Background Psychiatric advance directives (PADs) are written statements that allow people with mental illness to state their treatment preferences and exercise control over future health interventions.

Aim To explore mental health nurses’ perspectives on psychiatric advance directives in Ireland.

Methods A qualitative design comprising individual interviews supported by an interview guide, conducted with seven mental health nurses in Ireland. Data were subjected to thematic analysis.

Findings Themes identified were perceived benefits, perceived risks and barriers to implementation of PADs. Participants were supportive of PADs particularly as related to client autonomy. However, lack of training, risks of legal liability and service users’ competence were of concern.

Conclusions Mental health nurses in Ireland welcome PADs but report inadequate knowledge and confidence. Training is needed and clear guidelines, policy and legal basis for implementation of PADS. Service users, their families, carers and advocates should be involved in the process as well as related healthcare professionals.