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Colorado governor approves psychiatric advance directives

Coloradans already have the power to execute medical advance directives in which they can appoint agents to make medical decisions for them should they become unable to communicate their wishes. They can also provide instructions for future and end-of-life medical treatment in case of incapacity.

Advance behavioral health orders

We recently told readers about a more specific type of medical directive that deals with mental health treatment, the psychiatric advance directive, called a PAD in popular parlance. At the time of that post, Colorado did not recognize PADs, but on Aug. 2, a new law took effect with a legal framework for valid PADs for Coloradans who may struggle with mental health.

Mental health in Colorado

In June, an expert panel with a large public audience discussed Colorado’s problems with developing a stable, robust mental health care system, including the significant challenge of stigma, reports The Gazette. The coroner of El Paso County, one of the panelists, explained that “people should be able to discuss their mental challenges with friends and colleagues in the same way they talk about spraining an ankle.”

That the Legislature and governor have seen fit to approve the use of PADs is surely a step in the right direction. The move recognizes that mental health is in parity with physical health and that long-term planning for treatment is equally important for both aspects of human health. Specifically, the law includes a legislative declaration that adults have the right to direct and define the scope of mental or behavioral health treatment.

The Colorado PAD legislation

According to the bill summary, a Colorado PAD allows an adult to “communicate his or her behavioral health history, decisions, and preferences.” Officially, the law calls PADs “directives concerning behavioral health orders for scope of treatment.” Behavioral health treatment is defined as the “provision, withholding, or withdrawal of any related:

  • Exam
  • Service
  • Procedure
  • Medication

The law also specifies the detailed information that the PAD must contain, including:

  • Identifying information
  • Behavioral health treatment instructions, including medication and alternative treatment
  • A statement about whether the person wants to appoint an agent and the scope of the agent’s powers
  • Signatures or marks of the person creating the directive, two neutral witnesses and the agent, if one is named
  • Any health care provider of the person
  • Any health care facility “in which the adult is enrolled, if applicable”

Colorado directives for behavioral health treatment will become a standard part of comprehensive estate planning going forward. An attorney can answer questions about the new law.


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