Psychiatric Advance Directives

The National Mental Health Association envisions a just, humane and healthy society in which all people are accorded respect, dignity and the opportunity to achieve their full potential free from stigma and prejudice.  Consistent with this philosophy, NMHA supports and promotes the use of psychiatric advance directives as a tool for the expression of an individual’s free will and self-determination.

A psychiatric advance directive offers a clear written statement of an individual’s medical treatment preferences or other expressed wishes or instructions.  It can also be used to assign decision-making authority to another person who can act on that person’s behalf during times of incapacitation.

Psychiatric advance directives offer several key benefits.  Correctly implemented and executed, they can:

• Promote individual autonomy and empowerment in the recovery from mental illness;
• Enhance communication between individuals and their families, friends, healthcare providers, and other professionals;
• Protect individuals from being subjected to ineffective, unwanted, or possibly harmful treatments or actions; and
• Help in preventing crises and the resulting use of involuntary treatment or safety interventions such as restraint or seclusion.

NMHA supports the position that individuals considering the creation of a psychiatric advance directive must be fully informed about the benefits and limitations of these legal instruments.  Barriers to the implementation of psychiatric advance directives, such as state laws that add unnecessary procedural or legal burdens, should be eliminated.  Most importantly, anyone creating an advance directive must be able to do so without coercion, with choices regarding implementation and revocability, and with full knowledge and understanding of the implications of his or her decisions.

NMHA believes that psychiatric advance directives are an underutilized tool for empowering individuals and offer significant potential for preventing or mitigating crisis situations.  NMHA recommends that states adopt policies that ensure the enforceability of advance directives.  NMHA recommends that individuals, family members, friends, advocates, healthcare providers and other professionals meet in community dialogues and work together to promote education, training and research towards the successful creation and implementation of psychiatric advance directives programs.

EFFECTIVE PERIOD

This policy was adopted by the NMHA Board of Directors on March 2, 2002.  It will remain in effect for a period of five (5) years and is reviewed as required by the NMHA Public Policy Committee.

Expiration: March 2, 2007

For a copy of NMHA’s Issue Summary on Psychiatric Advance Directives, contact NMHA’s Advocacy Resource Center at 800-969-6642 or click here.