“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.

Georgia Q and A

Ten commonly asked questions about PADs for Georgia

Please note: the following 10 FAQs are designed to provide a quick and accessible guide to what your state’s Statutes say – or do not say – about PADs.  The FAQs do not attempt to provide a complete picture of the law in your state, nor can they take the place of legal advice.

1.  Can I write a legally-binding psychiatric advance directive (PAD)?

Yes.  Georgia House Bill 752 or Psychiatric Advance Directive Act amended the Advance Directive for Health Care Act to allow you to write a psychiatric advance directiveYou can directly state mental health care treatment preferences and desires using Georgia’s PAD form.  You may also use the form to appoint a mental health care agent to make mental health care decisions for you in the event you become unable to do so yourself.  

2.  Can I write advance instructions regarding psychiatric medications and/or hospitalization?

Yes, Georgia statutes were amended to allow you to write advance instructions for your psychiatric care using the psychiatric advance directive formPart One on the form includes specific questions about consent and preferences on hospitalization and medication.  

3.  Does anyone have to approve my advance instructions at the time I make them?  

No, but your psychiatric advance directive will become effective only after a physician or licensed psychologist who has personally examined you, or a court, determines you lack the capacity to make mental health care decisions on your own.  Completing a new form revokes any previous psychiatric advance directives and requires signatures from two witnesses.  A witness cannot be your designated mental health care agent, your current health care provider, or an employee of any local mental health care organization (with some exceptions).  To read the exact language and requirements, please see Georgia’s psychiatric advance directive form. 

4.  Can I appoint an agent to make mental health decisions for me if I become  incompetent?

Yes, you may appoint a mental health care agent in Part Two of the psychiatric advance directive form. Part One (treatment preferences) will be considered complete even if you do not appoint a mental health care agent.  Your health care agent may not be a physician or health care provider directly involved in your care, or an employee of a local mental health care organization. There are specific restrictions on existing or future spouses acting as your agent.  A psychiatric advance directive does not limit the involuntary examination, treatment, hospitalization or treatment services rendered under a court order.  Your agent may not make decisions which contradict preferences set in Part One.  Please see the psychiatric advance directive form for specific requirements.

5.  If I become incompetent, can my agent make decisions for me about medications, and/or hospitalization?

Yes.  The general rule is that your agent may consent or refuse any medical treatments or procedures on your behalf when you are incompetent to make decisions yourself.  However, you may choose to limit your agent’s authority in Part Two. 

6.  Does my agent have to make decisions as he/she thinks I would make them (known as “substituted judgment”), or does he/she have to make them in my “best interests”?

The statute says that the agent must not make a decision contrary to any decision you made when you were competent.  This amounts to a substituted judgment standard.  It is important to make your wishes known to your agent when you create your PAD.

7.  Is there any rule that says that I can only make advanced instructions, only appoint an agent, or that I must do both?

Yes.  As explained above, you may create a PAD by writing advance instructions without appointing a mental health care agent.

8.  Before following my PAD, would my mental health care providers need a court to determine I am not competent to make a certain decision?

No.  The statute states that the provider’s obligation to consult the agent begins when the patient is determined to “lack the capacity to understand the risks and benefits of, and the alternatives to, mental health care treatment decisions under consideration and… [is] unable to give or communicate rational reasons” for mental health care treatment. 

9.  Does the statute say anything about when my mental health providers may decline to follow my PAD?

YesProviders may decline requested mental health care if the care is: unavailable, medically contraindicated and could result in harm to the patient or inconsistent with reasonable medical standards.

10.  How long does my PAD remain valid?

Your psychiatric advance directive is valid until revoked.  You may revoke it at any time, orally or in writing.  If you choose to revoke your directive orally, you must do so in the presence of an adult witness who confirms it in writing within 30 days.  You may also revoke your advance directive by completing a new one or destroying the existing one.  If you marry after creating an Advance Directive for Health Care it will revoke any health care agent other than your spouse.  If you appoint your spouse as your agent and subsequently become divorced, the designation of your spouse as your health care agent will be revoked.