In 2004, Pennsylvania enacted legislation (Act 194) that provides the opportunity for individuals living with mental illness to create a Mental Health Advance Directive (MHAD) and plan ahead for mental health services and supports in the event they become unable to make decisions for themselves. A MHAD offers a clear written statement of an individual’s mental health treatment preferences or other expressed wishes or instructions should they become incapacitated. It can also be used to assign decision-making authority to another person who can act on that person’s behalf during times of incapacitation.

MHADs offer several key benefits. Correctly implemented and executed, they can:

  • Promote individual autonomy and empowerment in the recovery from mental illness;
  • Enhance communication between individuals and their families, friends, healthcare providers, and other professionals;
  • Protect individuals from being subjected to ineffective, unwanted, or possibly harmful treatments or actions; and
  • Help in preventing crises and the resulting use of involuntary treatment or safety interventions such as restrain or seclusion.

MHAPA, the Disability Rights Network of Pennsylvania, and the Pennsylvania Mental Health Consumers’ Association created a guide to MHADs that provides information about the forms and assistance in completing them. Download this entire publication. It includes the forms and instructions, answers frequently asked questions, and is available in English or Spanish.

Or download PDFs of the MHAD forms that you can fill in on your computer and save and share as PDFs. Please review the instructions before completing the forms and be aware that some of the fields are required.

Forms and Instructions

•   Combined form instructions and Combined form

•   Declaration form instructions and Declaration form

•   Power of Attorney form instructions and Power of Attorney form

If you have additional questions or need assistance with completing a form, contact any one of the following organizations:

MHAPA
1-866-578-3659
717-346-0549
info@mhapa.org

Disability Rights Network of Pennsylvania
1-800-692-7443
717-236-8110
1-877-375-7139 (TDD/TTY)

Pennsylvania Mental Health Consumers’ Association
1-800-88PMHCA
pmhca@pmhca.org