Patients decide which treatments they would allow

Pact gives mentally ill options
Patients decide which treatments they would allow

October 16, 2006

If you’re hospitalized and unable to make health decisions, a living will can guide doctors about how much medical intervention you want.But what if you have a mental breakdown? A similar document, called a psychiatric advance directive, details the mental health treatments you would prefer.

Psychiatric advance directives, or PADs, have been available for years, and Illinois’ document is among the best, experts say. But PADs are little known and seldom used.

To raise awareness, the National Resource Center for Psychiatric Advance Directives has started a Web site,, providing state-by-state PAD information and downloadable forms.

A PAD is prepared when a patient is lucid. “The benefit is that the patient feels heard,” said Dr. Marvin Swartz, co-director of the center. “The patient feels empowered.”

The center was developed by Duke University Medical Center and the Bazelon Center for Mental Health Law.

PADs are intended for people with a history of severe and persistent mental illness such as schizophrenia or bipolar disorder — about 3 percent of the population.

Good for three years

The Illinois PAD allows you to state whether you agree to be hospitalized for up to 17 days, and whether you would consent to electroconvulsive (shock) therapy. It also lists what psychotropic drugs you would take. You might, for example, agree to take a certain drug, but only after your doctor has tried your preferred drug.The directive takes effect if two doctors or a court determine you are unable to make reasonable decisions. (You can name one of the doctors in the PAD.) The PAD must be followed, unless there is an emergency or unless a court contradicts your wishes. And you still could be hospitalized, regardless of what your PAD says, if it’s determined you are a danger to yourself or others.

The PAD designates a friend or relative to make decisions about your mental health treatment. It must be signed by two competent adults who attest you were of sound mind when you signed it.

The directive remains in effect for three years. You can revoke it only if a doctor determines, in writing, that you are competent to cancel it.

Illinois’ law is 10 years old but only recently has begun to catch on, the Illinois Guardianship and Advocacy Commission said.

Comments (2)

sjbMarch 7th, 2007 at 12:15 am

I a series of nine ECT’s… there are about nine months missing from my life; along with information I don’t even realize that I don’t know I son’t have. THERE IS A PART OF ME THAT IS GLAD I had the ECT’s I will admit that there are a lot that scares me on the things that I don’t know about. I am now having tremors and siezures to include a possible stroke…are these some of the things I have to look forward to from now on??

Thank you for being here.

John791November 13th, 2011 at 5:21 am

Very nice site!

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