Psychiatric Advance Directives

As Psychiatric Advance Directive allows an individual to designate who would make mental health decisions for the patient in the event the patient cannot speak for himself or herself and mental health treatment is required. Currently, 25 States have statutes recognizing the validity of psychiatric advance directives, but other States such as Georgia, are considering them.

Historically, psychiatric advance directives are legal instruments that offer three types of self-directed planning for the patient’s own mental health care in anticipation of subsequent incapacity: (1) informed consent to future treatment; (2) a statement of personal values and preferences to guide future health care decisions; and (3) appointment of a mental health agent to act as proxy decision maker for mental health treatment. In Cruzan v. Director, Missouri Department of Health, the Supreme Court found that where the “prior expressed wishes” of an incapacitated patient can be determined by clear and convincing evidence, those wishes should be honored. The federal Patient Self-Determination Act of 1990 allows patients to documents their expressed prior wishes and requires hospitals and other health care organizations to inform patients of their rights under state law to prepare an AD, to inquire and document whether patients have executed advance directives, to ensure compliance with state laws by respecting advance directives, and to educate health care providers regarding these legal instruments.

Update (4/13/2022): HB 752 passed both houses of the Georgia legislature and is awaiting the governor’s signature. It creates the Psychiatric Advance Directive Act, providing patients with a mental health diagnosis the opportunity to direct their own care and to appoint an agent to assist with mental health care decisions. Bill text.

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