'The case for a pro-active approach to advance care planning in older person's mental health - insights from interdisciplinary mental healthcare professionals.

INTRODUCTION: Advance care planning (ACP) involves nuanced conversations to elicit an individual's beliefs, values, and preferences regarding future care. However, despite recognition of the positive impact, representative population surveys indicate low uptake of ACP, figures replicated internationally. Complex medical issues, including cognitive impairment, can interact with and exacerbate mental health challenges in later life, which can make decision-making more complex. ACP and Advance Healthcare Directives support people during periods of incapacitating mental illness. This paper reporting on the first stage of an action research study exploring ACP from the perspective of interdisciplinary mental healthcare professionals in the context of Older Person's Mental Health, took place in the dawn of the Assisted Decision-Making Capacity Act (2015), which has considerable implications for practice. METHODS: The first action research stage consisted of three sub-stages combining quantitative and qualitative methods, with the findings of each sub-stage iteratively informing the development of the next. RESULTS: The results of the study indicate that whilst overall ACP is largely viewed as positive by healthcare professionals, confidence, and experience levels vary in practice, with a strong desire for additional specific training and tools to support ACP engagement indicated. The study also revealed facilitators and barriers to ACP; and addressing existential anxiety, giving voice, person-centred approach, and push and pull factor themes. CONCLUSION: This study highlights some important implications for person-centred practice centring on the need to balance an active stance to ACP whilst also respecting the right not to engage for varying psychological and emotional reasons.