Skip to main content
Log in

Front Line Workers’ Attitudes towards Psychiatric Advance Directives

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Studies have begun to explore provider attitudes’ toward psychiatric advance directives (PADs) and how those attitudes are related to provider characteristics. The study gathered attitudinal data from a sample of 193 social workers serving mentally ill adults. Social workers with pro-healthcare power of attorney (HCPA) attitudes were likely to have prior experience with an HCPA and to believe that involuntary treatment violates the NASW Code of Ethics. Social workers are more favorable of HCPAs than advance instructions. The findings suggest that clinical experiences with PADs may positively impact social worker’s perceptions of the law.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Allen, M. (2004). Hargrave v. Vermont and quality of care. Psychiatric Services, 55, 1067.

    Article  PubMed  Google Scholar 

  • Appelbaum, P. S. (2004a). Psychiatric advance directives and the treatment of committed patients. Psychiatric Services, 55, 751–752, 763.

    Google Scholar 

  • Appelbaum, P. S. (2004b). In reply: Hargrave v. Vermont and the quality of care. Psychiatric Services, 55, 1067–1068.

    Article  Google Scholar 

  • Atkinson, J., Garner, H., & Gilmour, W. (2004). Models of advance directives in mental health care. Social Psychiatry and Psychiatric Epidemiology, 39, 673–680.

    Article  PubMed  Google Scholar 

  • Backlar, P., McFarland, B., Swanson, J., & Mahler, J. (2001). Consumer, provider, and informal caregiver opinion of psychiatric advance directives. Administration and Policy in Mental Health, 28(6), 427–441.

    Article  PubMed  CAS  Google Scholar 

  • Bentley, K. J. (1993). The right of psychiatric patients to refuse medication: Where should social workers stand? Social Work, 38(1), 101–106.

    PubMed  Google Scholar 

  • Bowers, L., Clark, N., & Callaghan, P. (2003). Multidisciplinary reflections on assessment for compulsory admission: The views of approved social workers, general practitioners, ambulance crews, police, community psychiatric nurses and psychiatrists. British Journal of Social Work, 33, 961–968.

    Article  Google Scholar 

  • Busseri, M. A., & Tyler, J. D. (2003). Interchangeability of the working alliance inventory and working alliance inventory, short form. Psychological Assessment, 15(2), 193–197.

    Article  PubMed  Google Scholar 

  • Davis, S. (2002). Autonomy versus coercion: Reconciling competing perspectives in community mental health. Community Mental Health Journal, 38(3), 239–250.

    Article  PubMed  Google Scholar 

  • Elbogen, E. B., Swartz, M. S., Van Dorn, R., Swanson, J. W., Kim, M., & Scheyett, A. (in press). Clinician decision-making and attitudes on implementing psychiatric advance directives. Psychiatric Services.

  • Encandela, J. A., Korr, W., Lidz, C. W., Mulvey, E. P., & Slawinski, T. (1999). Discretionary use of involuntary commitment by case managers of mental health clients: A case study of divergent views. Clinical Social Work, 27(4), 397–411.

    Article  Google Scholar 

  • Ende, J., Kazis, L., Ash, A., & Moskowitz, M. (1989). Measuring patients’ desire for autonomy. Journal of General Internal Medicine, 4, 718–733.

    Article  Google Scholar 

  • Hansen, T., Hatling, T., Lidal, E., & Ruud, T. (2004). The user perspective: Respected or rejected in mental health care? Journal of Psychiatric and Mental Health Nursing, 11, 292–297.

    Article  PubMed  CAS  Google Scholar 

  • Happell, B., Pinikahana, J., & Roper, C. (2002). Attitudes of postgraduate nursing students towards consumer participation in mental health services and the role of the consumer academic. Interational Journal of Mental Health Nursing, 11, 240–250.

    Article  Google Scholar 

  • Hashimoto, H. (2004). The influence of locus of control on preferences for information and decision making. Patient Education and Counseling, 55(2), 236–242.

    Article  PubMed  Google Scholar 

  • Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36(2), 223–233.

    Article  Google Scholar 

  • Joshi, K. G. (2003). Psychiatric advance directives. Journal of Psychiatric Practice, 9, 303–306.

    Article  PubMed  Google Scholar 

  • Keefe, B., & Pinals, D. A. (2004). Durable power of attorney for psychiatric care. Journal of the American Academy of Psychiatry & the Law, 32, 202–204.

    Google Scholar 

  • Kent, H., & Read, J. (1998). Measuring consumer participation in mental health services: Are attitudes related to professional orientation? International Journal of Social Psychiatry, 44(4), 295–310.

    Article  PubMed  CAS  Google Scholar 

  • Lepping, P., Steinert, T., Gebhardt, R.-P., & Rottgers, H. R. (2004). Attitudes of mental health professionals and lay-people towards involuntary admission and treatment in England and Germany—a questionnaire analysis. European Psychiatry, 19, 91–95.

    Article  PubMed  Google Scholar 

  • Manderscheid, R. W., & Henderson, M. J. (Eds.). (2001). Mental health, united states, 2000. Center for Mental Health Services. DHHS Pub No. (SMA) 01-3537. Washington, DC: Supt. of Docs., U.S. Govt. Print. Off., 2001.

  • Reinardy, J. (1999). Autonomy choice and decision making: How nursing home social workers view their roles. Social Work in Health Care, 29(3), 59–77.

    Article  PubMed  CAS  Google Scholar 

  • Scheid, T. L. (1994). An explication of treatment ideology among mental health care providers. Sociology of Health & Illness, 16(5), 668–693.

    Article  Google Scholar 

  • Srebnik, D., & LaFond, J. (1999). Advance directives for mental health treatment. Psychiatric Services, 50, 919–925.

    PubMed  CAS  Google Scholar 

  • Srebnik, D., Russo, J., Sage, J., Peto, T., & Zick, E. (2003). Interest in psychiatric advance directives among high users of crisis services and hospitalization. Psychiatric Services, 54(7), 981–986.

    Article  PubMed  Google Scholar 

  • Swanson, J., Swartz, M., Hannon, M., Elbogen, E., Wagner, H., McCauley, B., et al. (2003). Psychiatric advance directives: A survey of persons with schizophrenia, family members, and treatment providers. International Journal of Forensic Mental Health, 2, 73–86.

    Google Scholar 

  • Swanson J. W., Tepper M. C., Backlar P., & Swartz, M. S. (2000). Psychiatric advance directives: An alternative to coercive treatment? Psychiatry, 63(2), 160–172.

    PubMed  CAS  Google Scholar 

  • Taylor, M. F. (submitted for publication). Social workers and involuntary treatment in mental health.

  • Taylor, M. F., & Bentley, K. J. (In press) Professional dissonance: Colliding values and job tasks in mental health practice.

  • Tower, K. D. (1994). Consumer-centered social work practice: Restoring client self-determination. Social Work, 39(2), 191–196.

    PubMed  CAS  Google Scholar 

  • Van Dorn, R. A., Swartz, M. S., Elbogen, E. B., Swanson, J. W., Kim, M., Ferron, J., McDaniel, L. A., & Scheyett, A. M. (2006). Clinicians’ attitudes regarding barriers to the implementation of Psychiatric Advance Directives. Administration and Policy in Mental Health and Mental Health Services Research, 33(4), 449–460.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by the Greenwall and MacArthur Foundations, a National Research Service Award Postdoctoral Traineeship from the NIMH to Drs. Kim and VanDorn and NIMH K02 to Dr. Swanson. The corresponding author was also supported, in part, by the DHHS Agency for Healthcare Research and Quality (R24 HS013353) and the NIH National Center on Minority Health and Health Disparities (P60 MD000239)

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mimi M. Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, M.M., Scheyett, A.M., Elbogen, E.B. et al. Front Line Workers’ Attitudes towards Psychiatric Advance Directives. Community Ment Health J 44, 28–46 (2008). https://doi.org/10.1007/s10597-007-9104-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-007-9104-9

Keywords

Navigation