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What is a Psychiatric Advance Directive?

Erin Oxendine
Erin Oxendine

A psychiatric advance directive is a legal document that indicates a person's wishes regarding mental health treatment. This document also instructs family and friends as to types of preferred treatment in the event that the person who signed it becomes mentally incapacitated. The psychiatric advance directive allows individuals to have some control over the medical choices made on their behalf.

Unfortunately, individuals may become unable to make their own decisions about mental health treatment due to brain injuries, mental illness, or debilitating health issues. When this happens, the person may require immediate psychiatric or psychological treatment. Often, the person may not get treatment that they need until a doctor or judge declares that person mentally incompetent. Then the courts may then decide what type of care the person may get, which may not be what the individual would have wanted for himself. The psychiatric advance directive is helpful because it is usually very specific as to what type of hospital treatment, medication, and therapy the person would be willing to have if this situation occurred.

Man with hands on his hips
Man with hands on his hips

There is also other helpful information a person can put in a psychiatric advance directive. The document holder may want to include a person to contact in case of an emergency. Some people may also want to put preferred doctors and medical facilities in the directive.

Most of the time, psychiatric facilities will adhere to the signed psychiatric advance directive. The only exception to this is if a person is involuntarily committed to a mental health center. Doctors have to place the immediate needs and health of the individual first. Then the psychologist or psychiatrist will usually follow the directive regarding medication and hospital care.

In order to fill out a psychiatric advance directive, the person would need to fill out the form from the state or jurisdiction where he or she lives. In the US, most states require individuals to have someone witness them completing the form. Many jurisdictions also mandate that a notary notarize the form when it is being signed. The person will need to give an executed copy of the psychiatric advance directive to the preferred mental health doctors. It is also suggested that a family member or trusted friend have a copy of this form in case of an emergency.

Some medical professional have raised questions as to whether or not advance directives should be followed. The ethical issue is what if the person who is making the directive has a mental or behavioral condition that could prevent him from making wise medical decisions. There are providers who also feel it is not in the best interest of patients to exclude certain types of treatment.

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