All About Bipolar

Posted By atorturedsoul on September 2, 2009

Psychiatric Advance Directives, or Advance Directives for Mental Health Care, are an important step in maintaining control of treatment, even when you are incapable of making decisions.

A Psychiatric Advance Directive, or PAD, is a legally binding document that outlines treatment you approve and disapprove of in the event that you are unable to convey your wishes or have been deemed incapable of making decisions. Anyone who has been diagnosed with a mental illness should have an advance directive and anyone with a family history of mental health issues should strongly consider having one.

A PAD generally permits you to plan for, consent to, or refuse future treatment, such as:

• hospital admission

• administration of medication

• electroconvulsive treatment (ECT)

A PAD permits you to make these decisions in advance, anticipating that you may experience crisis at some future time when you will not be able to make decisions or communicate your wishes about treatment.

Please note that laws vary from state to state and it is important that you understand these laws so that your PAD is legally binding. Visit http://www.nrc-pad.org/content/view/282/83/ to learn more about the laws in your state.

In some situations, mental health care providers do not have to follow your directive. You should know what situations could result in the nullification of your Psychiatric Advance Directive. The state of Tennessee says:

“Your mental health providers could lawfully decline to follow your PAD if you were involuntarily committed to hospital under State law and a treatment review committee authorized such a course, or if there was an emergency endangering your life or health: Chapter 33-6-1006.  Additionally, an individual provider may withdraw care if he or she cannot comply with your PAD as ‘a matter of conscience’.  In that situation, he or she must arrange for your prompt transfer to the care of others.”

Knowing this, my goal is to avoid being involuntarily committed if at all possible. My family and my doctor will give me the option to voluntarily check in at a private mental health care facility before taking any further action. If it becomes necessary to have me committed involuntarily, I will be admitted by my husband to a private facility where he can maintain a great deal of control over my care. Having knowledge of the laws involved allows my family and me to take steps to avoid undesired types of treatment. In this case, knowledge really is power so be well-informed of the laws in your state.

What can be specified in an Advance Directive for Mental Health Care or Psychiatric Advance Directive (PAD)?

• Preferred treatment facilities and facilities to avoid
• Medications you prefer and medications to avoid
• Treatment that should not be used (i.e. electroconvulsive treatment)
• Provide power of attorney to allow someone to make decisions for you
• Provide past experience with medications you have taken

The state of Tennessee does not require that an advance directive is notarized. However, two witnesses must sign to confirm that you were not mentally incapacitated or coerced into completing the directive. One witness must be someone who is not related to you. Again, this may vary from state to state. You must find out if your directive has to be notarized or signed by witnesses to be legally binding.

It is also advisable to maintain two or more copies of the directive. Keep one, give one to the person you designate power of attorney, and provide your current doctor(s) with a copy to keep on file. This will ensure that your directive is available when needed.

Visit http://www.nrc-pad.org to learn more about Psychiatric Advance Directives. This is an important step in maintaining control over your mental health care.

If you live in the state of Tennessee, you can download the forms for a PAD at:

http://www.state.tn.us/mental/t33/DHMT_FORM.pdf

Instructions are located at:

http://www.state.tn.us/mental/t33/DMHT_bro.pdf

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Categories: About Bipolar Disorder, Agoraphobia, Bipolar 1, Bipolar 2, Cyclothymia, My Personal Experiences, NOS, Panic Disorder, Psychosis
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