Psychiatric Advanced Directives

As an advocate for your mental and physical health, it's important for you to be familiar with such legal documents as:

• Advanced Healthcare Directive
• Living Will
• Medical Power of Attorney

But, what about a Psychiatric Advanced Directive?

Many people either know about or have created their own Advanced Health Care Directive, or "Living Will." You may also be familiar with the Medical Power of Attorney. If you are not, the following explanation may provide valuable information for you and your loved ones.

When you create an Advanced Health Care Directive or, Living Will, you are stating your wishes for the kinds of medical treatment you do or do not want if you become seriously injured or ill and are not able to communicate your wishes at the time of treatment. It's important to understand, that this Healthcare document is completely separate from a will or trust that you create to leave your property to others upon your death. 

The Medical Power of Attorney differs from the Advanced Healthcare Directive in this way: while the Advanced Healthcare Directive specifically identifies the types of treatment you want or do not want based on your medical condition, the Medical Power of Attorney allows you to specify a specific representative to work with the doctors to make the best treatment choices for you based on the guidance you outlined in your Advanced Healthcare Directive.

However, those with Mental Health Issues might also want to create what is called, a "Psychiatric Advanced Directive" or PAD. It is also known as a Mental Health Advanced Directive.

What is a Psychiatric Advanced Directive?

The best definition I could find was from the US Library of Medicine National Institute of Health:

"Psychiatric advance directives (PADs) are written documents or oral statements that allow adults with decision-making capacity to declare their treatment preferences and/or to designate proxy decision makers to act on their behalf should they be deemed incapable in the future of making informed choices on their own.

In the U.S., the Patient Self-Determination Act  created momentum for recovery-oriented care, which has led to the enactment of mental health-related advance planning legislation in about two-thirds of the states. Internationally, increasing attention to such tools is found in the U.K., Ireland, Germany, Belgium, Canada, New Zealand, Australia and India."

The Bazelon Center for Mental Health Law has an extensive and comprehensive section regarding PAD's. Here is a link for information and an example of a form to complete for a Psychiatric Advanced Directive.

The National Resource Center on Psychiatric Advanced Directives can answer a lot of your questions, especially regarding specific statutes for the state in which you live. Another option is the Legal Consumer site that includes all types of Healthcare Directives, including Mental Health Care Directives by State.

Many people don't realize that the ADA, Americans with Disabilities Act, also protects those with Mental Illness.

"The ADA covers a wide range of individuals with disabilities. An individual is considered to have a "disability" if he or she has a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment."

As for me, I have already created an Advanced Healthcare Directive, "Living Will," and identified in writing a Medical Power of Attorney. I will definitely contact my lawyer to add a Psychiatric Advanced Directive to this list of my legal documents. All of these documents are important to have prior to any scenario that may occur when the emotions of my loved ones and clarity on my part can not determine the types of treatment I prefer.

It makes sense, if you consider the alternative. Who would you rather have in charge of your treatment choices? You, as stated in a legal document? Or, someone who knows nothing about you?

If you think about it like that, there isn't any reason to hesitate creating these documents, is there? Be pro-active. Be your own advocate.


IMPORTANT NOTE:  Verify your individual state or country laws whether your Psychiatric Advanced Directive/Mental Health Advanced Directive requires notarization.