Giving Patients a Voice in Their Mental Health Care Before They’re Too Ill to Have a Say

Psychiatric advance directives allow patients with serious mental illness to specify the treatment they want if they become too sick to say so.

Steve Singer, who has bipolar and borderline personality disorders, knows when he’s on the verge of a mental health crisis. The female voice he hears incessantly in his head suddenly shuts up, and the hula hoop he gyrates while walking to the grocery store stops easing his anxieties.

That’s when he gets to a hospital. Usually, talking briefly with a nurse or social worker calms him enough to return home. But this year a hospital placed him on a locked ward, took his phone, and had an armed guard watch him for 20 hours before a social worker spoke with him and released him.   more

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