Psychiatric Advance Directives (PADs) Innovation Project – Phase 2 Evaluation

Project Overview

Psychiatric Advance Directives (PADs) are legal documents that promote self-determination by allowing individuals to specify their support and treatment preferences in advance of a mental health crisis, when they may be unable to communicate, make decisions, or advocate for themselves. A central component of the PADs Innovation Project is the development and implementation of PADs on a web-based platform, designed to improve accessibility and usability of directives by individuals and key stakeholders, including county behavioral health agencies, first responders, law enforcement, and hospital personnel.

The Syracuse University Burton Blatt Institute (BBI) was contracted to conduct the independent evaluation of the PADs Innovation Project across two phases. Phase 1 focused on project development and implementation in seven California counties. Phase 2 shifts the focus from implementation to outcomes and impact across eight participating California counties, examining whether web-based PADs are effective in improving recovery-related outcomes of peers and whether improved access to PADs influences crisis response, service coordination, and related outcomes.

Goals and Objectives

• Evaluate how counties, community partners, and stakeholders work together to implement and sustain the PADs Innovation Project.
• Evaluate if the platform, training, and outreach efforts benefit individuals with mental health challenges and support the professionals who serve them.
• Assess if creating and using a PAD supports self-determination, communication of treatment preferences, and recovery-related outcomes.
• Evaluate how PADs are integrated into crisis response and service systems, and assess opportunities for scalability, replication, and sustainability.
• Evaluate how PADs usage influences service utilization, crisis response, and potential cost benefits such as a reduction in institutionalizations, incarcerations, and homelessness.

Contact Information

BBI Evaluation Project Director and Co-PI: Fitore Hyseni
Email: fhyseni@syr.edu

Website: https://www.padsca.org/

Funding Agency
California Mental Health Services Oversight and Accountability Commission (MHSOAC).

Partners
Eight participating California counties, CFC, Idea Engineering, Chorus, and Painted Brain.