EP15: Psychiatric Advance Directives with Bebe Smith, LCSW

Updated: Jan 19

Episode 15 of the Mental Horizons Podcast was with Bebe Smith, MSW, LCSW and the topic is Psychiatric Advance Directives.



Listen to the episode on Stitcher, iTunes, or SoundCloud.

Bebe is director of mental health and coordinator of the North Carolina Evidence Based Practices Center at Southern Regional Area Health Education Center, part of the North Carolina AHEC system. She is also project coordinator for the Crisis Navigation Project, a collaboration between SR-AHEC, Duke University Medical Center, and NAMI-NC to promote the use of psychiatric advance directives.


Prior to joining SR-AHEC, she worked for 21 years at the University of North Carolina at Chapel Hill in the Department of Psychiatry and the School of Social Work. She has taught mental health professionals from multiple disciplines in clinical and academic settings. Her clinical work has focused on providing humane and evidence-based treatment and services to persons who live with schizophrenia and other severe mental illnesses.


In 2005, she helped develop OASIS, the first early psychosis program in North Carolina. She was a founder and co-director of the UNC Center for Excellence in Community Mental Health in 2008. She led a pilot of Critical Time Intervention (CTI), a team-based intensive case management model originally developed for people experiencing homelessness, from 2012-2015. CTI was adopted for statewide expansion in 2014. She trains nationally and internationally in the CTI model and other psychosocial treatment approaches. She was the NASW-NC Social Worker of the Year in 2012, and won the Bryan Public Service Award from the Carolina Center for Public Service in 2015.


Three main talking points:


  1. Bebe talks with Virgil about her leadership roles in mental health and the ways she has had to challenge the mental health system throughout her career.

  2. Bebe teaches the listener about Psychiatric Advance Directives and how they can be powerful tools to help people maintain autonomy and a sense of control amidst crisis.

  3. And lastly, Bebe and Virgil discuss psychiatric advance directives and Assisted Outpatient Treatment. How are these two things related, if at all? Can they both protect a person's autonomy or are they on two ends of a spectrum? If so, how do we reconcile this dichotomy and not get bogged down in ideology when the goal is serving the best interests of the individual?

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Disclaimer: As therapeutic consultants, we advise, advocate, recommend, facilitate and empower, but we do not treat mental illness or addiction. We are not licensed mental health professionals, but will often refer you to professionals and programs for treatment. (Note: We have no financial relationship with any of these professionals or programs.)  Any consultation we give is for educational, informational and motivational purposes only and is not meant to replace professional psychiatric, psychological, programmatic, legal or financial advice you may need for yourself or your family member. 

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