Psychiatric Bulletin (2007) 31: 339-341. doi: 10.1192/pb.bp.106.013599
© 2007 The Royal College of Psychiatrists
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Advance statements: survey of patients’ views and understanding

Jane Foy, Senior House Officer in Old Age Psychiatry

Royal Alexandra Hospital, Paisley, email: yofenaj{at}hotmail.com

Alison MacRae, Specialist Registrar in General Adult Psychiatry

Stobhill Hospital, Glasgow

Alex Thom, Consultant in General Adult Psychiatry

Dykebar Hospital, Paisley

Ajay Macharouthu, Specialist Registrar in Old Age Psychiatry

Southern General Hospital, Glasgow

Declaration of interest

None.

AIMS AND METHOD

A survey of patients was undertaken to determine their knowledge and understanding of advance statements (a new addition to Scottish mental health legislation introduced with the Mental Health (Care and Treatment) (Scotland) Act 2003). Few patients have taken up this facility and this study attempts to identify potential explanations.

RESULTS

A minority of the initial 58 participants had heard of advance statements prior to the survey (5 of 58, 8.6%). After issuing information about advance statements, awareness and understanding increased significantly among those who completed the study, with 59% (16 of 27) now understanding the concept. The types of information that patients wished to be documented in an advance statement fell into two broad groups: treatment preferences and statements regarding loss of control and autonomy. Out of 27 participants 19 (70%) stated they would now consider drawing up an advance statement.

CLINICAL IMPLICATIONS

A lack of knowledge among patients about the existence of advance statements is highlighted. After a brief intervention, awareness, understanding and interest increased significantly, suggesting that poor uptake could be because of lack of awareness. Most participants would consult mental health professionals when drawing up an advance statement, therefore we have a responsibility to be fully informed about the process.




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