Advanced directives and coercive interventions

Psychiatric advanced directives (PADs) provide a legal means for competent people to refuse or consent to future mental health treatment during periods when they are incapable of making a decision. A major goal of the directives is to reduce coercive interventions during mental health crises but whether they can accomplish this in practice remains unclear. A study of 239 patients in the U.S. compared those who had filled out a PAD to those who had not and found out that those who had not filled out an advanced directive were twice as likely to have experienced a coercive intervention such as being picked up by the police, being committed, being placed in seclusion, being placed in restraints or receiving forced medication.

Swanson, Jeffrey W. ... [et al] - Psychiatric advance directives and reduction of coercive crisis interventions Journal of Mental Health June 2008, 17(3), 255-267