A psychiatric advance directive (PAD), also known as a mental health advance directive, is a written document that describes what a person wants to happen if at some time in the future they are judged to be suffering from a mental disorder in such a way that they are deemed unable to decide for themselves or to communicate effectively.
It can inform others about what treatment they want or don’t want from psychiatrists or other mental health professionals, and it can identify a person to whom they have given the authority to make decisions on their behalf. A mental health advance directive is one kind of advance health care directive.
PAD with a trained facilitator increases therapeutic alliance with clinicians, enhances involuntary patients’ treatment satisfaction and perceived autonomy, and improves treatment decision-making capacity among people labeled with severe mental illness.
Moreover, PADs provide a transportable document—increasingly accessible through electronic directories—to convey information about a detainee’s treatment history, including medical disorders, emergency contact information, and medication side effects. often have limited information about citizens detained and labeled as psychiatric patients who present or are coercively presented and labeled as in crisis. Nonetheless, these are the typical settings in which clinicians are called upon to make critical patient-management and treatment decisions, using whatever limited data may be available.
With PADs, clinicians could gain immediate access to relevant information about individual cases and thus improve the quality of clinical decision-making—appropriately managing risk to patients and others’ safety while also enhancing patients’ long-term autonomy.
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