An advance directive is a statement of a person's preferences for treatment, should he or she lose capacity to make treatment decisions in the future.
To evaluate whether use of advance directives by patients with mental illness leads to lower rates of compulsory readmission to hospital.
In a randomised controlled trial in two psychiatric services in inner London, 156 in-patients about to be discharged from compulsory treatment under the Mental Health Act were recruited. The trial compared usual psychiatric care with usual care plus the completion of an advance directive. The primary outcome was the rate of compulsory readmission.
Fifteen patients (19%) in the intervention group and 16 (21%) in the control group were readmitted compulsorily within 1 year of discharge. There was no difference in the numbers of compulsory readmissions, numbers of patients readmitted voluntarily, days spent in hospital or satisfaction with psychiatric services.
Users' advance instruction directives had little observable impact on the outcome of care at 12 months.
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 August 2025.
All research outputs
#4,954,273
of 33,503,100 outputs
Outputs from British Journal of Psychiatry
#2,404
of 7,355 outputs
Outputs of similar age
#82,020
of 491,868 outputs
Outputs of similar age from British Journal of Psychiatry
#1,771
of 5,860 outputs
Altmetric has tracked 33,503,100 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,355 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.5. This one has gotten more attention than average, scoring higher than 65% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 491,868 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 5,860 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
