Attitudes and knowledge relating to advance healthcare directives among psychiatry staff in Ireland.

Abstract

Background: Advance healthcare directives are the subject of increased interest in psychiatry. A new legislative framework for advance healthcare directives came into effect in Ireland in 2023 in the Assisted Decision Making (Capacity) Act, 2015.

Aim: To investigate levels of knowledge about, and attitudes towards, advance healthcare directives among multidisciplinary psychiatry inpatient staff in Ireland one year after commencement of the new legislation.

Methods: A survey was completed among psychiatry inpatient staff (n = 51) in Tallaght University Hospital, Dublin, Ireland between June and August 2024.

Results: Majorities of psychiatry inpatient staff have heard of advance healthcare directives (84.3%), think they are a good idea (90.2%), and recommend involving medical staff (84.3%) and/or family and friends (68.6%) in writing them. There are high levels of confidence that staff would respect and be able to access advance healthcare directives when needed, but divided opinions on whether patients understand enough about advance healthcare directives. A majority of staff members (74.5%) would prefer an advance care plan that was not legally binding but still included the patient's will and preferences.

Conclusions: Psychiatry inpatient staff are largely supportive of advance healthcare directives but identify needs for more patient education and an explicit option for non-binding, rather than binding, advance healthcare directives.