Table 1.
Informal ADMs.
| Purpose | Required parties involved (preferable inclusions) | Capacity assessment required (MCA) | Legally Binding for MH Services | Point at which effective | Requirements to alter/cancel plan | |
|---|---|---|---|---|---|---|
| Care Plan | On-going management of a condition in the short/medium term | MH services Service user (Family/Friends/Carers) |
No | No | On formulation of plan – ideally with agreement between all parties | Can be altered at any time – ideally with agreement between all parties |
| Joint Crisis Plan | Prospective management of a possible crises by identifying early interventions and treatment preferences | Independent facilitator MH services Service User (Family/Friends) (Independent Advocates) |
No | No | At a time of crisis when service user retains ability to enact agreed plan | Can be altered at any time – ideally with agreement between all parties |
| Crisis Plan | Prospective management of a possible crises by identifying support available | MH services Service user (Family/Friends) (Independent Advocates) |
No | No | At a time of crisis when service user retains ability to enact agreed plan | Can be altered at any time – ideally with agreement between all parties |
| Advance Care Plan | Prospective management of a chronic condition in the long term, including management of relapses. Made when service user is well. | MH services Service user (Family/Friends) (Independent Advocates) |
No – although some models include a form of capacity assessment | No | At a time when the service user becomes unwell/ suffers a relapse | Can be altered at any time – ideally with agreement between all parties |
| Self-binding advanced care plan “Ulysses contracts” | Prospective management of a fluctuating condition focused on period of impairment/incapacity when service user anticipates their treatment preferences will change. Made when service user is well. | MH Services Service user (Family/Friends) (Independent Advocates) |
No although some models stress capacity assessment. | No | At the time when the service user becomes unwell/losses capacity and preferences start to change | Can be altered/cancelled by service user at any time when well/with capacity. Altering treatment requests requires agreement with MH services. |