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Psychiatric Advance Directives

1. A psychiatric or mental health advance directive is a legal tool that allows a person with mental illness to state their preferences for treatment in advance of, or during, a crisis.

A. True

B. False

2. An advance instruction can do all of the following, except:

A. Detail preferences for treatment, give consent for admission and consent for contact in advance.

B. Detail preferred medications and treatment modalities.

C. Describe wishes for end of life care and other instructions.

D. Give instructions for tending to practical life matters, such as child care and contacting an employer.

3. A PAD goes into effect when a person:

A. Is found to lack decision-making capacity

B. Is under distress

C. Has sustained injuries

D. Is admitted to the emergency department

4. All of the following are examples of periods when a person may lack capacity, except for:

A. Being under the influence of alcohol or other substances

B. Acute psychosis

C. Delirium

D. Unconsciousness

5. In a crisis situation, if a person has been deemed incapable, the PAD goes into effect and treating medical professionals can refer to the PAD to get a clear description of the person’s preferences for treatment, who to contact in their support network, and how best to support the person in crisis.

A. True

B. False

6. When done within the context of mental health treatment, the conversation around developing a PAD:

A. Enhances the process of informed consent.

B. Improves continuity of care.

C. Gives a mechanism for the family or significant others to be involved in treatment officially.

D. When done within the context of mental health treatment, the conversation around developing a PAD enhances the process of informed consent, improves continuity of care, and gives a mechanism for the family or significant others to be involved in treatment officially, without having to go through a consent process during a crisis.

7. PADs support the ethical principles of autonomy, beneficence, and justice.

A. True

B. False

8. Which of the following pertain to PADs?

A. They require thinking forward to a future state that a person has never experienced before.

B. The information in PADs if often based on past treatment experiences.

C. Once the person has been deemed incapable, the PAD is only revocable by the power of attorney.

D. PADs cannot be overridden by involuntary treatment or other pressing emergencies.

9. All states permit competent adults to legally document some form of advance planning for mental health treatment during a future period of incapacity, typically by authorizing a durable power of attorney for health care.

A. True

B. False

10. All states have enacted instructional PAD statues, which offer a legal mechanism for people with mental illness to declare in advance their specific treatment preferences, plans, arrangements, and instructions, and to give or withhold consent to future psychiatric interventions and hospitalization.

A. True

B. False

11. Which of the following was not one of the top three common barriers that were reported for not having a PAD?

A. Individuals did not have enough of an understanding about PADs.

B. It was hard to find someone or some way to get help to complete the PAD.

C. They did not know what to say or write in the PAD.

D. Not having anyone to trust to make decisions for them, known as a healthcare agent or surrogate decision-maker.

12. The instructional directive cannot be completed without a health care power of attorney.

A. True

B. False

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