Evaluation of a Novel Educational Intervention for Mental Health Staff on Advance Care Planning with Older People with Mental Illness

Purpose To evaluate the effectiveness of a novel educational intervention for mental health staff on Advance Care Planning (ACP). The aims were to improve staff knowledge, attitudes, and confidence in facilitating ACP with older people with mental illness and to increase staff engagement in ACP. Methods Pre-post intervention study conducted across two public mental health services in Australia. Multidisciplinary mental health clinicians and peer workers (n = 110) participated in a one-hour, evidence-informed educational session combining theoretical content, videos, interactive discussion of case vignettes and handout resources. Evaluation used paired pre- and post-intervention questionnaires assessing staff knowledge, attitudes, and confidence (Wilcoxon Signed-Rank and Exact McNemar tests). A pre-post audit of mental health consumer (patient) electronic medical records (eMR) at both sites quantified changes in ACP documentation rates (two-sample z-test for proportions). Thematic analysis of free-text feedback was conducted. Results The intervention led to statistically significant improvements in staff attitude (p < 0.001, r = 0.48), knowledge (p < 0.001, r = 0.51), and confidence (p < 0.001, r = 0.87). Consumer eMR audits (pre: n = 1104; post: n = 1118) showed no significant change in ACP documentation rates, which remained low (7.6% vs. 8.0%). Participants’ feedback emphasised further practical training (e.g. role play, sample questions, eMR documentation), discussion of complex cases, and reinforcement strategies. Conclusions A brief, standalone educational intervention improved staff readiness for ACP, but did not translate into change in clinical practice. This knowledge-to-practice gap suggests that overcoming systemic and other barriers to ACP requires multifaceted strategies beyond education, such as organisational change and governance processes, audit and feedback, skills practice and champions.