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Patient attitudes towards compulsory community treatment orders and advance directives

Published online by Cambridge University Press:  13 June 2014

Brian O'Donoghue ,
John Lyne ,
Michele Hill ,
Linda O'Rourke ,
Sally Daly  and
Larkin Feeney
Brian O'Donoghue*
Affiliation:
DETECT-Early Intervention Service for Psychosis, Avila House, Block 5, Blackrock Business Park, Carysfort Ave, Blackrock, Co Dublin, Ireland
John Lyne
Affiliation:
DETECT-Early Intervention Service for Psychosis, Avila House, Block 5, Blackrock Business Park, Carysfort Ave, Blackrock, Co Dublin, Ireland
Michele Hill
Affiliation:
Cluain Mhuire Mental Health Services
Linda O'Rourke
Affiliation:
St John of God/St Vincents University Hospital Postgraduate Training Scheme in Psychiatry, Liaison Psychiatry, Cluain Mhuire Mental Health Services, Newtownpark Ave, Blackrock, Co Dublin, Ireland
Sally Daly
Affiliation:
St John of God/St Vincents University Hospital Postgraduate Training Scheme in Psychiatry, Psychiatry for Later Life, St Vincents University Hospital, Elm Park, Dublin 4, Ireland
Larkin Feeney
Affiliation:
Cluain Mhuire Mental Health Services, Newtownpark Ave, Blackrock, Co Dublin, Royal College of Surgeons, Ireland
*
*Correspondence Email: briannoelodonoghue@gmail.com
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Abstract

Objectives: The Mental Health Act 2001 was implemented in Ireland in 2006, however, within this new legislation there is no provision for compulsory community treatment or advance directives, which are now established practice in other countries. We aimed to determine the proportion of patients who believe that compulsory treatment may be justified, the preference for where the treatment should be delivered and factors which may influence this preference. We also sought to determine the proportion of people who would be interested in the option of having an advance directive in their future care plan.

Methods: Patients who had been admitted involuntarily in a 183 bedded psychiatric hospital in Dublin (St John of God Hospital) over a 15 month period were interviewed one year following discharge. A structured interview was used and included the Birchwood Insight Scale and Drug Attitude Inventory (DAI).

Results: Sixty-seven patients were interviewed, which resulted in a follow-up rate of 68%. A total of 56% of participants believe that there are situations in which involuntary treatment with medication may be justified. Of the participants 59% think that the person should be admitted to hospital if they are going to be administered medication without consent. A total of 41 % of participants stated they would have preferred to have been treated at home rather than hospital and this was associated with having a diagnosis of an affective disorder or it being their first involuntary admission. Of the participants 84% expressed interest in having the option of an advance directive in their treatment care plan.

Conclusions: With the increasing community based provision of mental health services in Ireland a debate on compulsory community treatment orders and advance directives needs to take place amongst all stakeholders.

Keywords

Compulsory community treatmentMental Health ActInvoluntary admissionCoercionAdvance directive
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 27 , Issue 2 , June 2010 , pp. 66 - 71
Copyright
Copyright © Cambridge University Press 2010

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