Development of an Advanced Care Planning Training Program in Mental Health

Advanced Care Planning (ACP) in mental health involves written documents that allow adults with mental illness to express future preferences and decisions, ensuring their choices are respected during crises when decision-making capacity may be compromised. Although ACP is legally supported in various countries, its clinical integration is limited, potentially due to insufficient knowledge, negative attitudes, and barriers among professionals, service users, and their support networks.

This study presents the development of a comprehensive ACP training program for Catalonia's mental health services, conducted in two phases. The first phase, a two-round Delphi study, involved national and international ACP experts, including mental health professionals, service users, and their support networks. In the first round, experts assessed the relevance of the training content (initially based on WHO's QualityRights materials and other ACP training programs), as well as suggested the ideal trainers (either peers or health professionals), and estimated the required training duration. In the second round, experts received results from the initial round, enabling them to re-evaluate and refine their opinions based on collective feedback. Contents included in the training program were those considered essential by at least 75% of the participants.

The second phase focused on creating training materials, guided by the Delphi study outcomes. A consensus conference with 30 experts reviewed these materials to ensure they aligned with Catalonia's mental health care structure. Participants individually examined the materials before the conference, then collectively discussed their feedback.

This ACP training program represents a significant step in mental health care, offering a user-centered approach to ACP. Its collaborative and iterative development process promotes practical applicability, addressing the diverse needs of mental health service users and caregivers. This program holds the potential to transform mental health care practices, fostering an environment of empowerment and improved care outcomes.