You may be familiar with estate planning documents such as an advance health care directive (sometimes referred to as a “living will”) and a health care power of attorney (HCPA), but you may not realize that you can also document your preferences for future psychiatric care with a psychiatric advance directive (PAD). It can play an important role if you ever suffer a mental health crisis.
Roles of an advance directive and an HCPA
An advance directive expresses your preferences regarding the use of life-sustaining medical procedures — such as artificial feeding and breathing, surgery and invasive diagnostic tests — specifying the situations in which these procedures should be used or withheld. Because a document prepared in advance can’t account for every scenario or contingency, it’s typically paired with an HCPA.
In the HCPA, you authorize your spouse or another trusted representative to make medical decisions or consent to medical treatment on your behalf when you’re unable to do so. An HCPA can include specific instructions to your representative, as well as general guidelines or principles to follow when dealing with complex medical decisions or unanticipated circumstances.
However, these two documents may not fully address the unique challenges that can arise during a mental health crisis. That’s where a PAD can make a difference.
How a PAD is different
A PAD is a legal document that allows you to express your preferences for future mental health treatment while you’re capable of making informed decisions. If you later experience a psychiatric crisis that impairs your ability to make or communicate treatment decisions, the directive can guide health care providers and family members.
A psychiatric advance directive may address a variety of mental health care issues, including:
- Preferred hospitals or other providers,
- Treatment therapies and medications that may be administered,
- Treatment therapies and medications that may not be administered, and
- A statement of general values, principles or preferences to follow when making mental health care decisions.
Many states also permit individuals to designate a trusted health care agent to make mental health treatment decisions on their behalf if necessary.
Should you add a PAD to your estate plan?
Many people think estate planning focuses on passing assets to heirs and reducing gift and estate tax liability, but a complete plan also addresses important health care decisions, including those related to mental health. Mental health crises can develop unexpectedly, leaving family members to make difficult decisions with little guidance. A PAD complements traditional planning documents by addressing circumstances that an advance directive or HCPA may not fully cover.
Bear in mind that the availability, format and legal requirements of PADs vary by state. Thus, it’s important to work with an experienced estate planning attorney to determine whether one is appropriate and how it should be prepared.