Self-Advocacy Through Power Statements
Using “power statements” can help people with serious mental illness clarify and communicate their personal goals for medication and treatment, according to a new study. A power statement is a short, self-advocacy statement prepared by a patient based on a template. The study found that people with serious mental illness typically view medications not only as a way to address symptoms, but as a means to pursue meaningful life goals.
More than 17,000 adults with serious mental illness at 69 public mental health clinics were given the option to develop power statements prior to meeting with their psychiatrist. More than 80 percent (more than 14,000) chose to develop them. The statements were developed using a brief Web-based template located at a computer in the clinics’ waiting rooms. The template involves a two-part prompt: “I want you to help me find a mediation that will help me….. so that I can …..” Clinic staff are trained to support patients in creating power statements.
The researchers looked at a random sample of 300 power statements by patients with serious mental illness. Typically, patients wanted to control their symptoms to achieve goals, such as enhancing relationships, well-being, and self-sufficiency. The research appeared in Psychiatric Services in Advance on April 3.
The power statements are part of CommonGround, a web application that helps people with serious mental illness to participate in making decisions collaboratively with their provider. It helps patients prepare before an appointment with a psychiatrist or treatment team by recording and organizing information on symptoms, changes, questions, etc. It provides an efficient and effective way to share information about a person’s progress, goals and concerns. It was designed to meet the challenge of covering a lot of information in a typically short psychiatrist visit.
Samples of Power Statements
“My family, and especially my three daughters, are very important to me. My time spent with family and my daughters is essential to my happiness and overall well-being. However, when depressed, I tend to be isolative and withdrawn from others, and my family. I need medication that will keep me from becoming depressed and isolative, so that I can better enjoy my family relationships."
“I am a young man that likes skateboarding. Being able to go back to school is the most important thing to me. I want to work with the doctor to find a medicine that helps me focus and be less depressed so that I can go back to school and complete it.”
The power statements are added to CommonGround health report that is reviewed by the psychiatrist at each visit. The CommonGround program was recognized in 2013 as a “Service Delivery Innovation” by the Agency for Healthcare Research and Quality and by the American Psychiatric Association with its Gold Achievement Award for psychiatric services.
Study lead author Patricia E. Deegan, Ph.D., and colleagues note that “for most, using medication to control symptoms was not an end in itself but a means to an end that includes improved relationships, work, and other aspects of meaningful life in the community.” The power statements can help ensure a better understanding between the individual and the provider and can help define successful treatment.
While the study was done as part of the online CommonGround program, the power statements can be done with just pen and paper without the use of the program. Especially because office visits are often short, the power statements provide an efficient, standardized way of focusing on a person’s goals.
Help for Patients & Families
Learn about common mental disorders, including symptoms, risk factors and treatment options. Find answers to your questions written by leading psychiatrists, stories from people living with mental illness and links to additional resources.