PT - JOURNAL ARTICLE AU - Jeffrey Swanson AU - Marvin Swartz AU - Joelle Ferron AU - Eric Elbogen AU - Richard Van Dorn TI - Psychiatric Advance Directives Among Public Mental Health Consumers in Five U.S. Cities: Prevalence, Demand, and Correlates DP - 2006 Jan 01 TA - Journal of the American Academy of Psychiatry and the Law Online PG - 43--57 VI - 34 IP - 1 4099 - http://jaapl.org/content/34/1/43.short 4100 - http://jaapl.org/content/34/1/43.full SO - J Am Acad Psychiatry Law2006 Jan 01; 34 AB - Psychiatric advance directives (PADs) are legal instruments that allow competent persons to document their preferences regarding future mental health treatment and to designate a surrogate decisionmaker in the event they lose capacity to make reliable treatment decisions during an acute episode of psychiatric illness. This study reports the findings of a survey of 1,011 psychiatric outpatients in five U.S. cities about their interest in, and completion of, PADs. Across the sites, only 4 to 13 percent of participants had completed a PAD; however, between 66 and 77 percent reported wanting to complete one if given assistance. Significantly higher demand for PADs was found among participants who were female; were nonwhite; had a history of self-harm, arrest, and decreased personal autonomy; and those who felt pressured to take medication. Actual completion of PADs was more likely among participants with higher insight, those reporting leverage by a representative payee, and those who felt external pressure to keep outpatient appointments for mental health treatment.