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Creating a psychiatric advance directive (PAD)

As we enter June, which is Post-Traumatic Stress Disorder (PTSD) Awareness Month, after just closing out Mental Health Awareness Month in May, we have some additional things to share with you regarding our efforts to raise mental health awareness. We are also sharing this information in follow up to our last blog The 3 Documents You Need In Your Estate Plan. In this article we offer you information on how to create a fourth kind of document to consider having alongside your estate planning documents. This document is called a psychiatric advance directive (PAD).

A PAD is a legal tool that allows a person with mental illness to state their preferences for treatment in advance of a crisis. They can serve as a way to protect a person's autonomy and ability to self-direct care.  

Creating a PAD is an essential step to protect your rights and to ensure you receive the care you want if you currently have, or are ever diagnosed, with a mental illness.  A PAD is an official document that outlines your preferences for how you want to be treated in the event that you are ever unable to make decisions for yourself. 

In this article, we'll discuss what makes up a PAD and why it's so important, as well as go over some important tips for creating your own PAD. Creating and storing your PAD correctly can save your loved ones from making difficult decisions on your behalf in times of crisis. With so much information to cover, let's get started!

Overview and Benefits 

PADs have been around for years but they aren't often used in clinical settings. Many people with mental illness, their families and healthcare providers are not familiar with them. Currently, only 25 states have laws that allow them according to The National Resource Center for Psychiatric Advance Directives.

According to the National Alliance for Mental Illness (NAMI), in states that do not have laws allowing PADs, an individual can still draft a PAD under the more general statutes connected to health care directives or living wills. Having a PAD in addition to general health care directives or living wills is more beneficial because of the unique issues of mental health care and treatment. These issues include medication preferences, inpatient treatment considerations and the reality that a person can experience changes in their mental health over time.

New Jersey is one such state that does have laws allowing PADs.  Additionally, in the State of New Jersey, there is a registry for PADs.  The Division of Mental Health and Addiction Services (DMHAS) has contracted with the U.S. Living Will Registry (USLWR) to manage and maintain a voluntary, secure internet based registry for PADs.  This secure online registry provides health care providers immediate and streamlined access to PADs.  Click here for more information and to access the registry.

Whether you choose to use the registry or not, you can also share your PAD with your local hospitals, providers, and police departments, so your preference of care is clear and easy to prioritize. And if you keep your family members up to date on your PAD, they can be better advocates for you in a time of need. Always keep a copy for yourself in a safe place also. 

What's Included in a Psychiatric Advance Directive?

A psychiatric advance directive is a written contract that outlines how you want to be treated if you ever experience a mental health crisis. Your PAD will include settings, treatments, and medical interventions that you want to be used in the event of a crisis. Your PAD can also include instructions for when you want to be put on involuntary psychiatric hold, as well as who you want to give your medical power of attorney to in such a situation if your choices are ever restricted.  The PAD serves as a pre-determined informed consent for treatments, and it contains valuable health history information.  Make sure you p​ut this plan in place during a time of wellness.

Why Create a Psychiatric Advance Directive?

A psychiatric advance directive is an important legal document that outlines your wishes for treatment in the event that you are diagnosed with a mental illness and are in crisis. When you're healthy, it can be easy to brush off this kind of planning as unnecessary, but things can get complicated when you're experiencing a mental health crisis. In the event that you are unable to make decisions for yourself, your loved ones will be responsible for making choices on your behalf. Unfortunately, many families are unfamiliar with mental illness, and this can make it difficult to know what to do in such a situation. This is why it's so important to create and store your advance directive correctly. Your PAD can help to prevent loved ones from making treatment decisions that you don't agree with while you're sick, which can be stressful and frustrating for everyone.

Tips for Creating Your Own Psychiatric Advance Directive

Now that we've gone over what a psychiatric advance directive is, it's time to go over some tips for creating your own PAD. Developing your own PAD is an empowering experience. You get to prioritize your own preferences for treatment and make sure your voice is heard. The first section of the PAD states your intention to complete an advance directive and your desire to have it followed. The following sections then state your health information and specific wishes. In the last section, you sign and date the form. In New Jersey, you must sign your PAD before at least one witness. A second witness is required in some situations.  Be sure to refresh your PAD regularly to account for any changes in your life.

Start Small and Build From There

When creating your own PAD, start by jotting down the settings and treatments that you want to be implemented if you ever experience a mental health crisis. This includes everything from where you would like to be treated to what kind of treatment you want to be administered. Once you have these preferences written down, you can start to build onto your PAD.  Be as specific as possible in your language, and include only the treatments that you feel comfortable with. 

Include Your Reasoning

It's important to include your reasoning behind each treatment you want to be implemented if you ever experience a mental health crisis.  This helps to ensure that your loved ones understand why you prioritized certain settings and treatments and can help to avoid any confusion or conflict in the future. This can also help to ease any concerns that your doctor or a healthcare provider may have about your preferences. After all, doctors want what's best for their patients and may have questions about why you selected a certain treatment

Where to Find the Right Help and Resources

Now that we've gone over what a PAD is, its benefits, and how to create your own, it's time to discuss where you can find the right help and resources related to this topic. 

This is a document that you have to create for yourself.  However, doctors and other mental health providers and organizations can help you through the process. Your local mental health provider can provide you with more information about psychiatric advance directives, as well as provide you with helpful materials, such as sample PADs. The Mental Health Association in New Jersey (MHANJ) also offers a PAD form, registry information and wallet card.  Click here to access these forms and information. They also have contact information for you to reach out with any questions about creating your PAD.

Conclusion

It's important to take the time to create a PAD because it can help you to protect your rights if you ever experience a mental health crisis. 

You can protect your family and appoint a guardian and trustee for your minor children very easily by doing a simple will. All it takes is a phone call or text to Serra Law Group (908) 534-1985. 

Our on-line platform called Smart Law  eliminates the hassle of schlepping into an attorney's office like in the old days and streamlines the intake process, so you never have to leave your home. And it can all be done in the palm of your hand on your phone at a fraction of the cost of a traditional law firm. The gap between knowing and doing has never been slimmer!

Act now and feel good you did something extremely important for the protection of your family. 

Why use a form when you can have a firm!

Book Your Free Consultation  with us today!

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