The Burton Blatt Institute (BBI) conducted a four-year qualitative evaluation of a multi-county initiative in California aimed at developing and assessing the functionality of a web-based Psychiatric Advance Directives (PADs) platform. The project involved a collaborative effort across seven counties and engaged a diverse range of stakeholders, including individuals with mental health conditions, service providers, hospitals, and law enforcement. The evaluators conducted an extensive literature review, which shaped the development of semi-structured interview protocols and observational tools.

Read Full Report – Evaluation of the California Web-Based Psychiatric Advance Directives – Phase #1

BBI collected and analyzed qualitative data from more than 375 observations of PADs workgroups, meetings, and training sessions, along with 79 semi-structured individual interviews. BBI’s evaluation focused on identifying barriers and facilitators to the potential adoption and implementation of PADs, as reported by individuals with lived experience, behavioral health staff, and other stakeholders. The evaluation explored the platform’s potential as a catalyst for broader systems change through alignment with Supported Decision Making (SDM) principles, which emphasize the use of trusted supporters to enable individuals to make their own decisions.

Findings indicate that the California Web-Based PADs Project is generating promising outcomes with implications for improving recovery-oriented mental health practices, enhancing individual autonomy during crises, and informing future mental health policy and systems reform. The platform may serve as a scalable model for PADs implementation in other areas. For more information, visit the project website: www.padsca.org.