When a person with mental illness is hospitalized for a mental health condition, they might get too sick to stay in charge of their own treatment. At those times, doctors and other people may make decisions about their care and treatment that they do not want.

Learn about Psychiatric Advanced Directive. It is a legal document which you can create when you are well to clearly spell out your wishes in case of a mental health crisis. It is a written document that expresses your wishes in advance about what types of treatments, services and other assistance you want when you are sick and unable to take part in decisions about your care.

Psychiatric Advanced Directive (PAD)

Mental Health conditions can become chronic illnesses. As with any other chronic condition, a person who has been doing well can unexpectedly experience a health crisis or “relapse”.  A mental health crisis is when a person is not able to make or communicate rational decisions. You can prepare for these crises situations ahead of time when you are in good mental health by creating a Psychiatric Advance Directive (PAD).

A Psychiatric Advance Directive (PAD) is a legal document completed by a person in a time of wellness. It allows you to prepare and have a say in your own treatment even if you do become incapacitated during a mental health crisis. In the PAD, you can state your treatment preferences, and/or name a friend or family member you authorize to make treatment decisions for you in the event you cannot do this for yourself.

There are two kinds of psychiatric advance directives:

  • An Instructive PAD gives specific instructions about the specific mental health treatment you prefer should you experience a psychiatric crisis. The treatment preferences could include medication preferences, inpatient treatment considerations and follow-up care instructions. This kind of PAD doesn’t give another person the right to make decisions for you.
  • A Proxy PAD names a healthcare proxy or agent to make decisions and advocate for you until the mental health crisis is over if you become incompetent to make your own decisions due to the illness.

By completing and regularly updating a PAD, you ensure that your support network (which may include family members or trusted friends) can partner with the treatment team and your case manager to advocate for you to receive the best treatment possible. At times, PAD may also be combined with a general advanced directive to address other medical health conditions.

Resources to learn more on Psychiatric Advanced Directive in California: