Mental Health Care Declaration Template

What Is the Mental Health Care Declaration?

A Mental Health Care Declaration, sometimes called a psychiatric advance directive, is a legal document that records your mental health treatment preferences while you have capacity to make informed decisions. It only becomes effective if a physician determines you temporarily lack capacity to consent to treatment.

This declaration lets you designate a mental health care agent, specify medication preferences, consent to or refuse electroconvulsive therapy, set hospitalization preferences, and document crisis de-escalation techniques. Unlike a standard advance directive focused on end-of-life care, this declaration addresses psychiatric treatment specifically.

 

 

Is This Mental Health Care Declaration Right for You?

You need this declaration if you're:

• Living with bipolar disorder, schizophrenia, or major depression
• Recovering from psychiatric hospitalization and planning ahead
• Concerned about forced treatment during mental health crises
• Managing conditions that could temporarily impair judgment
• Working with a therapist on crisis prevention planning
• Wanting control over ECT and medication decisions

You definitely need this declaration if:

• You've experienced involuntary hospitalization or forced medication
• Certain psychiatric medications caused severe side effects for you
• Family members don't understand or respect your treatment preferences
• You have trauma related to restraint or loss of autonomy
• Your mental health condition causes episodic capacity impairment

 

 

Why Thousands Trust Legal GPS Templates

Save Money

Attorney fees run upward of $500 for a basic psychiatric advance directive. Get the same protection for $35.

Save Time

Download immediately and complete in under an hour. No scheduling attorney consultations or waiting for drafts.

Look Professional

Attorney-drafted language that psychiatric facilities and courts will respect and honor during capacity proceedings.

Keeps You Out of Court

Clear documentation of treatment preferences through Article III Medication Preferences, Article V ECT provisions, and Article VII Crisis Intervention protocols reduces disputes with providers and family.

 

 

 

Get Protected in 3 Simple Steps

Step 1: Secure Checkout

Complete your purchase through our encrypted payment system. Receive instant access to your template.

Step 2: Instant Download

Download your Mental Health Care Declaration template immediately in Microsoft Word format. No waiting, no shipping delays.

Step 3: Fill In the Highlighted Fields

Complete the customizable sections using our comprehensive how-to guide. Execute with witnesses or notary as required by your state.

 

Frequently Asked Questions

Can I use this template multiple times?

Yes. You can use this template as many times as needed. Update it whenever your treatment preferences change, your mental health care agent changes, or you want to revise your medication or hospitalization preferences.

Is this declaration legally binding?

Yes, when properly executed. Mental health care declarations are recognized under state mental health laws, though specific requirements vary by state. Providers must honor your stated preferences unless doing so would violate professional standards of care or be medically contraindicated.

What's the difference between this and a regular advance directive?

Standard advance directives address end-of-life medical treatment decisions. This mental health care declaration specifically addresses psychiatric treatment preferences like medications, ECT, hospitalization, and crisis interventions. Most people need both documents.

Can this declaration prevent involuntary hospitalization?

No. This declaration cannot override statutory criteria for involuntary commitment if you meet legal standards for posing imminent danger to yourself or others. However, courts considering involuntary commitment will review your stated preferences and this declaration can influence treatment decisions once you're hospitalized.

Who should I designate as my mental health care agent?

Choose someone who understands your mental health history, respects your treatment preferences, can advocate effectively with medical professionals, and has the emotional resilience to make difficult decisions during crisis. This doesn't have to be family—choose whoever will actually honor your wishes.

What happens if I change my mind about ECT or medications?

You can revoke or update this declaration anytime you have capacity by creating a new declaration or executing a written revocation. Review it annually or whenever your treatment preferences change significantly.