Evidence Base and Benefits

  • Current health conditions
  • Effective (and preferred) medication interventions
  • Medications to avoid​
  • Effective interpersonal strategies
  • Personalized symptom descriptions
  • Contact information for key providers
  • Trauma-informed care considerations
  • Emergency contacts
  • …and more

Some additional suggested readings

Nicaise P, Lorant V, Dubois V. Psychiatric advance directives as a complex and multistage intervention: a           realist systematic review. Health Soc Care Comm 2013;21:1-14.

Nicholas LH, Langa KM, Iwashyna TJ, Weir DR. Regional variation in the association between
          advance directives and end-of-life medicare expenditures. JAMA 2011;306:1447-1453.

Srebnik D, Brodoff L. Implementing psychiatric advance directives: service provider issues and
          answers. J Behav Health Serv Res 2003;30:253-68.

Srebnik D, Rutherford L, Peto T et al. The content and clinical utility of psychiatric advance directives.                 Psychiatr Serv 2005;56:592-8.

Srebnik D, Russo J. Use of psychiatric advance directives during psychiatric crisis events. Adm Policy                 Ment Health 2008;35:272-82

Elbogen EB, Swanson JW, Appelbaum P et al. Competence to complete psychiatric advance directives:             effects of facilitated decision making. Law Hum Behav 2007;31:275-89.

Joshi K. Psychiatric advance directives. J Psychiatr Pract 2003;9:303-6.

Kim MM, Van Dorn RA, Scheyett AM et al. Understanding the personal and clinical utility of
          psychiatric advance directives: a qualitative perspective. Psychiatry 2007;70:19-29.

Scheyett AM, Rooks A. University students’ views on the utility of psychiatric advance
          directives. J American College Health 2012; 60: 90-93.

Van Dorn RA, Swanson JW, Swartz MS. Preferences for psychiatric advance directives among
          Latinos: Views on advance care planning for mental health. Psychiatric Services 2009;60:1383-               1385.

Zelle H, Kemp K, Bonnie RJ. Advance directives in mental health care: evidence, challenges and
          promise. World Psychiatry 2015;14:278-280.

Overview of some relevant AD research.pdf

Evidence is available supporting ADs, including ADs with instructions for mental health care.  The link below leads to slides that provide an overview of some mental health care AD research.  Several suggested readings are also noted below.


One point worth highlighting first is the fact that an AD can be helpful to care provision even before it is activated.  That is, even if the AD is not yet legally binding, it is still a “cheat sheet” full of crisis-relevant details about the person’s health care, including: