What is the Crisis Navigation Project?
The Crisis Navigation Project is a collaborative effort between Southern Regional AHEC, Duke University Medical Center, and NAMI – NC. The primary goal of the project is to promote the use of psychiatric advance directives (PADs).
PADs have been around for years, but they aren’t often used in clinical settings. We will be offering trainings designed to:
- Increase familiarity with PADs and how they can be helpful
- Recruit and train individuals to help facilitate the creation of PADs using a method developed by a Duke research team
- Assist providers and hospitals in knowing how to develop and respond to PADs, and how to incorporate them in quality care
This project is based at Southern Regional AHEC and Duke University School of Medicine, and is funded by a grant from The Duke Endowment. Training will be offered in Mecklenburg, Durham, Wake and Cumberland counties between May 2017-December 2019.
What is a psychiatric advance directive (PAD)? It is a legal document that allows persons with mental illness to state their preferences for treatment in advance of a crisis. They can even consent or refuse treatment during such a crisis. There are two kinds of legal documents in a PAD: (1) “Advance Instructions” to list treatment preferences and (2) “Health Care Power of Attorney” to appoint a trusted person to make decisions.
How are they used? If a person is in crisis, and not capable of speaking for him or herself, medical professionals can refer to the PAD to get a clear description of the person’s preferences for treatment and if there is a trusted person who can help make decisions. PADs are only used temporarily, and only when the person is incapable of making or communicating treatment decisions.
What are the benefits of PADs? PADs help people clarify their preferences and plan for crises – including having conversations that can sometimes help to prevent crises from occurring.
In research studies, PADs have been found to reduce the need for involuntary commitment and help people get the treatment they prefer.
What is a health care power of attorney? A person can legally appoint another person to represent their interests when incapacitated by giving them power of attorney for healthcare decisions. The person in this role is called a health care agent, and only speaks for the person when the person is incapacitated—that is, unable to make or communicate healthcare decisions.
Psychiatric Advance Directive Work Sheet
Psychiatric Advance Directive Form
Health Care Power of Attorney Work Sheet
Health Care Power of Attorney Form
Additional Resources for Facilitators
Checklist for PAD Facilitators
PAD flier Promise Resource Network
Here's an article on Psychiatric Advance Directives from the North Carolina Health News site: New Push to Help Mental Health Patients Determine their Treatment in Emergencies
Some articles from the New York Times
Now Mental Health Patients Can Specify Their Care Before Hallucinations and Voices Overwhelm Them
When Investigative Reporting Means Seeking Access to a Subject’s Mind
Psychiatric Advance Directives (letter to the editor)