Also known as Psychiatric Advance Directive or PAD

Families have historically struggled to provide assistance to a family member with severe mental health behavioral problems such as paranoid schizophrenia , bi polar disorder or any other mental health issue typically requiring medication to manage .Most family members with these diagnoses can be effectively treated with proper medication.  Unfortunately, many individuals stop taking their medications for a variety of reasons and can become suicidal, homeless, violent or incarcerated.  Families are left with few legal options to provide assistance to obtain medical treatment for their loved one.

Recently, Colorado law was changed to create a behavioral health-related advance directive. Colorado Revised Statute C.R.S 15-18.7-202 et. seq created a new “behavioral health order form” so that an adult may communicate his or her behavioral health history, decisions, and preferences (also referred to as a psychiatric advance directive or PAD) in the event that he or she lacks decisional capacity to provide consent to, withdrawal from, or refusal of his or her behavioral health treatment or medication in the future.  Behavioral health treatment is defined as “the provision, withholding, or withdrawal of any behavioral health examination, service, procedure, or medication.  A Behavioral Health Order Form is a document that outlines that individual’s instructions concerning behavioral health treatment, medication, and alternative treatment decisions, preferences, and history in the event that the individual lacks decisional capacity to provide consent to, withdraw from, or refuse treatment or medication.

Health care providers must make a good faith effort to locate and incorporate, as appropriate and desired, the behavioral health treatment, medication, and alternative decisions, preferences or history documented in a Behavioral Health Orders Form and comply  with a properly executed Behavioral Health Order Form that (1) has been executed in Colorado or another state, (2) is apparent and immediately available, and (3) reasonably satisfies the validity requirements.  Health care providers are not required to comply with the Behavioral Health Order Form if the instructions will cause substantial harm to the individual. However, the health care provider must make a good faith effort to consult with the individual’s Agent, if applicable, and offer an alternative course of treatment

 Instructions in a Behavioral Health Order Form that attempt to exempt the individual from an involuntary emergency procedure or commitment authorized by law are void. Similarly, an executed Behavioral Health Order Form does not mean that the individual waived the right to an involuntary commitment hearing before a judge or jury or that the individual consented to a petition for involuntary administration of medication.

There are numerous legal requirements that must be followed to create a valid Behavioral Health Directive. The Behavioral Health Order Form is effective for two years from the date the individual signed the form, unless the individual executes a new form or amends or revokes the Behavioral Health Directive.

The Behavioral Health Directive is not a substitute for a Health Care Power of Attorney.  Both documents should be  drafted to work together.  If there is a conflict between a Behavioral Health Order Form and an Advance Medical Directive, the document most recently executed controls for the behavioral health treatment, medication, or alternative treatment decision.

If there is a conflict between the Behavioral Health Directive and an individual’s request, the Directive controls for the behavioral health treatment, medication, or alternative treatment decision.  Families should be aware that a Behavioral Health Directive only goes into effect when the individual lacks capacity to provide informed consent to, withdraw from, or refuse medical treatment. A Behavioral Health Directive can be revoked at any time if the individual has capacity and the individual can always refuse to sign the document.

Behavioral Health Order Directive is a major step toward being able to provide support, care and assistance to a loved one experiencing a serious mental health situation which in the past was unavailable . Contact the Law Offices of Bradley J. Frigon to learn more about Behavioral Health Directives and if it could work for your family member .