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Mental Health Advance Directive August 30, 2011

Posted by Crazy Mermaid in Uncategorized.
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While I was at the NAMI Washington Conference a few weeks ago, I ran into an attorney who represents people with mental illnesses who have committed crimes (mostly misdemeanors). During the course of our conversation, she asked me if I had a Mental Health Advance Directive. I told her I had never heard of it, and decided that if I hadn’t heard of it, chances are you haven’t either.

A Mental Health Advance Directive (MHAD) is a written (legal) document that describes your directions and preferences for treatment and care during times when you are having difficulty communicating and making decisions. It can inform others about what treatment you want or don’t want, and it can identify a person called an ‘agent’ who you trust to make decisions and act on your behalf.

There are advantages to having a mental health advance directive, including the following:

• You have more control over what happens to you during periods of crisis;

• Providers and others will know what you want, even if you can’t express yourself well;

• Your directive can help your case manager and others who are involved in your mental health treatment;

• The law requires providers to respect what you write in a mental health advance directive to the fullest extent possible;

Anything that might be involved in your treatment can be a part of a mental health advance directive, including, for example, the following:

• Consent for, our refusal of, particular medications or inpatient admission;

• Who can visit you if you are in the hospital;

• Who you appoint to make decisions and take actions for you (your agent);

• Anything else you want or don’t want in your future care.

What is an agent? Should you have one?

An agent is someone you appoint to represent yourself in the event you become incapacitated and unable to represent yourself. If you want an agent, the agent has to be the following:

• At least 18 years old;

• Who knows you and knows what you want when you are doing well;

• Who can inform treatment providers about your preferences and can advocate for you;

(Note: By law, your agent can’t be your doctor, your case manager, or your residential provider unless that person is also your spouse, an adult child, or a sibling.)

Who should get a copy of your mental health advance directive?

If you name an agent, that person must be given a copy. After that, it is up to you who you give a copy to. Think about giving one to your current mental health provider, your lawyer, and trusted family members. Bring a copy if you are being admitted to a mental health facility. Any treatment provider who gets a copy is required by law to make it a part of your medical record.

Will everything in my mental health advance directive be followed? In certain instances, it may not be followed. Those instances include:

• Your instructions are against hospital policy or are unavailable;

• Following your directive would violate state or federal law;

• Your instructions would endanger yourself or others;

• You are hospitalized under the Involuntary Treatment Act, or are in jail.

I urge you to consider putting this document in place if you have a mental illness. You can find the form at: http://www1.dshs.wa.gov/mentalhealth. (Note: this is for Washington State, but other states and countries have their own).

Material taken from the following source: Washington State Department of Social and Health Services

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