All You Need to Know About Mental Health Care Directives


All You Need to Know About Texas’ Declaration for Mental Health Treatment

In many instances, when a person with a mental illness is in a crisis, they are not able to express to doctors, or other medical professionals, what medical treatment they would prefer to receive. This can result in the patient not receiving the most effective care for their condition. In Texas, it is possible for a person with a diagnosed mental illness to execute a Declaration for Mental Health Treatment and thereby to express their preferences for medical treatment. However, the Declaration for Mental Health Treatment has not been widely used, and some physicians may not be familiar with it. Additionally, the effectiveness of the Declaration for Mental Health Treatment is limited by only having a three-year period of validity and can be overridden in certain circumstances.

Who can execute a Declaration for Mental Health Treatment?

Any capacitated adult may, by written declaration, indicate his or her preferences or instructions for mental health treatment, including the right to refuse such treatment.

How long is a Declaration for Mental Health Treatment effective?

A Declaration for Mental Health Treatment is effective upon execution and expires on the third anniversary of its execution or when revoked, whichever is earlier.

What do I need to execute a Declaration for Mental Health Treatment?

  1. The Declaration for Mental Health Treatment document, which can be found on the Texas.gov website.
  2. Two Witnesses – The declaration must be witnessed by two qualified witnesses; meaning two people over the age of 14 who are not incapacitated.

When is a Declaration for Mental Health Treatment used?

When the person is unable to give informed consent. Informed consent is permission granted with the knowledge of possible consequences; to have knowledge of the possible benefits and risks of medical treatment. Physicians or other health care providers are to follow such declaration if the person is unable to give informed consent. However, as long as the declarant is capable for giving informed consent, such informed consent is to be sought.

When is a Declaration for Mental Health Treatment becomes ineffective?

  1. When the Declaration for Mental Health Treatment has been revoked.
  2. When more than three years have passed since the Declaration for Mental Health Treatment was executed.
  3. When the declarant, at the time of making the designation, is under a temporary or extended commitment and treatment is authorized under the Mental Health Code
  4. In the case of an emergency, when the declarant’s instructions have not been effective in reducing the severity of the behavior that has caused the emergency.
  5. When a Court determines that the declarant is incapacitated

What is in a Declaration for Mental Health Treatment?

  1. Symptoms of a diagnosed mental illness that may cause you to become incapacitated and unable to give informed consent.
  2. Psychoactive medications that you do and do not want administered, and the conditions under which a medicine is given.
  3. Your preferences for emergency treatment; the options are medication, seclusion, or restraint.
  4. Your preference of electroconvulsive treatment.
  5. Options for treatment before using restraint, seclusion, or medications.

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