About the Project

What is a psychiatric advance directive (PAD)? It is a legal document that allows persons with mental illness to state their preferences for treatment in advance of a crisis. They can even consent or refuse treatment during such a crisis. There are two kinds of legal documents in a PAD: (1) “Advance Instructions” to list treatment preferences and (2) “Health Care Power of Attorney” to appoint a trusted person to make decisions.

How are they used? If a person is in crisis, and not capable of speaking for him or herself, medical professionals can refer to the PAD to get a clear description of the person’s preferences for treatment and if there is a trusted person who can help make decisions. PADs are only used temporarily, and only when the person is incapable of making or communicating treatment decisions.

What are the benefits of PADs? PADs help people clarify their preferences and plan for crises – including having conversations that can sometimes help to prevent crises from occurring.

In research studies, PADs have been found to reduce the need for involuntary commitment and help people get the treatment they prefer.

What is a health care power of attorney? A person can legally appoint another person to represent their interests when incapacitated by giving them power of attorney for healthcare decisions. The person in this role is called a health care agent, and only speaks for the person when the person is incapacitated—that is, unable to make or communicate healthcare decisions.

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