Abstract
Advance directives allow users of mental health services to make statements for their future care. In New Zealand, their use is supported by the Health and Disability Commissioner, and was identified in the Disability Action Plan 2014-2018 as a key mechanism for advancing the human rights of people under the MHA. This study used a qualitative descriptive methodology involving focus groups to explore the perceptions of service users, whānau and peer support workers concerning advance directives. Thematic analysis revealed certain belief patterns about what should or could be included in an advance directive, and about how and with whom one should be created. It revealed generally positive perceptions about how they can uphold service users’ right to have preferences considered, to plan flexibly around dynamic needs, and about their value and utility. We conclude that advance directives can support services users’ expressions of their preferences for care, but they need to be supported by clinicians if they are to realise this potential. Our findings can also inform service provision in New Zealand, and the planned reform of the MHA.