Psychiatric Advance Directives Glossary and Resources

National Resource Center on Psychiatric Advance Directives. NRC-PAD is a nonprofit organization that offers a state by state guide to laws, rules, forms and other resources.

• NRC-PAD.org

Mental Health America.

• MHA Policy on Psychiatric Advance Directives
• Issues on Summary on Psychiatric Advance Directives (PDF)

Advance Directive: A document you write that gives instructions for your care at times when you can’t speak for yourself because of illness or because you lack the capacity — the ability to make informed decisions about your own care. You can also name another person or persons (healthcare agent) to act on your behalf in your advance directive.

Capacity: The ability to make informed decisions about your own medical care. You must be able to take in information, understand your choices and communicate your decision. If you are too sick to do this, doctors can determine that you lack the capacity and turn to other people to make decisions for you. This is when they should consult your psychiatric advance directive and your health care agent. Loss of capacity is usually temporary, until you are well enough to make decisions again. It is important to note that state laws on capacity may differ.

Health care Agent: A person that you instruct to make medical decisions for you when you lack the capacity to make them for yourself. Your psychiatric advance directive should spell out the powers you give to your health care agent to carry out your instructions, advocate for you and make decisions on your behalf. This person can also be called a proxy or patient advocate.

Informed Consent: A decision you make about your treatment based on a good understanding of the choices involved, alternative treatments you could choose and the consequences of the choices you make.

Incompetence: When a judge finds you as incompetent it means that you are incapable of managing your own affairs on a long-term basis. This might include the ability to make health care decisions, handle money or make major decisions about your life. The court then appoints a guardian to make your decisions.

Living Will: A document you write that gives instructions about how you want to be treated when you are terminally ill and not expected to recover. You spell out the treatment and care you want as well as measures you do not want taken. Your living will takes effect when you are unable to speak and make decisions for yourself.

Power of Attorney: Power you give to another person, called a health care agent, authorizing them to act on your behalf when you are unable to do so.

Protection and Advocacy (P&A) Agency: A state agency charged with protecting the rights and advocating for people with mental illness, intellectual disabilities and other disabilities, especially when they are in hospitals or other institutions.

Psychiatric Advance Directive: A special form of advance directive that spells out what treatments you want and don’t want and how you want to be treated when you are in a mental health crisis or hospitalized and unable to make your own decisions. It can also include the naming of your health care agent. You should consult with a lawyer (attorney) in your state that has experience preparing psychiatric advance directives. In an emergency situation, however, it is important to understand that doctors have the authority to make decisions that are necessary to ensure your safety and that of other patients and hospital staff.

Revocable: The ability to change your mind and cancel your advance directive. If your state law allows you may decide to make your psychiatric advance directive nonrevocable, which means it will remain in effect when you are very ill.

Repository: A central location in a state where advance directives are kept safe and made available to doctors and hospitals who need to consult them.

Ulysses Clause: A statement in a psychiatric advance directive that permits doctors to treat you over your own objections when you are very ill.