“This time, with a PAD, I did not receive any treatments that I did not want. They were very respectful. I really felt like the hospital took better care of me because I had my PAD. In fact, I think it’s the best care that I’ve ever received.” Read More PAD Stories...

About PADs

  • A psychiatric advance directive (PAD) is a legal document that documents a person’s preferences for future mental health treatment, and allows appointment of a health proxy to interpret those preferences during a crisis.
  • PADs may be drafted when a person is well enough to consider preferences for future mental health treatment.
  • PADs are used when a person becomes unable to make decisions during a mental health crisis.

Getting Started


Psychiatric advance directives (PADs) are relatively new legal instruments that may be used to document a competent person’s specific instructions or preferences regarding future mental health treatment, in preparation for the possibility that the person may lose capacity to give or withhold informed consent to treatment during acute episodes of psychiatric illness.

Almost all states permit some form of legal advance directive (AD) for healthcare, which can be used to direct at least some forms of psychiatric treatment. In the past decade, twenty-five states have adopted specific PAD statutes.

What are Psychiatric Advance Directives? View PDFAdobe Acrobat

Overview of Psychiatric Advance Directives in the United States View PDFAdobe Acrobat

“How to write a Psychiatric Advance Directive?” View video (15:20)

Creating a Psychiatric Advance Directive Jeffrey Swanson, Ph.D. (series of 5-minute videos) 

Type of PADsAdobe Acrobat

Federal Law on Advance Directives View PDFAdobe Acrobat

“Introducing Psychiatric Advance Directives” Marvin Swartz, M.D. View webcast (17:41)*

“What Information Goes Into Psychiatric Advance Directives?” Eric B. Elbogen, Ph.D., M.L.S. View video (12:08)

“Federal Law on Advance Directives: The Patient Self-Determination Act” Chris Koyonagi. View webcast (14:10)*

* requires Flash, cannot be viewed on an iPad or iPhone