Psychiatric Advance Directives (PADs): A Tool for Improving Crisis Care and Legal Issues for Implementation
Resource Availability
This course material was originally created by SMI Adviser, now rebranded as SMI CalAdviser. The content in this course material is still current and relevant, yet, please be aware that some external resources and links may no longer be active or available. 
Overview

Description 

Psychiatric Advance Directives (PADs) are a legal method for persons at risk of loss of decisional capacity during a behavioral health crisis to plan in advance and direct care during such a crisis. PADs permit persons while in a competent state to consent or refuse future treatment and appoint a proxy decision maker to speak for the incapacitated person to reinforce those preferences during a crisis. Over half of US states have passed PAD legislation, but in the remaining states such advance or planning can be written into a general health care advance care planning process. Implementation of PADs has been slow for a variety of reasons, including: their legal complexity, the lack of available resources to help draft them, and lack of implementation efforts by health systems. In addition, many physicians have concerns about their legal standing and/or fail to activate them by identifying incapacity in their patients. This webinar will discuss implementation of PADs and legal barriers to their use. 

Learning Objectives 

Describe the legal origins of PADs. 

Identify barriers and promotors of PAD implementation. 

Summarize legal principles and controversies around PADs. 

Outline  

  • Overview of psychiatric advance directives (PADs) and their benefits 
  • Review of legal origin of PADs 
  • Use of PADs across states  
  • Physician concerns around use of PADs and legal barriers 
  • Presenter Q&A 

Target Audience 

Psychiatrist, Physician (Non-psychiatrist), Physician Assistant, Pharmacist, Psychologist, Counselor, Social Worker, Peer Specialist/Peer Support 

Instructional Level 

Intermediate; Advanced 

Estimated Time to Complete 

Estimated Duration: 1.0 hours  
Program Start Date: July 30, 2025 
Program End Date: July 30, 2028 

Ongoing Interdisciplinary Discussion Board 

After completing the course, engage with colleagues in the mental health field through the Webinar Roundtable Topics discussion board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. Access through the discussion tab.  

How to Earn Credit  

After completing the evaluation, participants will have the opportunity to claim their hours of participation and download the appropriate certificate. Physicians may obtain an official CME certificate, other healthcare professionals may receive a CE certificate (as applicable), and all other attendees may generate a certificate of participation. Each certificate will reflect the event date and total hours earned.  

Continuing Education Credit  

In support of improving patient care, American Psychiatric Association (APA) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.   

Physicians    

The APA designates this live event for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.    

Nurses/Nurse Practitioners    

The American Psychiatric Association (APA) designates this activity for 1.00 Nursing contact hours. Nurses should only claim credit commensurate with the extent of their participation in the activity.    

Psychologists    

Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs.   

Social Workers     

As a Jointly Accredited Organization, American Psychiatric Association (APA) is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. APA maintains responsibility for this course. Social workers completing this course receive up to 1.00 general continuing education credits.  

Continuing education requirements vary from state to state. Many state boards grant reciprocity with national accrediting organizations and other state boards. It is the responsibility of each professional to understand the requirements for license renewal or check with the state or national licensing board and/or professional organization to become more familiar with their policies for acceptable continuing education credit. Social workers and Psychologists should contact their regulatory board to determine course approval.  

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME's Standards for Integrity and Independence in Accredited Medical Education. Any individuals in a position to control the content of a CME activity - including faculty, planners, reviewers, or others - are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.   

Faculty 

  • Debra A. Pinals, MD serves as the director of the Program in Psychiatry, Law, and Ethics and as a clinical professor of psychiatry at the University of Michigan Medical School. She is a clinical adjunct professor at the University of Michigan Law School. She also is the medical director of behavioral health and forensic programs for the Michigan Department of Health and Human Services. She is board certified in psychiatry and forensic psychiatry, and is a board certified in addiction medicine. From 2008 to 2016, she was the assistant commissioner of forensic services, and between 2012 and 2014, she was the interim state medical director for the Massachusetts Department of Mental Health. During her career she has been a clinical psychiatrist in community mental health, inpatient settings, forensic and correctional facilities, emergency rooms, and court clinics. Dr. Pinals reports no financial relationships with commercial interests. 
  • Marvin Swartz, MD, is professor and head, division of social and community psychiatry at the Duke University School of Medicine and co-director of the Services Effectiveness Research Program. Dr. Swartz reports no financial relationships with commercial interests.  

Program Planners 

  • Teri Brister, PhD, LPC, National Alliance on Mental Illness. Reports no financial relationships with commercial interests. 
  • Amy Cohen, PhD, American Psychiatric Association. Reports no financial relationships with commercial interests. 
  • John Torous, MD, Beth Israel Deaconess Medical Center. Reports no financial relationships with commercial interests. 
  • Sherin Khan, LCSW, Thresholds. Reports no financial relationships with commercial interests. 
  • Donna Rolin, PhD, APRN, University of Texas at Austin. Reports no financial relationships with commercial interests.  

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.  

Technical Requirements 

This internet-based CME activity is best experienced using any of the following:  

The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari  

Internet Explorer 11+  

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.  

Optimal System Configuration:  

Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)  

Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)  

Internet Connection: 1 Mbps or higher  

Minimum Requirements:  

Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content  

Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content  

For assistance: Contact educme@psych.org for questions about this activity |  Contact support@smicaladviser.org for technical assistance  

 

 

Summary
Availability:
On-Demand
Expires on Jul 30, 2028
Credit Offered:
1 CME Credit
1 NCPD Credit
1 Psychology CE Credit
1 Social Work CE Credit
1 COP Credit
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