nursingforsocialjustice

Advance care planning for times when someone who is involved in the mental health system is in acute crisis is not a new idea in mental health care. Psychiatric advance directives can decrease the perceived coercion of the patient and increase their feelings of empowerment (Khazaal, Manghi, Delahaye, Machado, Penzenstadler, & Molodynski, 2014). The psychiatric advance directive allows the person to have some input in to their preferences when acute crisis strikes, the time when they are not longer in the mental space to make decisions about treatment preferences (like preference of chemical verus environmental versus mechanical restraint). This is not a novel idea, but it might be something that can be better integrated into the care being provided, especially within the care plans of community teams that coordinate care (Easter, Swanson, Robertson, Moser & Swartz, 2016). Sometimes I feel like there is so much focus on crisis management that the focus on improvement care becomes secondary, which is unfortunate. I think that sometimes this really distorts the health care providers perception of what “good” care is and the possibilities of not just preserving relationships and therapeutic rapport, but actually improving it and building trust.

Peace,

Michelle D.

References

Easter, M., Swanson, J. W., Robertson, A. G., Moser, L., & Swartz, M. (2016). Facilitation of Psychiatric Advance Directives by Peers and Clinicians on Assertive Community Treatment Teams.

Khazaal, Y., Manghi, R., Delahaye, M., Machado, A., Penzenstadler, L., & Molodynski, A. (2014). Psychiatric advance directives, a possible way to overcome coercion and promote empowerment. Frontiers in public health, 2, 37.