Mental Health Advance Directive

A Mental Health Advance Directive can help if you have a mental illness that sometimes affects your ability to make health care choices. It's a form you use to say what you want to happen if your mental illness become so severe that you need help from others. It provides guidance for your health care agent, friends, relatives, and health care providers about what mental health care works best for you. It also allows you to approve specific medications and treatments that other health care directives and power of attorney forms cannot authorize.

You can include anything that might help others know how to give you the care you need when you experience severe symptoms from your mental illness, including the following examples:

• You can approve, refuse, or put limits on psychiatric medications.
• You can approve, refuse, or put limits on psychiatric treatments.
• You can approve hospitalization if your symptoms become severe.
• You can say who can and cannot visit you if you are in the hospital.
• You can name the kinds of care you want medical staff to try before they resort to more serious measures like restraints.

You should attach a copy of your Power of Attorney form to your Mental Health Advance Directive.

• Important! A general health care power of attorney can't authorize mental health hospitalization or electroconvulsive therapy (ECT). If you want your power of attorney to be able to consent to those things, you must appoint a power of attorney for mental health care. You can do that on your Mental Health Advance Directive form. You should appoint the same person as your agent for mental health care as for general health care to avoid confusion.

If you don't have a Power of Attorney for Health Care, you should fill that out too. You can fill it out separately or at the same time as your Mental Health Directive on Washington Forms Online. Think carefully about who you want as your power of attorney (agent). Choose someone that you trust to make decisions in line with your health care values, even if they would make different decisions for themself. 

Under state law, you're capable of making your own decisions if you don't have a guardian and no judge has found you to be "incapacitated." You can read the state law about this, including the legal definition of capacity, at RCW 71.32.020.

You can also change or cancel your Mental Health Advance Directive at any time.

It's best if you sign your directive in front of a notary.

If you can't find a notary, you can sign in front of 2 witnesses. Here's a list of people who cannot witness your signature:

• Someone you've given power of attorney for health care to
• Your medical provider
• An owner or employee of any facility where you're a patient or where you live
• Anyone related to you
• Anyone who you're dating
• Anyone who could profit from you getting mental health treatment

You should give it to any medical providers involved in your mental health treatment and any agent you've named in your directive and Power of Attorney form.

You should also ask your local hospital if they'll put it on file for you.

Yes. A Mental Health Advance Directive is a legal advance directive. Medical providers are usually legally required to follow your advance directives. The best way to make sure your wishes will be honored is to talk with your medical team, your care facility, your caregivers, and your family members about your Mental Health Advance Directive.

Yes. There are directives for care if you have a serious or terminal illness or dementia.

You can find information about these other directives at WashingtonLawHelp.org.