A review of barriers to using psychiatric advance directives in clinical practice.

L.S. Shields, S.R. Pathare, A.J. van der Ham, J.G.F. Bunders-Aelen

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Despite advocacy and demand for psychiatric advance directives (PADs), uptake and implementation in clinical practice is low. We examine why PAD implementation has been difficult globally by reviewing barriers in existing evidence. The review includes 30 studies, and identified 13 barriers, clustered into system level barriers, health professional level barriers, and service user level barriers. The considerable barriers to uptake and implementation hamper PAD use. We propose several potential strategies for overcoming some of the barriers. In order to realise these strategies, additional research is needed, particularly more field-based and operational research to understand processes and difficulties experienced in clinical practice.
Original languageEnglish
Pages (from-to)753-766
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Volume41
Issue number6
DOIs
Publication statusPublished - 2014

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Advance Directives
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A review of barriers to using psychiatric advance directives in clinical practice. / Shields, L.S.; Pathare, S.R.; van der Ham, A.J.; Bunders-Aelen, J.G.F.

In: Administration and Policy in Mental Health and Mental Health Services Research, Vol. 41, No. 6, 2014, p. 753-766.

Research output: Contribution to JournalArticleAcademicpeer-review

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AU - Pathare, S.R.

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AU - Bunders-Aelen, J.G.F.

PY - 2014

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N2 - Despite advocacy and demand for psychiatric advance directives (PADs), uptake and implementation in clinical practice is low. We examine why PAD implementation has been difficult globally by reviewing barriers in existing evidence. The review includes 30 studies, and identified 13 barriers, clustered into system level barriers, health professional level barriers, and service user level barriers. The considerable barriers to uptake and implementation hamper PAD use. We propose several potential strategies for overcoming some of the barriers. In order to realise these strategies, additional research is needed, particularly more field-based and operational research to understand processes and difficulties experienced in clinical practice.

AB - Despite advocacy and demand for psychiatric advance directives (PADs), uptake and implementation in clinical practice is low. We examine why PAD implementation has been difficult globally by reviewing barriers in existing evidence. The review includes 30 studies, and identified 13 barriers, clustered into system level barriers, health professional level barriers, and service user level barriers. The considerable barriers to uptake and implementation hamper PAD use. We propose several potential strategies for overcoming some of the barriers. In order to realise these strategies, additional research is needed, particularly more field-based and operational research to understand processes and difficulties experienced in clinical practice.

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DO - 10.1007/s10488-013-0523-3

M3 - Article

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JO - Administration and Policy in Mental Health and Mental Health Services Research

JF - Administration and Policy in Mental Health and Mental Health Services Research

SN - 0894-587X

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