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When a mental health crisis strikes, families often find themselves powerless to help — not because they don’t care, but because they lack legal authority...

Real Case Example:

• Someone I loved, who was well respected and highly functioning in society suddenly was showing severe signs of emotional breakdown and suicidal ideation. The family removed all the guns and knives from his home. But because they had no guardianship or power of attorney, they were shut out of hospital discussions. He later used a decorative sword to end his life. At the time I could not fully imagine the pain he was in.

• My Own Experience: I had several challenging situations. During one hospital stay, the hospital chose to release me without coordinating with my wife or providing a medical care plan to me, her or any future medical counsel. Booting me out the door and leaving me on my own. Somehow, I ended up at a motel and drove myself home, although I have no memory of it. • On another occasion, I was hospitalized after experiencing severe catatonia and deliberately injuring myself on a table saw. My wife was home and managed to get me an ambulance promptly. Fortunately, I avoided major injuries to my vocal cords or major artery and they were able to treat my wounds and transfer me to the psychiatric unit, which later admitted they lacked expertise in my condition. I was then moved to another psychiatric facility downstate where ECT was recommended as the only viable solution. The hospital restricted visitation and phone calls, making it difficult to communicate with my wife how bad the conditions at this hospital were. Finally I was able to get a message out and My wife quickly obtained guardianship and medical power of attorney, preventing further electroconvulsive therapy. Her intervention preserved my health and dignity. While some find ECT beneficial, my experience was not positive. Observing the treatment of others at that facility has motivated me to write this book and these appendices.

• Medical Power of Attorney (MPOA)
• Psychiatric Advance Directive (PAD)
• Durable Power of Attorney (DPOA)
• Guardianship documentation (temporary or permanent)
• HIPAA Release Form

• Have a calm conversation about future care and potential psychiatric emergencies.
• Collaborate with a lawyer to complete all necessary forms for your state.
• Store signed copies of all documents in a secure but accessible location.
• Share digital and paper copies with the designated decision-maker, primary care physician / psychiatrist, and local hospital or crisis center (if possible).

• If a loved one is spiraling and refusing care
• If you're being excluded from hospitalization decisions
• If you believe someone may be harmed without intervention
• If you're facing resistance from providers due to HIPAA or liability issues

• Medical Power of Attorney (MPOA)
• Psychiatric Advance Directive (PAD)
• Durable Power of Attorney (DPOA)
• Guardianship documentation (temporary or permanent)
• Emergency contacts list and current medication list readily available
• HIPAA Release Form to everyone on your support team (Doctors, Psychiatrist, Talk Therapists, Family, Advocates)

📚 Resources

• American Bar Association – Planning for incapacity toolkit
• National Center for State Courts – Adult guardianship initiatives
• National Disability Rights Network. (n.d.). Find your state protection & advocacy agency
• National Family Support Technical Assistance Center. (n.d.). Supporting families.
• Substance Abuse and Mental Health Services Administration. (n.d.). Behavioral health treatments and services. U.S. Department of Health and Human Services.
• Mental Health America. (n.d.). Position statement 22: Involuntary mental health treatment.
• Treatment Advocacy Center. (n.d.). Civil commitment laws: A summary of the criteria for initiating involuntary treatment in each state.
• SAMHSA – Advance Directives
• Psychiatric advance directives: An alternative to coercive treatment? – Psychiatry
• U.S. Department of Health and Human Services – HIPAA for professionals FAQ