An advance directive says what you would want done about your medical care if you were unable to make a decision at that moment, such as being in a coma.  A psychiatric advance directive states what you would want done if you were unable to make a decision about your mental health care.  You can either limit it to what you write on the paper, or you can name someone (and a backup) who can make these decisions for you.

Different states have different laws regarding advance directives and psychiatric advance directives.  The National Resource Center on Psychiatric Advance Directives is a good place to start looking for information in your state.

It can be difficult and quite painful to think about a scenario in which things are so bad you cannot legally make your own psychiatric treatment decisions, but I think it is worth that difficulty to guarantee that if something like that does happen, you still have a say in your care.

I recently completed my psychiatric advance directive.  In it I have listed medications that have been helpful in the past, and medications I refuse to take, such as habit forming benzodiazapines.  In addition I list what hospital I would prefer to be admitted to.  I also list both a primary and secondary decision maker.  The last and probably the slightly more rare written decision was that any major medication changes must first be run through my current psychiatrist.

What I wrote on my psychiatric advance directive is just an example of what you can decide with it.  I think anyone who is living with a mental illness should consider completing a psychiatric advance directive.