top of page

Mental Health Directives vs Power of Attorney


There is something that most of us do not think about when creating our advanced directives. It is also something that many people who care for a mentally ill loved one may not know about. It is a simple law that could have big ramifications called 755 ILCS 43, the Mental Health Treatment Preference Declaration Act. In summary, the law gives an individual the “option,” to designate someone to advocate for them if they are unable to make competent decisions due to a short-term mental health challenge. This person is referred to as an “attorney-in-fact.”


When we work with families in need of support for a loved one with mental illness, I make them aware of the Psychiatric Advance Directives (PAD’s) form. In most cases, a Power of Attorney for healthcare will not be acknowledged if a loved one is experiencing a mental health crisis. This is where the mental health directive comes into play. Most facilities will ask for this directive in addition to a POA. The only possible exception is when there is a guardian in place, but even then it is good practice to have a Mental Health Directive in place. In my personal experience, I have come across hospitals that have a very good understanding of the law and others that are not as informed. Nonetheless, in most cases they usually err on the side of caution.


The advantage of the Mental Health Directive is that it spells out exactly what treatments your loved one has agreed they would want and which they would not. It empowers them to make decisions pro-actively and express concerns regarding certain treatments. If you have been appointed the attorney-in-fact, it is beneficial to have a discussion about the decisions your loved one would want and make sure that you are emotionally capable of making those decisions. Having these conversations pro-actively can create insight into what it is like to live with mental illness. Most of us cannot imagine what it is like to have a mental illness and cope with the stigma or the challenges around managing it. I have been privy to conversations prompted by this form that have had a positive impact on everyone involved.


I have experienced first-hand how devastating a crisis can be when there is no mental health directive in place. I appreciate the need for this law to protect people from being declared mentally incompetent without cause. These types of laws are put in place for the protection of the individual and their freedoms. The flipside is that without this directive, you may not be able to advocate for a mentally ill loved one, creating the need for an emergency and/or temporary guardianship. This option is costly, time consuming and aggressive.


If you or someone you love has a Mental Health diagnosis and there is no mental health directive in place, consider downloading the form below and discussing this option with an attorney. It could save you and those you love a lot of hardship.


For an Illinois Declaration for Mental Health Treatment Form please visit the following website: http://www.dph.illinois.gov/sites/default/files/forms/declaration-mental-health-treatment-040416.pdf COUNSELING AND PSYCHOLOGICAL SERVICES


Additional PADs Resources: For more information about creating and implementing a Psychiatric Advance Directive to ensure that your treatment choices are heard, please refer to the following websites:


National Resource Center on Psychiatric Advance Directives website: www.nrc-pad.org/ For State by State information regarding PADs or State specific PAD forms, please refer to: www.nrc-pad.org/state-by-state



By Fran Piekarski


President, CEO and founder of Living Life with Dignity and Life with Dignity. A Certified Professional Guardian, expert in Hoarding Disorder, published author and speaker. Passionate about assisting and educating families and individuals with Mental Health issues and Dementia to create holistic, comprehensive solutions for care. "I strive to help those in these under served, under resourced communities uncover and support the best approach of care for their individual needs."

38 views0 comments
bottom of page