Planificación anticipada de decisiones en salud mentalmodelos, utilidades y propuestas de aplicación

  1. Amets Suess Schwend 1
  2. Águila Bono del Trigo 1
  3. Vicente Ibáñez Rojo 2
  4. Javier Romero Cuesta 3
  5. María Dolores Romero Jimeno 4
  6. María Isabel Tamayo-Velázquez 1
  7. Evelyn Huizing 5
  1. 1 Escuela Andaluza de Salud Pública, Granada, España
  2. 2 Complejo Hospitalario Torrecárdenas, Almería, España
  3. 3 Área de Gestión Sanitaria Serranía de Málaga, España
  4. 4 Grupo Derechos Humanos y Salud Mental, II Plan Integral de Salud Mental de Andalucía, Consejería de Salud, Junta de Andalucía, España
  5. 5 Programa de Salud Mental, Consejería de Salud, Junta de Andalucía, España
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Journal:
Revista de la Asociación Española de Neuropsiquiatría

ISSN: 0211-5735

Year of publication: 2016

Volume: 36

Issue: 129

Pages: 79-102

Type: Article

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More publications in: Revista de la Asociación Española de Neuropsiquiatría

Abstract

Introduction: Over the last years, the Convention on the Rights of Persons with Disabilities (CRPD) has contributed to increase attention to the detection and prevention of human rights violations in mental health services. Among different strategies for improvement, the introduction of models for Advance Directives in Mental Health (AD-MH) and Advance Care Planning in Mental Health (ACP-MH) has been proposed. Material and methods: 1. Literature review. Analysis of concepts, models, utilities and limitations of documents related AD-MH and ACP-MH processes in different countries. 2. Discussion, identification and elaboration of strategies for the adaptation in the Andalusian context conducted by the Human Rights and Mental Health Working Group of the Comprehensive Mental Health Plan of Andalusia. Results: In the international context, the existence of differentiated models and terminologies is observed. In the reviewed studies different utilities are identified, among them the protection of rights, an increased participation and empowerment, the improvement of the relation between users, health providers and relatives, as well as aspects related to clinical utility and cost-efficacy. Among the potential limitations, the lack of institutional support and professional training is highlighted. For the Andalusian context, the Working Group proposes the introduction of an ACP-MH process as a clinical tool focused on information, dialogue and decision making, at the same time as working towards the creation of a legally binding model. Conclusions: The introduction of ACP-MH is identified as a useful strategy to protect the rights of users of mental health services in coherence with the principles established in the CRPD

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