Mental Health Advance Directives: Barriers to Implementation and Education to Increase Utilization

  • Katelyn Holmes
  • Summer 2026

Faculty instructor: Dr. Kelsey Pascoe

Abstract

Background: Current literature supports mental health advance directives (MHADs) as a tool for decreasing involuntary hospitalizations and increasing empowerment among mental health consumers. Despite this, mental healthcare providers and consumers are often unaware of MHADs or believe incorrect information that deters them from supporting them. Problem: Additional training and resources are needed to promote the benefits of MHADs among both mental healthcare providers and consumers. The purpose of this project was to learn more about barriers to MHAD implementation and develop a poster to educate healthcare providers on MHADs and their benefits. Methods: One interview was conducted with a person who has received inpatient mental health services in the past and currently works as a mental health provider. A survey related to knowledge of and beliefs about MHADs was sent to mental healthcare providers and received 5 responses. The same survey was modified for mental health service consumers and received 4 responses. A literature search was conducted using keywords “mental health advance directive” and “psychiatric advance directive.” Research published prior to 2020 was excluded. Discussion: Healthcare providers, especially working in mental health, need additional training and resources to promote MHADs as viable tools to promote both autonomy and recovery in mental health service consumers.

Keywords: mental health advance directives, psychiatric advance directives, recovery-orientation, provider education