Can peer-facilitated psychiatric advance directives decrease involuntary commitment and improve clinical outcomes among individuals with serious mental illness?

A psychiatric advance directive (PAD) is a legal document that allows you to express your preferences in advance so that if a crisis occurs and you are unable to make decisions for yourself, your supporters can make decisions about your treatment based on the information you provided. The benefits of developing a PAD include improving crisis planning and decreasing coercive intervention and involuntary commitment. Peer specialists are uniquely qualified to support individuals in expressing their treatment preferences while promoting autonomy and self-determination by virtue of their shared experience with mental health diagnosis and services, and their adherence to core values such as empathy, respect, and mutuality. This article describes the positive results of a randomized clinical trial in which completion of a PAD with a peer was associated with a significant decrease in involuntary commitment and a significant increase in positive mental health outcomes such as recovery and empowerment among individuals with serious mental illness and prior involuntary commitment. Asking your peer specialist to partner with you to develop a PAD is an effective strategy for protecting your authority to direct your care while promoting communication with your support network.

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