By Caroline Stegeman, RN, BSN, MJ, ONC, CPHRM, CPSO
Director of Patient Safety, LHA Trust Funds
Caring for a behavioral health patient experiencing a crisis can be a challenge under the best of circumstances. Determining a treatment plan becomes even more difficult when healthcare practitioners are not aware of the patient’s wishes regarding their own psychiatric healthcare. The Psychiatric Advance Directive Form (PAD), created by the Office of Mental Health and the Mental Health Advocacy Service, is a tool designed to help prevent such situations.
The PAD is a legal tool that allows a person with a mental health condition to state their preferences and wishes for treatment in advance of a crisis. The tool protects a person’s autonomy and ability to self-direct care. The patient with a mental health condition and the healthcare practitioners ultimately want the same thing – safe and quality mental health care, quality of life and optimal functioning capacity for the patient.
The PAD goes into effect when a patient is found to lack decision-making capacity during a mental health crisis, including acute psychosis, mania, catatonia, delirium or unconsciousness among other conditions. The treating healthcare practitioners can then refer to the PAD to gain a clear understanding of the patient’s preferences for treatment, who to contact in their support network and how to support and treat the patient throughout the crisis.
Being proactive by being prepared, having tough conversations with family and healthcare practitioners and developing a personalized PAD is a great option for the behavioral health population. A PAD promotes self-directed care in psychiatric treatment, makes progress towards equality in mental health treatment and supports crisis planning along with the rights of people who live with mental illness.