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Do You Need a Psychiatric Advance Directive (PAD)?

By Daniel Taylor, Esq. on September 11, 2014 | Last updated on March 21, 2019

Advanced directives are legal documents allowing you to express your wishes regarding your medical treatment in the event that you are incapacitated and unable to make decisions yourself. But along with living wills and durable powers of attorney, there's another form of advanced directive that may be useful for long-term planning: the psychiatric advance directive.

What can a psychiatric advance directive do? Here's a general overview:

What Is a Psychiatric Advance Directive?

A psychiatric advance directive (also known as a PAD) is an advance directive that specifically directs your mental health treatment in the event that you are ruled incapacitated or unable to make your own mental health treatment decisions.

According to the National Resource Center on Psychiatric Advance Directives, PADs are generally used to consent to, or refuse, treatments such as:

  • Hospital admission,
  • Medication, and
  • Electroconvulsive treatment.

In addition, PADs can allow you to appoint a trusted friend or family member to make decisions for you in the event that you are unable to do so yourself. PADs often combine both of these functions into a single document.

How Do You Draft a PAD?

The laws for drafting a valid PAD vary by state. In some states, such as Maryland, there is a specific form to use. In all, 20 states have statutes specifically addressing PADs, including Arizona, Hawaii, and Washington state.

In others, there is no specific form, but a PAD can be drafted independently or as part of an overall healthcare advance directive. In most of these states, this PAD must be signed, witnessed or notarized, and given to treatment providers.

Possible Limitations of PAD

Although PADs can be valuable tools for dictating preferences for mental health treatment, they may be overridden in some cases, such as when a person is involuntarily committed to a mental institution. Even in that circumstance, however, a PAD's preferences regarding treatment and medication should still be followed.

Additionally, your PAD may be disregarded if you lacked capacity at the time you signed it.

If you're interested in drafting a psychiatric advanced directive, a living will, or a durable power of attorney, an experienced estate planning lawyer can explain the process and discuss your options.

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