By Tania Gergel

These are such uncertain times with so many challenges to face. For those of us living with bipolar, an added uncertainty can be about accessing familiar healthcare resources and receiving suitable care and treatment if we become unwell. It’s very likely that this will be more difficult than usual and that it may not be possible to be treated by professionals you already know and who know you and your medical history.

One useful way to manage some of this uncertainty would be to write a document in which you provide key information for professionals who might treat you if you become unwell. Here you can provide information about things like your condition, treatments which work/don’t work and contact details both for family/friends and for health professionals who are familiar with your history. This ‘Mental Health Advance Choice’ document – which may also be referred to as an Advance Directive or Advance Planning document – would be useful at any time, not just during coronavirus. It’s not a formal or binding document – but can provide important details and guidance, especially for professionals who are unfamiliar with you.

I updated my own ‘Advance Choice’ document last week – as someone both living with bipolar and as a researcher in the field, it seemed a good idea. But it was also challenging – thinking about times when I’ve been unwell and trying to think through possible contingency plans if usual treatment or teams are unavailable. Even so, I found that writing the document was a good way to reflect on my health and maybe even bring some increased sense of understanding or control at this time. Hopefully, writing this document, either yourself or with your family or friends, can also be helpful for you.

The documents can be accessed online and  downloaded here or via Twitter.

If you think this could be useful for people with bipolar or other mental health issues, please do help it to reach others, using the Share details be or by forwarding the link/retweeting.

Also, if you’d like further updates on our work on Advance Decision-Making and Mental Health, follow me on Twitter here.

Below is information about how to fill in an ‘Advance Choice’ document about your mental health care. It is designed to provide key information to health professionals about contacts, treatment and other care issues, including relevant physical health issues. You can complete and expand this form as you need to.

This ‘Advance Choice’ document is not a formal legal document and the requests it makes are not binding. However, the MHA Code of Practice instructs mental health professionals to encourage service users to create advance statements and to follow these preferences wherever possible (for more info see MHA Code of Practice 1983 Sections 1.8 and 9 here.

 

Here are some instructions for filling out the form, which you can download here.

1. Feel free to adapt the form if you think that certain sections do not apply to you or that there are other things you would like to add. There are some ideas for what to include in some sections written in light grey font: like this. You can delete this writing as you fill in the boxes.

    2. Try to make sure this document can be accessed during a healthcare crisis. Ask your mental health team; GP; family/friends and others involved in your care to have copies of this document which can be accessed during a mental health crisis. Where possible ask for the document to be added to your medical records and ‘flagged’, so that it is clearly visible to those who might provide future care. 

3. If you are currently pregnant and this increases risk of illness during/after birth, seek advice from those providing care for you on how to plan for this within your document. More support and advice can be found here

General tips for writing about your treatment or care in Advance Choice documents:

4. Try to keep information as clear and concise as possible. This can help professionals understand your key points quickly and clearly.  Think about what your main priorities for treatment etc. would be - e.g. what medications or other treatments have worked/not worked in the past.
5. Make realistic treatment requests and provide alternative suggestions if these are unavailable. Especially at the current time, medical resources are stretched, and certain treatments may be unavailable.  Try to keep requests as manageable as possible for those providing healthcare and suggest alternatives where possible.
6. Make it clear to professionals why you need help: mental health teams will be providing treatment to those with most immediate needs due to e.g. risk; severity of illness; lack of support; those in physical ‘high-risk’ groups. Try to indicate these needs where possible.
7. If there are other health factors involved, include them in the form. If you have other existing health conditions, please give details and indicate current treatments on your form.

Find out more about writing an advance choice document – please see the results of the advance decision-making survey

We also have a downloadable leaflet available providing information on writing an ‘Advance Choice’ document.

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