‘ Finally, I feel listened to ’: hearing the voices of those with mental health challenges – using WRAP to formulate an advance healthcare directive

Abstract In recent years, mental health policy and legislation have changed dramatically, allowing for more human rights-based and recovery-orientated services to come into being. One example of this is the enactment of The Assisted Decision Making (Capacity) Act 2015 which allowed for conversations to begin within mental health about respecting the wishes of the person, even when they are in crisis. Within health discourse, this can be achieved through the creation of an advance healthcare directive. However, to date, within mental health services, clinicians, and service users do not have a recognised template that can be adapted for this purpose when a service user loses capacity to make decisions about their own life and care they receive. This paper proposes that Wellness Recovery Action Planning (WRAP), and particularly the crisis and post-crisis planning section of the programme should be used as a potential structure for such advance healthcare directives to be formulated. This is potentially plausible due to how engrained WRAP is in Irish mental health services, the evidence base backing for WRAP as well as the ease of use of the initiative to support overall well-being. As such, this paper has laid out how such plans can be used as an advance healthcare directive in an Irish setting and is also likely to be applicable internationally.