One of the most difficult issues in dealing with a loved one with a mental illness is the feeling of utter helplessness in getting them the assistance they may need. Some serious mental health conditions, such as schizophrenia and bi-polar disorder, are relapsing and remitting in nature—serious symptoms may only appear occasionally. These symptoms may, for a period of time, interfere with the ability of an individual to make or communicate decisions which are consistent with the wishes of that same individual before or after those periods.
In 2017, the Nevada Legislature enacted NRS 449A which provides for Advance Directives for Psychiatric Care which are also known as Psychiatric Advance Directives (“PADs”). PADs permit people to determine what treatment they will receive if and when they lose the capacity to make treatment decisions. This document differs significantly from a Durable Power for Health Care Decisions (“DPOA”) as it is specifically addressed to psychiatric treatment and the administration of psychotropic medication.
Many persons are unaware that they can execute a PAD. However, up to three quarters of persons in one survey indicated they would complete a PAD if provided the choice and support. Swanson J, Swartz M, Ferron J, Elbogen E, Van Dorn R J Am Acad Psychiatry Law. 2006; 34(1):43-57.
A person of sound mind who is 18 or more years of age or who has been declared emancipated may execute at any time an advance directive for psychiatric care. The principal may designate another natural person of sound mind at 18 or more years of age to make decisions governing the provision of psychiatric care. The advance directive must be signed by the principal, or another at the principal’s direction, and attested by two witnesses. Another significant difference from the DPOA is that an advance directive becomes effective upon its proper execution and remains valid for a period of two years after the date of its execution unless revoked. The PAD enables a person to consent or refuse to consent to future psychiatric care if the person later becomes incapable of making or communicating those decisions.
A person is “incapable” for the purposes of this advance directive when in the opinion of two providers of health care (the Statute delineates who these provides must be) determine the person currently lacks sufficient understanding or capacity to make or communicate decisions regarding psychiatric care.
The PAD provides for the person to consent to psychoactive medications. It also may contain a consent to admission to a particular medical facility for psychiatric care. In addition, the party can request the facility contact certain persons in the event of a mental health crisis.
For patients who often feel a lack of control over their lives because of mental illness, a PAD can empower them to dictate their own health care.
For more than 30 years, Attorney Lee A. Drizin has practiced in the areas of estate planning, probate, trusts, guardianship and real estate matters representing clients throughout the state of Nevada.
Drizin Law is providing this information for educational purposes only. It should not be construed as legal advice or a legal opinion as to any specific facts or circumstances. This information is based on general principles of Nevada law at the time it was created and you should be aware laws frequently change. Moreover, the laws affecting you may differ depending on the circumstances. You should consult with a qualified attorney in your own state or jurisdiction concerning your particular situation. Review of this information does not create an attorney-client relationship.