© 2002 The Royal College of Psychiatrists
Advance directives for patients compulsorily admitted to hospital with serious mental illness
Randomised controlled trial
Royal Free and University College Medical School, London, UK
University of Otago, Dunedin, New Zealand
Correspondence: Professor M. King, Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK. E-mail: m.king{at}rfc.ucl.ac.uk
Funding detailed in Acknowledgements.
Background An advance directive is a statement of a person's preferences for treatment, should he or she lose capacity to make treatment decisions in the future.
Aims To evaluate whether use of advance directives by patients with mental illness leads to lower rates of compulsory readmission to hospital.
Method In a randomised controlled trial in two psychiatric services in inner London, 156 in-patients about to be discharged from compulsory treatment under the Mental Health Act were recruited. The trial compared usual psychiatric care with usual care plus the completion of an advance directive. The primary outcome was the rate of compulsory readmission.
Results Fifteen patients (19%) in the intervention group and 16 (21%) in the control group were readmitted compulsorily within 1 year of discharge. There was no difference in the numbers of compulsory readmissions, numbers of patients readmitted voluntarily, days spent in hospital or satisfaction with psychiatric services.
Conclusions Users' advance instruction directives had little observable impact on the outcome of care at 12 months.
Related articles in BJP:
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BJP 2002 181: 0.[Full Text]
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