Disadvantages of Advance Directives for Mental Health Care

Most people have heard of advanced directives for medical care. But did you know that for those who struggle with mental health issues from time to time, drawing up mental health advance directives might be the wise thing to do?

Although there are several advantages of having such documents, the nature of such directives also yields to some possible disadvantages. Depending on whether one's competency is determined when the document is written and when it's put into effect, traversing the court and mental health system can be tenuous, according to the National Association on Mental Illness website (NAMI). Read on for 3 disadvantages of mental health directives.

--Who is to say when you're competent enough to actually complete your advance directives for mental health care? Maybe you believe you're competent enough but your spouse or sister does not. This determination of competence actually varies from state to state. Some states require a judge's ruling to say you're competent enough to write the directives. Other states will accept affidavits from 2 physicians stating you're competent.

--Who determines that you are not competent at the time of your hospitalization? After all, you most likely must be deemed incompetent in order for your advance directives to "kick in." Usually, a judge makes this assessment based on information he received from the treatment providers at the inpatient facility where you've ended up.

--Speaking of sticky wickets, consider this: what if a person who is now deemed mentally incompetent wants to reject or revoke his own advance directives (written when he was mentally healthy)?

Advance directives can be very helpful as long as they are well-written, contain medically helpful info regarding treatment in the past that's worked for you and you accept and follow your own directives when the time comes. Also, depending on your state's laws, the process of writing and using your mental health directives may be clearly defined and easy to follow.

In the event you're considering drawing up advanced directives for your psychiatric care, take some time to discuss your concerns with the mental health expert you normally see. Also, contact your state's department of mental health to inquire about whether it is within your legal right to have advanced directives for mental health care in your state.

If so, ask for more information about how to go about empowering yourself to remain the decision-maker regarding your treatment, should you be hospitalized. Consider the advantages as well as the disadvantages of devising your own mental health advanced directives.

For a discussion of the advantages of mental health directives, see this author's earlier article on the subject entitled, "Advantages of Advanced Directives for Mental Health." To read, "What Does Good Mental Health Look Like?" click here. If you'd like to know more about borderline personality disorder, see the article, "I Love You, I Hate You--Understanding Borderline Personality Disorder," also by Pearl Grace.

Sources

Macomb County Community Mental Health website

National Alliance on Mental Illness website

Professional experience