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Advance Instruction for Mental Health Treatment
What is an Advance Instruction for Mental Health Treatment When Does an AIMHT Become Effective How A Health Care Agent is Appointed A Health Care Agent's Authority A Health Care Agent's Potential Liability Advance Instruction for Mental Health Treatment Form
You have the right to control the decisions about your medical care. To make these decisions, you must be competent and able to communicate. If you are not competent or able to communicate, someone else must make these decisions for you. With advance directives, you can guide how these decisions will be made. Advance directives may take different forms. A living will is an advance directive in which you express your desire to die a natural death. A health care power of attorney is an advance directive that appoints a health care agent to make decisions when you are unable to make them. It also allows you to express how you want your medical treatment handled. An advance instruction for mental health treatment is an advance directive that applies only to mental health care.
Who may make an advance instruction for mental health treatment? Any person of sound mind who is age 18 or over may make an advance instruction for mental health treatment. This person is called the "principal."
What is an advance instruction for mental health treatment? An advance instruction for mental health treatment allows you to give instructions and preferences regarding mental health treatment. The advance instruction may include consent to or refusal of mental health treatment. "Mental health treatment" is defined by statute to mean the process of providing for the physical, emotional, psychological, and social needs of the principal for the principal's mental illness. 'Mental health treatment' includes, but is not limited to, electroconvulsive treatment, treatment of mental illness with psychotropic medication, and admission to and retention in a facility for care or treatment of mental illness. An advance instruction may include
The advance instruction for mental health treatment is designed for people who have mental illnesses, such as paranoia, schizophrenia, or a bi-polar disorder. It is not designed for people who may be experiencing mental health problems associated with aging, such as Alzheimer's disease or dementia. People who are concerned with these types of mental health problems may use a health care power of attorney to express their preferences for mental health care treatment. A statutory form for an advance instruction for mental health treatment is provided by § 122C-77 of the North Carolina General Statutes. Other forms may be used as long as they comply with the requirements of the statute. If you use a form, read and understand all provisions before signing. Your lawyer can explain and, if necessary, modify the available forms.
How do you execute an advance instruction for mental health treatment? The principal must sign the advance instruction for mental health treatment in the presence of two qualified witnesses who believe the principal to be of sound mind at the time of the signing. The signatures of the principal and the witnesses must be acknowledged before a notary public. A qualified witness is someone who personally knows the principal, and who is not
An advance instruction becomes effective when it is signed, witnessed, and notarized. It remains in effect unless revoked by the principal. The doctor may rely upon an advance instruction in the absence of actual knowledge of its revocation or invalidity. If the principal is capable, he or she may revoke the advance instruction at any time in whole or in part. The revocation is effective when the principal notifies his or her doctor that it is revoked. The principal's doctor must note the revocation in the principal's medical record.
The principal's doctor must continue to obtain the principal's informed consent to all mental health treatment decisions when the principal is capable of providing informed consent or refusal. Instructions given by the principal while he or she is capable supersede the instructions written in the principal's advance instruction. The doctor must make the advance instruction part of the patient's medical record. The doctor must comply with it to the fullest extent possible, unless compliance is not consistent with
If the doctor is unwilling to comply with part or all of the advance instruction for one or more of the reasons stated above, he or she must notify the principal and, if applicable, the health care agent. The doctor must record the reason for noncompliance in the patient's medical record, and must also document the notification.
How is a health care agent appointed? A health care agent may be appointed with a health care power of attorney. A health care agent makes decisions when the principal is unable to make them. An advance instruction for mental health treatment may be combined with a health care power of attorney. A health care agent must be competent, at least 18 years old, and not providing health care to the principal for remuneration.
What is the health care agent's authority? The health care agent may make decisions about mental health treatment on behalf of the principal only when the principal is incapable. The principal is incapable when the doctor or eligible psychologist determines that the principal currently lacks sufficient understanding or the capacity to make and communicate mental health treatment decisions. A health care agent's decisions about mental health treatment must be consistent with any statements expressed in the principal's advance instruction for mental health treatment. If the principal does not have an advance instruction, the health care agent must make mental health decisions consistent with what the agent, in good faith, believes to be the wishes of the principal.
What is the health care agent's potential liability? The agent is not subject to criminal prosecution, civil liability, or professional disciplinary action for any action taken in good faith pursuant to an advance instruction.
The advance instruction for mental health treatment statutory form is not designed to be used for general mental health problems associated with growing older. If you are interested in addressing these issues, you can use a general health care power of attorney. Ask your attorney for more information. NOTE: Information in this section was obtained from the North Carolina State University Cooperative Extension. |
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