Psychiatric Advance Directives (PAD)

Most of us are familiar with a Living Will or a Physical Advance Directive. But did you know there is a psychiatric counterpart? A Psychiatric Advance Directive (PAD) is a document that expresses your wishes regarding:

  1. Types of treatment

  2. Services and other assistance you want during a crisis

A PAD provides a detailed statement of your medical treatment preferences and other wishes or instructions (An instructive PAD). You can also use it to grant legal decision-making power to another person (A proxy PAD).

The advantages of a PAD are that it:

promotes autonomy and empowerment;

improves communication between you, your doctor and your family;

protects you from unwanted, possibly harmful interventions; and

helps prevent mental health crises.

I have been hospitalized three times and, while I never felt I was in danger or receiving inadequate care, I feel I would benefit from a PAD.

For instance, it is very important to me to be able to contact my husband while hospitalized. Mayo’s Mood Disorder Clinic ensures this right by having at least six wireless phones to for use by patients as well as letting you use your own cellular phone after you’ve been there for a day.

Mayo’s doctors also presented me with options for my care and carried out my wishes.

A PAD would virtually guarantee that I receive the care I want and that my family is involved in decision-making.

A lawyer can draw up a PAD for you, provided you are not currently considered incapable of making decisions.

A PAD might make you feel a little more comfortable if you have to be hospitalized. You can rest assured that your wishes will be followed.

The first time I was hospitalized, I had this image of them locking me in a room, just because I didn’t know what to expect. If I would have had a PAD, I wouldn’t have been as nervous. I would have known that my rights and wishes would be followed. This is not to say that a PAD makes everything perfect, but it does afford you protection.

Its something to consider as you travel along your mental health journey.


Mental Health America, “Psychiatric Advance Directives: Taking Charge of Your Care”.

National Alliance of Mental Illness, “Psychiatric Advance Directives”.

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