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People who are concerned that they may be subject to involuntary psychiatric treatment or commitment at some future time can prepare a legal document in advance to express their choices about treatment. This is called a psychiatric advance directive.
Under federal law, advance directives must be offered in any facility receiving Medicare or Medicaid reimbursements (including any psychiatric hospital). The law applies equally to individuals with a psychiatric illness and those with any other medical condition. States also have laws governing advance directives and have often produced their own suggested forms for such a document. More information on state laws can be found at the National Resource Center on Psychiatric Advance Directives, a joint project of the Bazelon Center and Duke University.
Advance directives can specify the treatment a person wishes to receive if they are found incapacitated, such as which medications they prefer, treatments they do not wish to have or ways in which treatment may be administered (such as refusing shots and choosing pills). It also allows them to make other specifications, such as who they would like to be allowed to visit them in a hospital, what arrangements they want for their children or for pets, and any financial arrangements that are needed (such as how their bills should be paid). What is included in an advance directive is entirely up to the person who creates it.
The Bazelon Center has developed a Psychiatric Advance Directives template for consumers’ use to create their own.
The Bazelon Center created a fact sheet to help people understand the federal law on advance directives.
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