Administration and Policy in Mental Health and Mental Health Services Research

, Volume 35, Issue 4, pp 272–282

Use of Psychiatric Advance Directives During Psychiatric Crisis Events

Authors

    • Department of Psychiatry and Behavioral SciencesUniversity of Washington/Harborview Medical Center
  • Joan Russo
    • Department of Psychiatry and Behavioral SciencesUniversity of Washington/Harborview Medical Center
Original Paper

DOI: 10.1007/s10488-008-0172-0

Cite this article as:
Srebnik, D. & Russo, J. Adm Policy Ment Health (2008) 35: 272. doi:10.1007/s10488-008-0172-0

Abstract

This paper presents the first empirical data regarding the rates and predictors of using psychiatric advance directives. Directives were accessed in only 20% of crisis events for the 69 participants selected on the basis of frequent use of psychiatric emergency and hospital services. Directives were 10 times more likely to be accessed when a surrogate decision-maker was involved in the crisis event. Directives were also more likely to be accessed over time and for people who had repeated crises, fewer prior hospitalizations, no substance use, and no prior outpatient commitment orders. Creation of more directives to increase clinician and system familiarity and more consistent appointment of surrogate decision-makers could increase use of directives.

Keywords

Psychiatric advance directivesMental health advance directivesAdvance directives

Copyright information

© Springer Science+Business Media, LLC 2008