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Abstract：
This article discusses advance statements in mental health care, which allow individuals with mental disorders to express their preferences for treatment during mental health crises. Despite the evidence supporting their effectiveness, their implementation in clinical practice remains limited. This article explores variations among advance statements, such as psychiatric advance directives (PADs), joint crisis plans (JCPs) and self-binding directives (SBDs), highlighting their content, development process and legal status. We outline the benefits of advance statements, including empowerment, early intervention, improved therapeutic relationships and reduced compulsory admissions. We then draw attention to the challenges that may contribute to their lack of implementation, including legal complexities, communication issues, cultural factors, potential inequities, healthcare provider knowledge, changing preferences, resource constraints, crisis responses, data privacy, family involvement, and long-term evaluation. In conclusion, advance statements offer significant benefits but require addressing these critical aspects to ensure ethical and effective use. Bridging the evidence-to-practice gap is essential, with a focus on implementation science. Integrating these tools into routine clinical practice can significantly benefit individuals with severe mental disorders and mental health systems.
摘要：
本文讨论了精神卫生保健中的预先陈述，它允许患有精神障碍的人在精神健康危机期间表达他们对治疗的偏好。尽管有证据支持它们的有效性，它们在临床实践中的实施仍然有限。本文探讨了预先陈述之间的变化，如精神病学预先指令(PAD)，联合危机计划(JCP)和自约束指令(SBD)，突出他们的内容，发展过程和法律地位。我们概述了预先声明的好处，包括赋权，早期干预,改善治疗关系，减少强制入院。然后，我们提请注意可能导致其缺乏执行的挑战，包括法律复杂性，沟通问题,文化因素,潜在的不平等，医疗保健提供者的知识，改变偏好,资源限制，危机应对措施,数据隐私,家庭参与,和长期评估。总之,预先陈述提供了显着的好处，但需要解决这些关键方面，以确保道德和有效的使用。弥合证据与实践的差距至关重要，专注于实施科学。将这些工具整合到常规临床实践中可以使患有严重精神障碍和精神卫生系统的个人显着受益。
