A psychiatric advance directive (PAD) is a legal, rights document enabling people to plan for, prevent, and/or reduce the severity of potential future mental health crises by:
  • Stating preferences regarding mental health
  • treatment inside a psychiatric hospital.
  • Providing de-escalation tools to reduce emergency
  • interventions.
  • Providing de-escalation tools for law enforcement and
  • crisis personnel.
  • Providing information about physical medical
  • conditions and needs.
  • Identifying medical and mental health agents and
  • supporters.
  • Planning in advance to address practical matters.
Further, a psychiatric advance directive may also enable people to identify the supports and services they need to meaningfully integrate in the community by addressing the following issues:
  • Housing
  • Employment
  • Education
  • Finances
  • Terms of jail diversion, probation, and parole.
  • Information on trauma triggers and responses.


Painted Brain (PB) was awarded the PADs Peer Voice-Advocacy and Education Grant, a California Statewide Project funded through the MHSA Multi-County PADs Innovation Project


How Do I make a PAD? A hand holding a pen on a sheet of paper

How Do I Make A Pad?

How Do I make a PAD? Two hands holding a cup

Do i need a lawyer to create a pad?

How Do I make a PAD? A doctor with a female patient

will people be required to follow my pad?

Painted Brain on Supported Decision Making 1 

At the center of all decision-making is choice! Your needs, who you are, and how you carry yourself through the world you live in all comes down to your choices and decisions.

We are a collection of all the choices we have ever made, and it’s vital that we continue to have a say and a choice in the kinds of medical care we receive.

Psychiatric Advance Directives (PADs) is a set of documents that give peers the opportunity to voice their preferences about the kind of care they would like to recieve in the event of a psychiatric emergency. In order to have medical care that is both fair and respectful to the peer, it’s crucial to keep their voice–and choices–at the center of their treatment plan.

Painted Brain on Supported Decision Making 2

Choice and decision making are vital to receiving healthcare treatments that help us in our times of need. PADs (or psychiatric advance directives) are here to revolutionize the way we recieve medical care and treatment in the event of a psychiatric emergency.

At Painted Brain, we want to encourage peers to advocate for their needs, and recognize that the peer voice is necessary in order to receive adequate medicines and treatment in the event of an medical emergency; because everyone should have the right to a voice and a choice.

Painted Brain on Supported Decision Making 3

Supported decision making (SDM) is a crucial part of how we navigate life’s tough moments, and uncomfortable or new scenarios. And it happens so frequently, most of the time we don’t even know we’re doing it: whether it’s asking loved ones for advice asking big purchases for a house or a car or talking to your friends about difficulties in relationship, we often lean on those closest to us for feedback and guidance to maneuver through new territories.

The same can be said for mental health: PADs (psychiatric advance directives) is a series of documents that outline a peer’s choices to recieve special kinds of medical attention and care in the event of a psychiatric emergency.

A peer relies on their friends, family and loved ones to support them in making decisions that will be the best for them in emergency situations, and affirms that their voice and choice matters.

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In collaboration with the California Association of Mental Health Peer-Run Organizations (CAMHPRO), PB will support the peer voice through self-determination, advocacy, education, and community outreach. In coordination with the following seven Counties that signed on to support the Project: Fresno, Mariposa, Tri-City, Orange, Contra Costa, Shasta, and Monterey, we will ensure the peer voice is represented. 

This Project supports the goals of system transformation that is peer-driven, culturally competent, and collaborative in design through thoughtful peer engagement and participation in PADs creation and implementation. PB & CAMHPRO will support developing and implementing the PADs template, training videos, local and state level policies, and programs and access to quality services and support.

By this Project’s end, peers will have enhanced their autonomy and self-determination in California’s mental health system through the Project’s education, advocacy, and outreach efforts.

The interior of an empty office room

Learn More about the pads project here

We need your voice! Join the PADs Project today.

Registration Demographic Participation

Survey Link

PADs Demographic Survey Questions


During the darkest moments the PAD speaks for me by allowing me to be an active part of my treatmentwhen I am not able to. - Aaron Willis

our vision

Painted Brain creates lasting community-based solutions to mental health challenges and the impact of social injustice through arts, advocacy, and enterprise. Join our community of peers redefining the mental health system of care to improve access and the quality of treatment.