ArticleInternational journal of law and psychiatry
The PACT advance decision-making template: preparing for Mental Health Act reforms with co-production, focus groups and consultation.
Article in International journal of law and psychiatry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Co-Production within Child and Adolescent Mental Health: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Community engagement in health guidelines and other normative products: a methodological review.Bulletin of the World Health Organization · 2025Review
- Integration of Psychiatric Advance Directives Into the Patient-Accessible Electronic Health Record: Exploring the Promise and Limitations.Journal of medical Internet research · 2025Article
- Developing and testing Advance Choice Document implementation resources for Black African and Caribbean people with experience of compulsory psychiatric admission.BMC psychiatry · 2024Article
- Digital advance care planning with severe mental illness: a retrospective observational cohort analysis of the use of an electronic palliative care coordination system.BMC palliative care · 2024Observational
- Opportunities and challenges of self-binding directives: A comparison of empirical research with stakeholders in three European countries.European psychiatry : the journal of the Association of European Psychiatrists · 2023Article
- Opportunities and challenges of self-binding directives: an interview study with mental health service users and professionals in the Netherlands.BMC medical ethics · 2023Article
- Implementation of self-binding directives: recommendations based on expert consensus and input by stakeholders in three European countries.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2023Article
- Advance Statements for Black African and Caribbean people (AdStAC): protocol for an implementation study.BMC psychiatry · 2023Article
- Article
- Opportunities and risks of self-binding directives: A qualitative study involving stakeholders and researchers in Germany.Frontiers in psychiatry · 2022Article
- Preparing for Mental Health Act reform: Pilot study of co-produced implementation strategies for Advance Choice Documents.Wellcome open research · 2022Article
- Reasons for endorsing or rejecting self-binding directives in bipolar disorder: a qualitative study of survey responses from UK service users.The lancet. Psychiatry · 2021Article
- Shared Decision-Making: An Autoethnography About Service User Perspectives in Making Choices About Mental Health Care and Treatment.Frontiers in psychiatry · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundAdvance decision making (ADM) in mental health is supported by stakeholders but faces significant barriers. These must be overcome, not least to support the UK government's commitment to introduce statutory mental health ADM in England and Wales.
aimsTo build understanding and address the gap between aspirations for ADM and actuality, with feasible co-produced ADM resources.
methodsWe used focus groups and consultation to explore experience and views of stakeholders on ADM processes and materials. Discussions included feedback on an ADM template which was adapted accordingly throughout the research process.
resultsBetween September 2017 and December 2019, 94 individuals, representing stakeholders advised on design and process of ADM, alongside wider discussion at stakeholder events. Collaborative ADM was universally supported. Valued outcomes were diverse and combining aspirations with practicality required resolving dilemmas. A prototype template and guidance, the PACT (Preferences and Advance decisions for Crisis and Treatment) was co-produced, designed to help manage fluctuating mental capacity through collaborative decision making. The PACT enables direct engagement with medico-legal frameworks, with provision to facilitate person-centred assessments, treatment refusals and requests. Resources including supported engagement and cross-agency awareness and accessibility were seen as essential.
conclusionOur research confirms high stakeholder motivation to engage in ADM is hampered by multiple barriers. We identified enabling conditions for ADM and co-produced an ADM template and guidance which supports achievement of a range of valued outcomes. Further developments to support and evaluate the process of implementation are now needed to prepare for statutory change.
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