Washington County Designated as Pilot Site for Psychiatric Advance Directives
For many years, health care professionals and consumer rights groups have promoted Advance Directives for medical care. Sometimes called a "living will," this document allows individuals to make known their medical treatment preferences prior to a health crisis and to designate an agent to make health care decisions for them if a physician determines that they have lost the capacity to make informed decisions for themselves.
The Ohio Department of Mental Health has joined many other states in recognizing the value of this document for persons with a history of mental illness and has designated Washington and Stark Counties as the two sites for a psychiatric Advance Directive pilot project. Many people with mental illness live in fear of what will happen to them if they need involuntary treatment. They have critical decisions to make, and by instituting a psychiatric Advance Directive, they can address the following important issues before a mental health crisis: Who they will designate to speak for them and represent their best interests Choice of medications that they may or may not want to take Choice of where treatment is provided Preferences about types of treatment (i.e., electroconvulsive treatment) Choices about discharge plans Choices about the temporary care of children Choices about who they do or do not want to be notified or be allowed to visit Because the use of Advance Directives for psychiatric care is relatively new, it is unclear to what extent the courts will find them legally binding. However, many mental health care consumers who are now using these documents report that an Advance Directive greatly increases the likelihood that doctors, hospitals, and judges will honor their choices. One of the many advantages of a psychiatric Advance Directive is its flexibility. The document can range from a simple selection of who to notify in the event of involuntary treatment to a complex and detailed list of treatment and pharmacological preferences. Perhaps the greatest benefit of Advance Directives to mental health care consumers is empowerment, providing the consumer an opportunity to remind treatment providers, families, and friends that she/he is a human being who is capable of making choices and who has the right to be heard, no matter what the circumstances. The process of developing an Advance Directive opens new avenues of thought and discussion about the individual's experiences with mental illness. By discussing signs and symptoms or triggers for relapse, the consumer takes ownership of his or her illness and gains insight and more control of his or her psychiatric condition. The Washington County Mental Health and Addiction Recovery Board will designate several county locations to have Advance Directives on hand and to provide assistance in completing the documents. Presentations on psychiatric Advance Directives are available to any interested groups in Washington County. For more information, please call Ron Rees or me at 374-6990. We are excited to be a part of such an important initiative that is empowering to mental health care consumers and affords respect to their needs and choices.