What are Psychiatric Advanced Directives?

When an individual living with a serious mental illness experiences a mental health crisis, it is possible that they enter a state where they temporarily lose their ability to participate in making decisions for their care. Previous research and experience show that this puts those individuals at risk for forced treatment and/or jail. In order to help prevent unwanted treatment, there is a document called a psychiatric advance directive, or PAD. This is a medical-legal document in Texas that requires clinicians to read and respond to patient preferences that follow professional standards of care. It provides capacitated persons living with serious mental illness the ability to state their wishes and preferences for care during a mental health crisis. A capacitated person is someone who does not need a legal guardian to make health care decisions for them. Our team knows this is important because communities of color are overrepresented in the criminalization of mental illness. Use of a PAD helps make sure that providers review what kind of care people want during a mental health crisis.

A PAD includes 3 main kinds of treatment:

Today, not many people are using a PAD even if they are at risk of a mental health crisis. Researchers have found that one of the reasons why is that the language in the form is hard to understand. This stops people from easily filling it out and using it. This brings us to why we are here today. We are conducting a community engagement studio, or CES. A CES helps to create a better research project by including the feedback of community members (such as yourselves) from the very start of the project. For this study, your feedback will help us develop the first draft of a revised PAD form.