More than an Intervention Tool?

Goulet,

Sergerie-Richard,

Dostie

et al. 2024

Healthcare

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Background/Objectives: Coercion in mental health is challenged, prompting reduction interventions. Among those, the Joint Crisis Plan (JCP), which aims to document individuals’ treatment preferences in case of future de-compensation, regardless of the potential loss of discernment, has been identified as a key path to study. Identified challenges related to its implementation highlight the need to adapt this intervention to the local context. Considering that in Quebec (Canada), the JCP is not widely used, but the scientific literature supports its adoption and corroborates its potential impact on reducing coercion, this study evaluates the feasibility, acceptability, and preliminary outcomes of the JCP among psychiatric and forensic inpatient settings. Methods: A pilot mixed-methods study was conducted through 16 individual interviews with inpatients and healthcare providers, combined with a pre–post analysis of seclusion and restraint use and the violence prevention climate (VPC) based on healthcare providers’ (n = 57) and inpatients’ perspectives (n = 53). Results: Although the challenging implementation of the JCP complicated the evaluation of its effects on seclusion and restraint use, a moderate change (d = 0.40) in the VPC was identified based on healthcare providers’ perspectives. Qualitative findings are also insightful to understand the acceptability and feasibility of the JCP use. A tension emerged between the perspectives of inpatients and healthcare providers: while inpatients valued the reflective process of completing the plan, providers focused more on its technical aspects. Conclusions: The results support the integration of the JCP into patient care pathways, as it provides a tool to amplify patients’ voices, promote patient empowerment, facilitate open dialog on alternatives to coercion, and foster more collaborative and humane mental health care.

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Psychiatric advance directives facilitated by peer workers among people with mental illness: economic evaluation of a randomized controlled trial (DAiP study)

Cited by 3 publications

References 56 publications

Advance statements in mental healthcare: time to close the evidence to practice gap

Advance statements in mental healthcare: time to close the evidence to practice gap

Supported Decision‐Making Interventions in Mental Healthcare: A Systematic Review of Evidence on the Outcomes for People With Mental Ill Health

Joint Crisis Plan in Mental Health Settings: A Reflective Process More than an Intervention Tool?

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