title: What do service users want? A content analysis of what users may write in psychiatric advance directives in India.
abstract: Although psychiatric advance directives give service users control over their care, very few studies exist on the content of PADs. This paper aims to contribute to this evidence base by presenting the content of psychiatric advance directives in India. Participants were 75 clients seeking outpatient care at a mental health services organisation in Tamil Nadu, India, who agreed to draft a PAD. Most clients were comfortable with appointing a representative (usually a family member) to make decisions on their behalf during a period of decisional incapacity or relapse, were willing to accept admission to the hospital/clinic and take medication if required, wanted to have a trusted person to discuss their mental health problems. No client used the opportunity to outright refuse treatment. This study highlights an important first step in improving the quality of mental health care by documenting user preferences for care in India. More in-depth research is needed to elicit rich descriptions of experiences of care and user-centred understanding of rights.
authors.affiliation: Centre for Mental Health Law and Policy, Indian Law Society, Law College Road, Pune 411 004, India. Electronic address: spathare@cmhlp.org.
authors.forename: Soumitra
authors.initials: S
authors.lastname: Pathare
authors.affiliation: Centre for Mental Health Law and Policy, Indian Law Society, Law College Road, Pune 411 004, India; Athena Institute, VU University Amsterdam, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands. Electronic address: l.s.shields@vu.nl.
authors.forename: Laura
authors.initials: L
authors.lastname: Shields
authors.affiliation: Centre for Mental Health Law and Policy, Indian Law Society, Law College Road, Pune 411 004, India. Electronic address: renuka@cmhlp.org.
authors.forename: Renuka
authors.initials: R
authors.lastname: Nardodkar
authors.affiliation: The Banyan, 6th Main Road, Mugappair Eri Scheme, Mugappair West, Chennai 600037, Tamil Nadu, India. Electronic address: Lakshmi.narasimhan@thebanyan.org.
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Narasimhan
authors.affiliation: Athena Institute, VU University Amsterdam, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands. Electronic address: j.g.f.bunders-aelen@vu.nl.
authors.forename: Joske
authors.initials: J
authors.lastname: Bunders
mesh_terms: D000328:Adult; D016223:Advance Directives; D000553:Ambulatory Care; D003657:Decision Making; D004522:Educational Status; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D010344:Patient Advocacy; D057240:Patient Preference; D019727:Proxy; D012944:Social Support
keywords: Care preferences; India; Psychiatric advance directive