Mental Health Advance Directive
What it Does For You
How To Set Yours Up

A Mental Health Advance Directive (MHAD) is an important tool if you, or a loved one, deals with a mental health condition that can cause lapses in the ability to make decisions for yourself/themselves. Putting a MHAD in place is a fairly simple and straightforward process. Before you begin the process, we want to make sure that setting up a Mental Health Advance Directive is right for your situation.

So we will outline what is is, what it does, who gets a copy, and how to set one up for yourself or loved one. So, please read through the following information first, and then follow the link below to access the Mental Health Advance Directive form.

What is an MHAD?

It is a written document that describes your directions and preferences for treatment and care during the times that you are having difficulty communicating and making decisions. It can inform others about what treatment you do want, and what treatment you don't want. It can also identify a person as your "agent", who you trust to make decisions and act on your behalf.

Should I have a Mental Health Advance Directive?

There are several advantages to having an MHAD set up.

• You have more control over what happens to you during periods of crisis.


• Providers and others will know what you want, even if you cannot express yourself well.


• Your directive can help your case manager and others who are involved in your mental health treatment.


• The law requires providers to respect what you write in your Mental Health Advance Directive, to the fullest extent possible.

What's included in a MHAD?

Anything that might be involved in your treatment can be included in your advance directive.

• Consent for particular medications or inpatient admission.


• Refusal of particular medications or inpatient admission.


• Who can or cannot visit if you are in the hospital or other inpatient facility.


• Who do you appoint to make decisions and take actions for you (your agent).


• Anything else you want or don't want in your future care and treatment

Should I have an agent?

You have the option of naming an agent in your Mental Health Advance Directive, and they must meet the following criteria:

• Be at least 18 years of age.


• Know you and what you want when you are doing well.


• Be able to inform treatment providers about your preferences and able to advocate for you.

By state law, your agent cannot be your doctor, your case manager, or your residential provider unless that person is also your spouse, adult child, or sibling.

Who should get a copy of my MHAD?

If you elect to name an agent, that person must be given a copy. After that, it is entirely up to you who you give a copy to. You might want to give a copy to your current mental health provider, your lawyer (if you have one), and trusted family members or friends. Bring a copy with you if you are being admitted to a mental health facility. Any treatment provider who gets a copy is required to make it a part of your medical record.

Will everything in my MHAD be followed?

These are the instances in which your Mental Health Advance Directive may not be followed:

• Your instructions are against hospital policy, or are unavailable.


• Following your directive would violate state or federal law.


• Your instructions would endanger you or others.


• You are hospitalized under the Involuntary Treatment Act, or you are in jail.

Can I change or revoke my MHAD?

As long as you have the capacity you can change or revoke it at any time. If you are incapacitated, you can only change or revoke it if you have specified that ability to do so in your MHAD. Changes need to be done in writing. Be sure to notify everyone who has a copy if you revoke or make changes to it.

What if I already have a living will or durable power of attorney?

Where there is a conflict between a Mental Health Advance Directive and any previous directive, such as a living will, the newer document will have legal priority. To reduce confusion, it is probably best to have one person act as your MHAD agent and durable power of attorney.

How do I create a Mental Health Advance Directive?

You can find the MHAD form - Word version here.

You can find the MHAD form - PDF version here.

Where can I go for more information about MHADs?

You can read the law online at Washington State Legislature. Follow the link to "Laws and Agency Rules", it is in the navigation bar on the left side of the page. Look under the Revised Code of Washington for RCW 71.32. Note when the Laws and Agency rules page loads, there is a search box in the upper right hand corner of the page, with three different options for searching. In the box for RCW, simply type in 71.32 and you can view the entire bill and all of its subsections.

Call your local mental health provider or ombuds service.

Call the Mental Health Office of Consumer Affairs at 1-800-446-0259

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