Advance Directive Form
What is a mental health advance directive?
A mental health advance directive is a written document that
describes what you want to happen if you become so
incapacitated by mental illness that your judgment is
impaired and/or you are unable to communicate effectively.
It can inform others about what treatment you want or don't
want, and it can identify a person to whom you have given
the authority to make decisions on your behalf.
How do I complete a mental health advance directive?
A model "fill-in-the-blanks" form was included in the state
law and it is probably the best and easiest way to create a
mental health advance directive. You can download the form,
or contact the
Ombuds for a
form, or your mental health provider may
also have copies of the form.
Does my provider have to follow what I say?
The law requires mental health providers to respect your
mental health advance directive, but they are not required
to follow it in all cases. If instructions or preferences in
your mental health advance directive are against hospital
policy or are unavailable, or would violate state or federal
law or immediately endanger you or others, providers are not
obligated to comply with those provisions. Also, if you are
involuntarily hospitalized under the Involuntary Treatment
Act, or are incarcerated in jail, your mental health advance
directive may not be fully honored.
If you would like further assistance with understanding and
filling out your advance directive you can contact the
Mental Health Ombuds at (360)
867-2556 or (800) 658-4105.