After thinking more about the woman who died of starvation and hypothermia after being discharged from a mental hospital (see my prior blog), I did a little research on mental health advance directives (MHADs). In her case, I don’t see where the MHAD would have been helpful, since in most cases, the state can override a person’s request to forgo treatment, refuse medications or hospitalization, or (as in her case) simply be left alone. I’m not entirely convinced, but in some cases this might be a useful tool.
Washington State is among a few states that recognize and honor MHADs. Fashioned after directives that are written to guide family and providers about a person’s wishes for end-of-life care, the MHAD offers the opportunity to:
- Name an agent who is authorized to make treatment decisions for a person who is deemed temporarily unable to make competent decisions due to mental illness;
- List preferences regarding medications, treatments (such as electroshock therapy), institutions, and providers; and
- Control who should and should not be told that there is a mental health crisis.
I’ve had my own mental health crises, so I have personal reasons to consider this. It might be important to you or someone you know. More to the point, I’ve witnessed so much suffering due to mental illness and feel haunted by it. I’m not even sure what mental illness is from a medical standpoint, but I know it causes extreme suffering and can lead to death. I know that we don’t talk enough about it; don’t know how to support people during crises; and don’t have a mental health care system that knows how to relieve suffering and prevent deaths.