Psychiatric Advance Directives (PADs) are a legal method for persons at risk of loss of decisional capacity during a behavioral health crisis to  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. 

Format

Recorded webinar, non-interactive, self-paced distance learning activity with post-test.

This presentation was recorded on October 8, 2021.

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

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

Instructional Level

Introductory, Intermediate 

Estimate Time to Complete

Estimated Duration: 1.0 hour
Program Start Date: October 12, 2021 
Program End Date: October 12, 2024

Ongoing Interdisciplinary Discussion Board
After completing the course, engage with colleagues in the mental health field through SMI Adviser's 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

Participants who wish to earn AMA PRA Category 1 Credit™, nursing continuing professional development contact hours (NCPD, formerly CNE), CE credit for psychologists, CE credit for social workers, or a certificate of participation may do so by viewing the live presentation and completing the evaluation. Participants claiming CE credit for psychologists and those claiming CE credit for Social workers, must have full attendance to claim credit. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians), NCPD (nurses), CE certificate (psychologists), CE certificate (social workers) or certificate of participation (other disciplines) showing the event date and hours earned.  

Continuing Education Credit

Physicians

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The APA designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Psychologists

The American Psychiatric Association is approved by the American Psychological Association to sponsor continuing education for psychologists. American Psychiatric Association maintains responsibility for this program and its content.

Nurses/Nurse Practitioners

The American Psychiatric Nurses Association is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Social Workers 

American Psychiatric Association, provider #1743, 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 as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. American Psychiatric Association maintains responsibility for this course.  

ACE provider approval periods: 05/18/2020 - 05/18/2021 and 05/18/2021 - 05/18/2024.  

Social workers completing this course receive 1.0 continuing education credits. 

Faculty and Planner Disclosures

All financial relationships relevant to this activity have been mitigated.

Instructor

• 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.  

Planners

• Teri Brister, PhD, LPC, National Alliance on Mental Illness. Reports no financial relationships with commercial interests.
• Amy N. 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 website 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 SMIadviserhelp@psych.org for technical assistance