Abstract

SUESS SCHWEND, Amets et al. Advance Care Planning in Mental Health: models, Utilities and Proposals for Application. Rev. Asoc. Esp. Neuropsiq. [online]. 2016, vol.36, n.129, pp.79-102. ISSN 2340-2733.

Introduction: Over the last years, the Convention on the Rights of Persons with Disabilities (CRPD) has contributed to increase attention to the detection and prevention of human rights violations in mental health services. Among different strategies for improvement, the introduction of models for Advance Directives in Mental Health (AD-MH) and Advance Care Planning in Mental Health (ACP-MH) has been proposed. Material and methods: 1. Literature review. Analysis of concepts, models, utilities and limitations of documents related AD-MH and ACP-MH processes in different countries. 2. Discussion, identification and elaboration of strategies for the adaptation in the Andalusian context conducted by the Human Rights and Mental Health Working Group of the Comprehensive Mental Health Plan of Andalusia Results: In the international context, the existence of differentiated models and terminologies is observed. In the reviewed studies different utilities are identified, among them the protection of rights, an increased participation and empowerment, the improvement of the relation between users, health providers and relatives, as well as aspects related to clinical utility and cost-efficacy. Among the potential limitations, the lack of institutional support and professional training is highlighted. For the Andalusian context, the Working Group proposes the introduction of an ACP-MH process as a clinical tool focused on information, dialogue and decision making, at the same time as working towards the creation of a legally binding model Conclusions: The introduction of ACP-MH is identified as a useful strategy to protect the rights of users of mental health services in coherence with the principles established in the CRPD

Keywords : human rights; mental health; decision making; advance directives; advance care planning; personal autonomy.

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