psychiatric-advance-directive

name	psychiatric-advance-directive
title	Psychiatric Advance Directive (PAD)
description	Drafts jurisdiction-specific Psychiatric Advance Directives (PADs) capturing treatment preferences, agent authority, and crisis plans for psychiatric incapacity. Trigger when the user mentions psychiatric advance directive, PAD, mental health advance directive, mental health treatment declaration, psychiatric crisis planning, Ulysses clause, psychotropic medication preferences, ECT consent planning, crisis activation plan, or mental health agent appointment.
author	CaseMark
author_url	https://github.com/CaseMark/skills/tree/main/skills/legal/psychiatric-advance-directive
license	Apache-2.0
version	0.1.0
execution_mode	open
jurisdiction	us
practice	trusts-and-estates
language	en
tags	["agreement","drafting","regulatory","transactional"]

Psychiatric Advance Directive (PAD)

A PAD preserves autonomous psychiatric treatment choices across a capacity gap. It captures medication preferences, agent authority, de-escalation instructions, and crisis contacts in a clinically actionable format — with a first-page crisis summary for intake staff.

DRAFT FOR ATTORNEY REVIEW ONLY — Not legal advice. Not execution-ready without jurisdiction-specific verification of statutory formalities, citations, and Ulysses Clause availability.

Pre-Draft Intake

Gather before drafting (skip only if user says "use defaults"):

1. Jurisdiction — required; controls enforceability, formalities, Ulysses Clause availability. Flag portability limits for multi-jurisdiction use
2. Clinical history — diagnoses (with consent), prior hospitalizations, involuntary holds, current medications, allergies/adverse reactions
3. Agent designation — primary + alternate: full legal name, address, phone, email, relationship; identify conflicting statutory default surrogates
4. Exclusions — persons blocked from agent role or information access (protective/no-contact/restraining orders)
5. Treatment preferences — ECT, seclusion/restraint, psychotropic drug classes, de-escalation techniques, voluntary vs. involuntary admission, peer respite, law enforcement involvement
6. Crisis activation — early warning signs, sensory/trauma triggers, preferred first contacts
7. Existing documents — general AHCD, health care proxy, guardianship orders, prior PAD
8. Execution logistics — notary access, witness availability, statutory disinterest rules, agent acceptance requirement

Defaults if no response: General PAD framework without jurisdiction-specific formalities; primary agent + one alternate; standard medication structure; marked NOT EXECUTION-READY.

Workflow

1. Build Document Architecture

First-page crisis summary (intake staff must find key info in <2 minutes):

• Agent name + 24/7 phone
• Top 3 crisis triggers / early warning signs
• Top 3 treatment preferences (including critical refusals)

Section map:

Section	Content
Title & Purpose	PAD title; plain-language purpose; conflict-of-directives priority clause