Advance Planning — MRCPsych Paper B MCQ

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EasyRehabilitationAdvance PlanningMRCPsych Paper B

A person with recurrent severe mental illness is currently well and has decision-making capacity. During rehabilitation, the team offers to develop an advance statement and crisis plan. What is the main recovery-oriented purpose of this advance planning?

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Correct answer: E — Preserve the person's preferences and voice during future illness

The correct answer is E. Advance statements and jointly developed crisis plans support recovery by recording the person's preferences, values, early warning signs and preferred responses while they can participate fully. This promotes autonomy, self-management and continuity of the person's voice if they later become acutely unwell or lose capacity. An advance statement does not make every preference legally binding, so A is incorrect; its legal status differs from a valid and applicable advance decision to refuse treatment. Planning complements rather than replaces continuing shared decision-making, excluding C. It may include strategies and support intended to prevent hospitalisation, but cannot guarantee this outcome, excluding D. Advance planning is relevant across adult mental health services and is not confined to forensic settings, excluding E.

Reference: NICE. Service user experience in adult mental health: improving the experience of care for people using adult NHS mental health services (CG136), recommendations 1.1.11–1.1.12 and 1.4.5, 2011. https://www.nice.org.uk/guidance/cg136/chapter/Recommendations