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Clinician knowledge and attitudes of mental health advance statements in Victoria, Australia

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James, RW ORCID: 0000-0003-0995-5586, Maude, P and Searby, A 2022 , 'Clinician knowledge and attitudes of mental health advance statements in Victoria, Australia' , International Journal of Mental Health Nursing , doi: 10.1111/inm.13022.

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Abstract

Embedded into Victoria's mental health legislation as part of the 2014 Mental Health Act suite of reforms, advance statements are designed to convey an individuals' preferences for treatment during times when the ability to communicate or make decisions may be impaired. This study investigated Victorian mental health clinicians' knowledge and attitudes of advance statements as well as their experience with training and implementation. We used an online Qualtrics survey of Victorian mental health clinicians (n = 190) to achieve this aim. Instrument validity was determined using the Content Validity Index (CVI) with field experts rating each item for relevance. A value of 80% or higher was sought and computed for each individual item on the scale, as well as for the overall scale. The Cronbach's Alpha coefficient was conducted to determine internal consistency reliability with a value of α = 0.721 for the survey, suggesting that the scale had acceptable internal consistency and reliability. Despite widespread support and positive attitudes towards advance statements existing among mental health clinician participants, the level of knowledge and perception of barriers continues to significantly affect the wide-spread uptake of advance statements. The quality and extent of training in legal and clinical aspects of advance statement varied widely among the study participants, with the quality and benefits of the training affecting participant reported confidence level as well as their practical experience with advance statements. Three recommendations can be made: that advance statements are embed into routine mental health practice to identify individuals who have existing advance statements and support those who do not to prepare one; that regular co-produced and facilitated training be provided to increase understanding, promotion, and overall use and uptake of advance statements; and finally, for local mental health service to develop a culture for positive engagement and promotion of autonomy through inclusive practices around decision-making.

Item Type: Article
Authors/Creators:James, RW and Maude, P and Searby, A
Keywords: advance directives, advance statements, health services, mental health, psychiatric wills, autonomy, empowerment
Journal or Publication Title: International Journal of Mental Health Nursing
Publisher: Wiley-Blackwell Publishing Asia
ISSN: 1445-8330
DOI / ID Number: 10.1111/inm.13022
Copyright Information:

© 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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