A study published in a journal called Psychiatric Services explains that individuals in nursing homes who have a serious mental illness are less likely to receive advance care directives than individuals who do not have mental illness.
Advance care directives provide individuals with the ability to make knowledgeable decisions about ongoing treatments or to allow someone else to make health decisions on their behalf if they become unable to do so.
For the study, four different types of plans 13,500 different residents were analyzed in 1,174 nursing homes. The four types were: (1) restrictions on feeding tubes/medications/treatment, (2) orders to not hospitalize, (3) do-not-resuscitate, and (4) living wills.
Of those analyzed, 68 percent of individuals without a mental illness had at least one of the previous four health plans and only 57 percent of individuals with a mental illness had a plan. For this study, individuals with bipolar disorder or schizophrenia were classified as having a mental illness.
Researchers explain that those with mental illnesses should be the first to receive advance care plans. Whether the decisions are bias or not, nursing homes show definite favoritism towards individuals without a mental illness rather than developing plans based on actual health needs.
Typically, nursing homes spend more time and effort working to manage chronic medical conditions or functional disabilities, and many are believed to lack personnel who have been adequately trained to treat mental health illnesses.