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Sessions Can Help Mentally Ill Complete Advance Directives

Many of these patients desire advance directives, but few complete them without help

FRIDAY, Nov. 3 (HealthDay News) -- Facilitated sessions can increase the use of advance directives by patients with severe mental illness so that they can pre-establish their treatment preferences in the event they become incapacitated, according to results from a randomized, controlled trial published in the November issue of the American Journal of Psychiatry.

In the study, Jeffrey Swanson, Ph.D., from Duke University Medical Center in Durham, N.C., and colleagues looked at how structured facilitation can improve implementation and completion of advance directives, as well as what patient characteristics predict completion, and how advance directives might have a secondary benefit of improving patient care.

Among the 469 study patients with severe mental illness, 61 percent of patients randomized to a structured session completed an advance directive or authorized a surrogate decision-maker compared with only 3 percent of control participants.

"The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients' treatment preferences," the authors write. "Achieving the promise of psychiatric advance directives may require system-level policies to embed facilitation of these instruments in usual-care care settings."

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