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Psychiatric Advance Directives

Psychiatric advance directives (PADs) allow competent persons to document advance instructions for their future mental health treatment or designate a health care agent to make decisions for them in the event of an incapacitating psychiatric crisis. PADs may enhance patient self-determination, improve therapeutic alliance, and prevent psychiatric crises; however, there are a number of legal, ethical, and logistical barriers preventing the effective implementation of PAD laws. Research shows that most people with mental illness would want a PAD if they received help and that a manualized facilitation increased completion and understanding of PADs as well as improved working alliance and perceived met treatment need. Studies also show that people with mental illness incorporate clinically useful information in PADs but that much more work is needed ...

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