Psychiatric advance directives (PADs) document a patient's advance instructions (AIs) for treatment and/or designation of a potential proxy decision maker. Approximately 50% of a total of N=167 U.S. psychiatrists who completed a mail survey of their attitudes and views regarding PADs had a favorable opinion of a law authorizing AIs, whereas two-thirds of psychiatrists endorsed proxy decision making legislation. However, 42% perceived important barriers in the service system that would prevent effective implementation of PADs, while 30% considered clinical factors to be important barriers to implementation. Psychiatrists who are correctly apprised of applicable state mental health law are generally more supportive of PADs; they may be more willing to support PADs if they are educated about key aspects of PAD legislation.
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