EAT-PAD: Educating about psychiatric advance directives in India

Sharad Philip, Dhanya Chandran, Albert Stezin, Geetha C Viswanathaiah, Guru S Gowda, Sydney Moirangthem, Channaveerachari Naveen Kumar and Suresh Bada Math

International Journal of Social Psychiatry, 2019, vol. 65, issue 3, 207-216

Abstract: Background: With India enacting the Mental Health Care Act (MHCA; No. 10 of 2017a), Psychiatric Advance Directives (PADs) have been legalised and have become binding orders for psychiatrists treating patients. There is a paucity of research into acceptability of PADs in Indian mental health care, likely due to a lack of awareness. There are no educational measures about PADs provided for in this Act. Facilitators and facilitation methods have not been elaborated upon as well. Aim: The aim of this study is (a) to develop/evaluate the effectiveness of a structured Education-cum-Assessment Tool (EAT) in providing information regarding PADs and (b) to evaluate modes of facilitation required by patients to complete PADs. Methods: A tool was developed as per provisions regarding PADs in the Mental Health Care Bill of 2013. This tool was administered to patients ( n  = 100), purposively sampled from the adult psychiatry review out-patient department (OPD). Patients were evaluated on retention of information, completion of PADs, modes of facilitation and time taken to write one. Results: Mean years of education was 8.28 (±5.74) years and mean duration of illness was 8.30 (±7.04) years. In all, 65% had Below-Poverty Line (BPL) status. All participants completed valid PADs in an average of 15 minutes. About 93% required facilitation via assistance in writing and reminding. The mean EAT scores implied above 70% retention but did not relate to types of facilitation. Conclusions: EAT scores can be used as an approximate measure of the patient’s ability to understand and retain information which is a part of decisional capacity. Types of facilitation can help in understanding patient’s ability to communicate their choices. Service providers may find EAT a time-effective tool for uniformly educating service users regarding PADs and indirectly assessing competence.

Keywords: Education; Facilitation; Psychiatric Advance Directives; India (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:65:y:2019:i:3:p:207-216

DOI: 10.1177/0020764019834591

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