According to a study from the United States, 'Psychiatric advance directives are intended to enable self-determined treatment for patients who lose decisional capacity, and thus reduce the need for coercive interventions such as police transport, involuntary commitment, seclusion and restraints, and involuntary medications during mental health crises; whether PADs can help prevent the use of these interventions in practice is unknown. This study examined whether completion of a Facilitated Psychiatric Advance Directive (F-PAD) was associated with reduced frequency of coercive crisis interventions.'
'The study prospectively compared a sample of PAD completers (n = 147) to non-completers (n = 92) on the frequency of any coercive interventions, with follow-up assessments at 6, 12, and 24 months. Repeated-measures multiple regression analysis was used to estimate the effect of PADs. Models controlled for relevant covariates including a propensity score for initial selection to PADs, baseline history of coercive interventions, concurrent global functioning and crisis episodes with decisional incapacity. F-PAD completion was associated with lower odds of coercive interventions (adjusted OR = 0.50; 95% CI = 0.26-0.96; p< 0.05). PADs may be an effective tool for reducing coercive interventions around incapacitating mental health crises,' wrote J.W. Swanson and colleagues, Duke University, Medical Department (see also Mental Health).
The researchers concluded: 'Less coercion should lead to greater autonomy and self-determination for people with severe mental illness.'
Swanson and colleagues published the results of their research in the Journal of Mental Health (Psychiatric advance directives and reduction of coercive crisis interventions. Journal of Mental Health, 2008;17(3):255-267).
For additional information, contact J.W. Swanson, Duke University, School Medical, Dept. of Psychiatry & Behavioral Science, DUMC 3071, Durham, NC 27710, USA.
The publisher of the Journal of Mental Health can be contacted at: Informa Healthcare, Telephone House, 69-77 Paul Street, London EC2A 4LQ, England.
Keywords: United States, Durham, Mental Health, Psychiatric, Psychiatry, Duke University, Medical Department.
This article was prepared by Biotech Week editors from staff and other reports. Copyright 2008, Biotech Week via NewsRx.com.
