Consider a Mental Health Power of Attorney

Imagine that you have just had a health emergency that has rendered you incapable of making medical decisions for yourself that you would otherwise be able to make. For situations like this, you (i.e., the principal) can get a type of advance directive called a power of attorney (POA), which would legally authorize another person (i.e., the agent) of your choosing to make decisions about your medical care or even about your property or finances. Of course, a POA requires some forethought, so you want to get a POA in place before you actually need it. The two main types of POAs are financial and healthcare, but there is also a more specific type of healthcare POA called a mental health POA. A mental health POA, which is a type of psychiatric advance directive, is a legal document giving an adult that you select the power to make decisions related to your mental health when you yourself are incapable of doing so. Such decisions include, but are not limited to, admitting you to a psychiatric ward or accepting treatment for you in the form of medication. Your POA can be as general or specific as you would like.

While there are no national guidelines for POAs, there are state-specific rules and requirements of which to be mindful. I currently reside in Alabama, so I will speak here on an Alabama-specific guideline. On the advance directive form, you can choose from a list of options how much freedom the person you authorize is allowed to exercise in terms of your care. However, your mental health care providers are not required to comply with the wishes of either you or your agent. For instance, a provider may decline treatment if his/her facility does not allow a treatment that you want or that your agent wants for you.

I have not yet gotten a POA, but I do feel that it is a necessary next step for my mental health care because a POA eliminates the need for court-appointed guardianship and/or conservatorship in the event that I were to become incapacitated. This may be something you choose not to do because it seems foreboding, but you never know what could happen to you. If it brings you any comfort at all, a POA does not have to remain valid indefinitely. It can always be revoked via a written notice at any time.

Now that you have read through this post, you may (or may not) be wondering how a POA differs from a crisis plan, which I discuss here first and again here. I would say that it’s the legality of the POA. Don’t get me a wrong: A crisis plan is very helpful for both you and your loved ones to ensure that you receive the best care. However, if your mental state declines to the point that you need another person to make medical decisions for you or to care for your estate, then a POA is the way to go.

Signed,

Lai (Bipolar I)