Abstract
An innovative Virginia health care law enables competent adults with serious mental illness to plan for treatment during incapacitating
crises using an integrated advance directive with no legal distinction between psychiatric or other causes of decisional incapacity.
This article reports results of a survey of 460 individuals in five stakeholder groups during the initial period of the law’s
implementation. All respondents held favorable views of advance directives for mental health care. Identified barriers to
completing and using advance directives varied by group. We conclude that relevant stakeholders support implementation of
advance directives for mental health, but level of baseline knowledge and perception of barriers vary. A multi-pronged approach
will be needed to achieve successful implementation of advance directives for mental health.
crises using an integrated advance directive with no legal distinction between psychiatric or other causes of decisional incapacity.
This article reports results of a survey of 460 individuals in five stakeholder groups during the initial period of the law’s
implementation. All respondents held favorable views of advance directives for mental health care. Identified barriers to
completing and using advance directives varied by group. We conclude that relevant stakeholders support implementation of
advance directives for mental health, but level of baseline knowledge and perception of barriers vary. A multi-pronged approach
will be needed to achieve successful implementation of advance directives for mental health.
- Content Type Journal Article
- Category Original Article
- Pages 1-8
- DOI 10.1007/s10488-011-0401-9
- Authors
- Christine M. Wilder, Services Effectiveness Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 905 West Main Street, Box 54, Durham, NC 27701, USA
- Jeffrey W. Swanson, Services Effectiveness Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 905 West Main Street, Box 54, Durham, NC 27701, USA
- Richard J. Bonnie, Institute of Law, Psychiatry and Public Policy, University of Virginia School of Law, Charlottesville, VA, USA
- Tanya Wanchek, Institute of Law, Psychiatry and Public Policy, University of Virginia School of Law, Charlottesville, VA, USA
- Laura McLaughlin, Institute of Law, Psychiatry and Public Policy, University of Virginia School of Law, Charlottesville, VA, USA
- Jeanita Richardson, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
- Journal Administration and Policy in Mental Health and Mental Health Services Research
- Online ISSN 1573-3289
- Print ISSN 0894-587X