Abstract
Psychiatric advance directives (ADs) allow service users to participate in their mental health care, but few are completed. This paper reports on factors that help and hinder AD completion. Perceived barriers included resource limitations, procedural issues, access and storage problems, and mistrust between clinicians and service users regarding their implementation. What seems to help includes having management and nursing “champions”, and organising outreach meetings for all interested parties. Targeted education and training promotes creation and use of ADs, addresses negative attitudes, and assists service users to create ADs. Information technology support is vital to having ADs uploaded and accessed.
Dr X has a research contract with Douglas Pharmaceuticals to develop novel formulations of ketamine. No other authors report competing interests.
Funding for this project was a grant from the James Hume Foundation.