National Mental Health Association

Monday, April 08, 2002

Advance Directives Help Prevent Psychiatric Crises and Promote Recovery NMHA Position Calls For Use and Enforcement Nationwide ALEXANDRIA, Va. (March 26, 2002) A new National Mental Health Association policy statement promotes the use of psychiatric advance directives and asks states to adopt policies that will ensure their enforcement. NMHA also has developed a detailed “issue summary” to help advocates promote the adoption and use of advance directives in each of the 50 states. “NMHA is deeply concerned that clinicians and judges sometimes make treatment decisions for individuals in times of psychiatric crisis without regard to or knowledge of the individual’s past experiences or treatment preferences,” said Michael M. Faenza, NMHA president and CEO. “Psychiatric advance directives give people with mental illness a voice in their treatment during a psychiatric crisis, and can even serve to prevent crisis situations from developing in the first place.” Similar to a “living will,” a psychiatric advance directive is a statement of an individual’s treatment and service preferences. They also can assign decision-making authority to another person who can act on the writer’s behalf during times of incapacitation. When correctly implemented, advance directives: Promote individual autonomy and empowerment, which are key to recovery from mental illness; Enhance communication between individuals with mental illness and their families, friends, healthcare providers and other professionals; Protect individuals from ineffective, unwanted, or possibly harmful treatments or actions; and Help prevent crises, involuntary treatment, or traumatic interventions such as restraint or seclusion. “Knowing what works and what doesn’t, in advance, should be extremely useful information to clinicians,” said Faenza. “Advance directives help prevent and reduce psychiatric hospitalization, thus cutting costs within our overburdened public health system.”