What is a PAD?

A Psychiatric Advance Directive (PAD) is a self-directed legal document that details a person’s specific instructions or preferences regarding future mental health treatment. It is used to plan for the possibility that someone may lose the capacity to give or withhold informed consent to treatment during acute episodes of psychiatric illness. It allows a person in a mental health crisis to retain their decision-making capacity by choosing trusted agents to help advocate for their choices.

PADs Innovation Project in California

The California Mental Health Services Oversight and Accountability Commission (MHSOAC) included PADs 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 (PADs). This supports a statewide movement to create a standardized, sustainable PADs 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 PAD process, including the form, legal language, a training “tool-kit,” and evaluation.

The Benefits of PADs

PADs 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 (PADs) Innovations Project

Annual Report

Frequently Asked Questions

Click on the question or plus sign to view answer.

What are the PADs Innovation project objectives?
What can be addressed in a PAD?
Who are Peers?
Will PADs be available in different languages?
See CountiesSee News & Updates