Mental health advance directive

This form lets you state what you want to happen if your mental health problems become so severe that you need help and treatments from others.

For example, if your mental health problems become severe enough that your judgment is impaired, or you are unable to say what you want, you can:

• let your decision makers and care providers know what medical care and mental health treatments have worked for you in the past and
• let them know what types of treatment or care you would like to get

You can include anything that might be involved in your treatment in your mental health advance directive.

For example:

• consent for, or refusal of, particular medications or inpatient admission;
• who can visit you if you are in the hospital;
• anything else you want or don’t want in your future care.

It can if you choose to name (appoint) a Mental Health agent in this form. Having an agent to advocate for you can really help make sure your mental health decisions are followed.

But if you also have a durable power of attorney form that lists a different agent for your general non-mental health decisions, things can get complicated.

If you use the form below to appoint a mental health agent, you should also fill out a Durable Power of Attorney form to choose a trusted friend or relative to help you with your other types of health care decisions. It’s better if you can choose the same agent for both sets of decisions.

Our Durable Power of Attorney Documents has questions and answers, and forms and instructions for you to use.

Yes. You can still make your own health care decisions if you are capable. You can also change or cancel your directive at any time.

You should sign your form in front of a notary.

If you cannot find a notary, you can sign in front of two “disinterested” witnesses.

You should give it to your mental health and medical providers, your agent, and a trusted friend or relative.

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

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

You can find these other directives at WashingtonLawHelp.org.