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AZ Mindfree Project

Psychiatric Advance Directives and Self-Directed Care

A psychiatric advance directive (PAD), also known as a mental health advance directive, is a written document that describes what a person wants to happen if at some
time in the future they are judged to be suffering from a mental disorder in such a way that they are deemed unable to decide for themselves or to communicate

It can inform others about what treatment they want or don't want from psychiatrists or other mental health professionals, and it can identify a person to whom
they have given the authority to make decisions on their behalf. A mental health advance directive is one kind of advance health care directive.

It has become clear that the potential significance of PADs is becoming widely recognized among those targeted for coercive psychiatry, survivors of coercive psychiatry,
influential policy makers, clinicians, family members, and patient advocacy groups but that significantly more concerted efforts at dissemination were needed. The
community of stakeholders interested in PADs and the broader concept of self-directed care are in need of online resource and gathering place for exchange of views
and information.

As a result, in the United States, a collaboration between the Bazelon Center for Mental Health Law and Duke University has led to creation of the MacArthur
Foundation-funded National Resource Center on Psychiatric Advance Directives, the only web portal exclusively devoted to developing a learning community to
help people targeted for coercive psychiatry, their families, and clinicians prepare for, and ultimately prevent, coercive psychiatry interventions. The
NRC-PAD includes basic information, frequently asked questions, educational webcasts, web blog, most recent research, legal analyses, and state-by-state
information on PADs and patient-centered crisis planning. The NRC-PAD website thus includes easy step-by-step information to help those targeted for forced
drugging, family, and clinicians complete PADs that mirror the provisions in the PAD statutes.

The Federal Patient Self Determination Act (enacted in 1990) addresses the rights of health (including mental health) care users to stipulate in advance how they
would like to be treated by health care providers when they are incapacitated. These wishes can be articulated by consumers in a specific document (an advance
directive) or by appointing someone as a health care agent to speak for them.

National Resource Center on Psychiatric Advance Directives

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