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Mental Health Advanced Directives

A Mental Health Advance Directive (MHAD) offers a clear written statement of an individual’s mental health treatment preferences or other expressed wishes or instructions should they become incapacitated. 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.

In 2004, Pennsylvania enacted legislation (Act 194) that provides the opportunity for individuals living with mental illness to create a MHAD and plan ahead for mental health services and supports in the event they become unable to make decisions for themselves.

MHADs 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 restrain or seclusion.

MHAPA, the Disability Rights Network of Pennsylvania, and the Pennsylvania Mental Health Consumers’ Association created a guide to MHADs that provides information about the forms and assistance in completing them. Download this entire publication. It includes the forms and instructions, answers frequently asked questions, and is available in English or Spanish.

Or download PDFs of the MHAD forms that you can fill in on your computer and save and share as PDFs. 

Forms and Instructions

The following are forms and instructions you can fill in on your computer or print. Please review the instructions before completing the forms and be aware that some of the fields are required.

Combined Form

Pennsylvania’s law allows you to make a combined Mental Health Declaration and Power of Attorney. This lets you make decisions about some things, but also lets you give an agent power to make other decisions for you. You choose the decisions that you want your agent to make for you, as many or as few as you like. This makes your Mental Health Advance Directive more flexible in dealing with future situations, such as new treatment options, that you would have no way of knowing about now.

You are presumed to be capable of making an Advance Directive unless you have been adjudicated, incapacitated, involuntarily committed, or found to be incapable of making mental health decisions after examination by both a psychiatrist and another doctor or mental health professional.

Declaration Form

A Declaration contains instructions to doctors, hospitals, and other mental health care providers about your treatment in the event that you become unable to make decisions or unable to communicate your wishes. A Declaration usually deals with specific situations and does not allow much flexibility for changes that come up after the document is written, such as a new type of medical crisis, new kinds of medication, or different treatment choices.

Power of Attorney

A Power of Attorney allows you to designate someone else, called an agent, to make treatment decisions for you in the event of a mental health crisis. A Power of Attorney provides flexibility to deal with a situation as it occurs rather than attempting to anticipate every possible situation in advance. When using a Power of Attorney it is very important to choose someone you trust as your agent and to spend time with that person explaining your feelings about treatment choices. Your doctor or his/her employee, or an owner, operator, or employee of a residential facility where you are staying cannot serve as an agent.

If you have additional questions or need assistance with completing a form, contact any one of the following organizations:

MHAPA
1-866-578-3659
717-346-0549
info@mhapa.org

Disability Rights Network of Pennsylvania 
1-800-692-7443
717-236-8110
1-877-375-7139 (TDD/TTY)

Pennsylvania Mental Health Consumers’ Association
1-800-88PMHCA
pmhca@pmhca.org

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