Georgia Psychiatric Advance Directive: What the 2022 PAD Act Covers

In 2022, Georgia passed HB 752, creating a formal statutory framework for psychiatric advance directives (PADs). This gives adults the legal right to document their mental health treatment preferences in advance — including which medications they accept or refuse, which facilities they prefer, and who should make psychiatric decisions if they lose capacity.

Before HB 752, Georgia had no specific statute governing psychiatric directives. Individuals could include mental health preferences in their standard healthcare advance directive, but the legal authority of those provisions during a psychiatric crisis was unclear.

What a Psychiatric Advance Directive Can Do

A Georgia PAD allows you to document preferences about:

• Medications: Which psychiatric medications you consent to and which you refuse, including specific drugs, drug classes, and dosage limits
• Treatment settings: Which facilities or types of facilities you prefer for inpatient psychiatric care
• Electroconvulsive therapy (ECT): Whether you consent to or refuse ECT under specific circumstances
• A psychiatric agent: A named individual authorized to make mental health treatment decisions when you lack capacity — similar to the healthcare agent in a standard advance directive, but specifically for psychiatric care

How It Differs from the Standard Healthcare Advance Directive

The standard Georgia Advance Directive for Health Care under O.C.G.A. § 31-32 covers medical treatment broadly, including some mental health situations. The PAD is a complementary document with important distinctions:

The critical limitation: a psychiatric advance directive cannot override a valid court order for involuntary examination, treatment, or hospitalization. If a court determines you meet the criteria for involuntary psychiatric commitment, your PAD's treatment refusals do not apply.

Who Should Consider a PAD

Psychiatric advance directives are most valuable for people who:

• Have a recurring mental health condition (bipolar disorder, schizophrenia, major depressive disorder) with episodes that impair decision-making capacity
• Have strong preferences about specific medications — particularly those who've experienced adverse reactions to drugs commonly used in psychiatric emergencies
• Want to prevent specific interventions like ECT or involuntary sedation during a crisis
• Have experienced involuntary treatment and want to establish documented preferences for future episodes

For individuals without psychiatric conditions, the standard healthcare advance directive typically provides sufficient coverage for incidental mental health situations.

Execution Requirements

Like the standard advance directive, a PAD must be executed while you have decision-making capacity. The signing requirements include witnesses, and the document must clearly identify itself as a psychiatric advance directive under the 2022 PAD Act.

Your psychiatric agent can be the same person as your healthcare agent, but consider whether the person best suited for medical decisions is also the best advocate for your psychiatric care preferences. The skills and knowledge required are different.

Practical Considerations

Share it with your treatment team. Your psychiatrist, therapist, and any facility where you receive regular care should have copies. During a psychiatric crisis, the treatment team may not have time to search for documentation.

Update it after major medication changes. If you start or stop a psychiatric medication, your PAD's drug preferences should reflect your current experience and knowledge.

Coordinate with your standard advance directive. If both documents name different agents, clarify which agent has authority in overlapping situations — for example, a medical crisis with psychiatric components.

The Georgia Advance Directive & Living Will Kit covers how the standard healthcare advance directive and the psychiatric advance directive work together, including guidance on the 2022 PAD Act's provisions and limitations.

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