Psychiatric wills of mental health professionals: a survey of opinions regarding advance directives in psychiatry

Pscychiatric wills are advance directives for an eventual involuntary treat ment in psychiatry. We attempted to determine psychiatric professionals' kn owledge and opinion about this legal option and obtain their formulations o f advance directives for themselves. A total of 101 psychiatric nurses and psychiatrists at the Department of Psychiatry of the University of Vienna r esponded to a questionnaire about psychiatric wills and anonymously drafted advance directives for themselves concerning psychiatric treatment in case of an acute psychosis. Fifty-four percent knew about this legal option, 55 % considered it an appropriate legal possibility. and 29% considered it ina ppropriate. The study also found that 75% of respondents reject certain met hods of therapy, e.g. 30% want to exclude the use of neuroleptic medication s, and 46% reject ECT. We conclude that although there is little experience so far with advance directives for psychiatric patients, there is an inter est and predominance of positive attitudes towards this legal option among mental health professionals. Concerning their preferences, professionals fe lt inclined to make very specific statements as to which available treatmen t strategies they would reject and which they would request for their treat ment. This bodes well for the widespread use of advance directives in menta l health settings.