What kinds of mental health care details can go into an AD?


You can write preferences and instructions for all sorts of things, like:

  • The medications you take now,
  • The medications you prefer,
  • The medications you refuse,
  • Non-medication treatments and strategies that you prefer,
  • Contact information for your psychiatrist, case manager, therapist, etc.,
  • Information on what helps you when you are in crisis,
  • Information on what makes things worse when you are in crisis,
  • Hospitals and crisis units you prefer and do not prefer,
  • Whether your agent can consent to hospitalization,
  • And more…


That sounds like information I have in my crisis plan.

There is definitely some overlap between ADs with mental health care instructions and crisis plans.  But ADs are more specific and aimed at giving doctors the targeted information they need.  Also, ADs are legal documents but crisis plans usually are not.

What power will my agent have over inpatient hospitalization?

You can decide what power your agent will have.  The law and AD forms assume that you want your agent to have power related to inpatient hospitalization.  But you can cross out the power if you do not want your agent to have it.


Are there any limits on an agent’s power over inpatient hospitalization?

Yes, definitely.

First, an agent cannot just decide that a person should be inpatient hospitalized for mental health care.  Instead, it must be a case where doctors have decided that the person meets the conditions for inpatient hospitalization.


Second, there has to be a hospital or unit that is willing to admit the person.

Then, it comes time for the doctors to get consent from the agent.  (And an agent could refuse consent if the agent does not think it is the best option or what the person would want.)

Finally, an agent’s consent is good for only 10 days.   If the person is doing better before 10 days are done, the person could be found ready to leave the hospital.  If the person still needs to be in the hospital, then the hospital will seek continued hospitalization based on the person’s consent or a court order.

Can I put mental health details in a separate AD?

Yes.  The law makes it possible to put everything in one AD but it does not require you to do so.  If you want to make a separate mental health advance directive, here are some things to plan for:

  • How will a general medical doctor find out about your mental health medications?
  • Will you have different agents for the different ADs?
  • Is it OK for your agent to give mental health details if it is important for getting care?

Health includes mental wellness.  Over half of states have realized this and made laws that allow people to plan ahead for mental health care.  Virginia is the only state that changed its laws to clearly reflect how mental health is one part of the whole person.  So, in Virginia you can make one AD that covers all your health care, including mental health care.

Advance Directives and Mental Health Care