Chapter 17 - § 17.2 • TOOLS AND RESOURCES

• Jurisdiction: Colorado

§ 17.2 • TOOLS AND RESOURCES

In addition, it is often a phone call from a family member that initiates a request for a mental health law solution. This section focuses on legal tools that can be applied to a given situation, with the understanding that some of these tools are voluntary, while others require court process.

§ 17.2.1—Colorado's Psychiatric Advance Directive

Colorado's 2019 legislative session brought forth a bill that authorizes a person to direct mental health care in a written form in advance of a period where he or she may become unable to communicate preferences. The bill was founded on the concept of the Medical Orders for Scope of Treatment (MOST) legislation and places the law directly after the MOST legislation at C.R.S. §§ 15-18.7-201, et seq. This legislation was important for the main goal of initiating a psychiatric advance directive form in Colorado, but is also an imperfect solution due to the hybrid legal nature of the end-product (is it a directive, a medical order, or a power of attorney?) and the uncertainty within the medical community on handling the form. This author suggests that the form be completed with the help of a mental health practitioner, although there is no such requirement under the law. Instead, it is a voluntary tool for a person to use regardless of their access to mental health care.

The new directive is known to some as the Behavioral Health Orders for Scope of Treatment Act (Act) or Behavioral Health Orders Form. It was decided during the "unofficial" form-making process to go with a name that is already familiar to many; thus, the form is generally referred to as a Psychiatric Advance Directive (PAD). The Act authorizes a person to create positive mandates for his or her mental health care — for example, "The following medications are to be administered unless doing so will cause substantial harm" — provide alternative instructions, and select an agent. An agent's authorization is limited to either executing the person's behavioral health treatment instructions or making decisions concerning the person's behavioral health treatment, medications, and alternative treatment.

One of the areas of disagreement in the national discussion on psychiatric advance directives is whether and when a person can alter or revoke a psychiatric advance directive. Judy A. Clausen, "Bring Ulysses to Florida: Proposed Legislative Relief for Mental Health Patients," 16 Marq. Elder's Advisor 1 (2014). Colorado resolved the...