Nurse and woman looking at tablet device.Nurse and woman looking at tablet device.

Project Goals

  • Develop a standardized Psychiatric Advance Directive template available to customize via an online and interactive technology platform
  • Co-create with peers, families, service providers and first responders
  • Create a sustainable and easily reproducible approach that can be used across California
  • Train first responders and healthcare providers

Psychiatric Advance Directives Innovation Project in California

The California Mental Health Services Oversight and Accountability Commission (MHSOAC) included Psychiatric Advance Directives as part of their 2020–2023 Strategic Plan. Seven counties have opted to initiate this multi-county Innovation project to test the feasibility of using Psychiatric Advance Directives. This supports a statewide movement to create a standardized, sustainable Psychiatric Advance Directive process. The goal of the Innovation project is to help counties improve access to personal, health, and daily life care, the appropriateness and quality of care, preservation of the individual’s life goals and preferences, and to improve positive outcomes for people at risk of involuntary care, homelessness, unnecessary hospitalizations, and involvement with the criminal justice systems, at all stages of life.  

The project includes development of all stages of the Psychiatric Advance Directive process, including the form, legal language, a training “tool-kit,” and evaluation. A key feature is the development of a user-friendly and secure online platform where people can learn about, complete, and store their Psychiatric Advance Directives, which will be accessible in real-time for first responders, crisis teams, and healthcare staff.

The Benefits of Psychiatric Advance Directives

Psychiatric Advance Directives have the potential to enhance individual independence for persons with mental health needs and related conditions. The benefits of this early advocacy include:

  • Allowing individuals to take responsibility for their recovery
  • Supporting person-centered thinking
  • Supportive decision-making
  • Allowing an appointed person to assist in making decisions during times when the person’s capacity is impaired
  • Enhancing a family’s trust in the “system,” that their family member will receive the treatment to which they are entitled, and in a supportive fashion
  • Providing appropriate and supportive care
  • De-escalating potential crisis situations

Innovations Work Plan

Project Title: Multi-County Psychiatric Advance Directives Innovations Project

Annual Report

A PAD is a simple, effective way to understand the immediate needs of our clients in crisis.

– Jason Ivins, Captain, OCSD

Knowing that I have a PAD, I know that when I can’t make sound decisions. I will be taken care of.

– Cynthia A., Certified Peer Support Specialist

This is so impactful in helping not only individuals, but their families as well. This could be a game changer for future generations and avoid some unnecessary traumas.

– Rachel S., Certified Peer Support Specialist

This is really an exciting time, as this tool can truly be an empowerment tool, to allow and ensure those with a PAD are able to control their own wellness and recovery.

– Ahmad Bahrami, Division Manager, Fresno County Department of Behavioral Health

A PAD is a simple, effective way to understand the immediate needs of our clients in crisis.

– Jason Ivins, Captain, OCSD

Knowing that I have a PAD, I know that when I can’t make sound decisions. I will be taken care of.

– Cynthia A., Certified Peer Support Specialist

This is so impactful in helping not only individuals, but their families as well. This could be a game changer for future generations and avoid some unnecessary traumas.

– Rachel S., Certified Peer Support Specialist

This is really an exciting time, as this tool can truly be an empowerment tool, to allow and ensure those with a PAD are able to control their own wellness and recovery.

– Ahmad Bahrami, Division Manager, Fresno County Department of Behavioral Health

Frequently Asked Questions

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What is a Psychiatric Advance Directive (PAD)?
What are the Psychiatric Advance Directives Innovation project objectives?
What can be addressed in a Psychiatric Advance Directive?
Who are peers?
Will Psychiatric Advance Directives be available in different languages?
What if I want to fill out a PAD now?
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