Introduction

A psychiatric advance directive (PAD) is a written document that allows you to state in advance what kind of treatment, services, and other assistance you would prefer to receive in the event that you experience a mental health crisis. You can also use a PAD to grant another person the authority to make legal decisions on your behalf. This person would be your advocate and agent until the crisis is over.

Please be warned that filling out a PAD does not guarantee that your recorded preferences will be respected, as we have observed cases in which psychiatric personnel ignored the contents of their patients’ PADs.

Nevertheless, we recommend PADs as a potentially useful tool. Please refer to the following links for more information about PADs in your country:

 

Frequently Asked Questions

When will I need a PAD?

A PAD goes into effect once it has been determined that you no longer have the capacity to make decisions for yourself. Completing a PAD when your capacity for decision-making is not being questioned can enable you to influence what happens to you once it is called into question.

What information does a PAD include?

  • Whether or not you want to take psychiatric drugs
  • The names and dosages of the psychiatric drugs that you do and do not want to take
  • The names of facilities and/or healthcare professionals whom you would like to be involved in your care
  • The names and contact information of people who can help you with important tasks (e.g. paying your bills, taking care of your children or pets, etc.)
  • The name and contact information of the person whom you would prefer to make decisions for you while you are institutionalized
  • The names of people whom you do or do not wanted to be visited by while you are institutionalized

Do I need a lawyer to prepare a PAD?

Laws vary by location, but we generally recommend having both a lawyer and a doctor sign your document in order to verify your competence at the time when it was signed. This will improve the likelihood that your documented preferences will be enforced.

Who should have a copy of my PAD?

In addition to keeping a copy in your home where it can be easily found, you should also be sure to give copies to people you trust such as friends or relatives. You should also have one on file at any hospital where you have been a patient before.

Can I change my mind?

Yes, you can change the contents of your PAD by either making corrections to it or filling out a new one. However, you will be responsible for ensuring that the individuals and facilities relevant to you each have a copy of the most up-to-date version.

Depending on where you live, you may be able to reserve the right to cancel your PAD even during a crisis. This must be stated in writing in advance. However, if you choose to revoke your PAD, your designated decison-making agent will no longer be able to advocate for you. Before you decide whether to make your PAD revocable, you should thoroughly discuss this possibility with your friends, family and healthcare providers.