FAQs

• Yes. You can plan now for a time when you may be unable to make your own mental health treatment decisions.

• Oregon has a form that you can fill out and sign now to protect yourself when you may be in crisis and are unable to make your own treatment decisions. This form is called a Declaration for Mental Health Treatment.

• Only a court or two physicians can decide if you are unable to understand and make decisions about your mental health treatment.

• A Declaration form is used only when you are unable to understand and make decisions about your mental health treatment.

• You can make choices about your future mental health care. You can describe the kind of care that you want to receive (e.g., medications, types of therapies). You can also describe the kind of care you do not want to receive (e.g, medications you’ve had adverse reactions to).

• You can also provide additional information about your mental health treatment needs.

• It is wise to prepare this part of the Declaration carefully. You may want to discuss this section with your physician or mental health provider.

• Yes. You can choose an adult to represent you, though you don’t have to. If you pick a representative, this should be someone you trust who can make decisions about your mental health care when you cannot do so for yourself. Of course, the person you name must agree to do so.

• On the Declaration form the person you choose is called a Representative.

• There are certain people who cannot be your representative. Unless related to you, these people cannot be your representative.

1. Your attending physician or provider

2. an employee of the physician or provider

3. an owner, operator or employee of the facility where you’re a patient.

• Also, any parent, guardian, or former guardian cannot serve as your representative if you were permanently removed from their care.

• You can also choose a back-up representative in case your main representative is unavailable when they are contacted on your behalf.

• On the form, you can identify a representative and an alternative representative. They each have to sign your Declaration. The form also has to be signed by two competent, adult witnesses.

• Witnesses who sign your Declaration form should be people whom you know and trust. They can verify that you signed the form by your own free choice, without being forced.

• Other patients at OSH can sign as a witness, so long as they are well enough to understand their role. A provider can speak with them to be sure and will briefly document their conversation.

• There are certain people who cannot serve as witnesses. These people cannot serve as your representative.

1. Your provider (physician/psychiatrist/psychiatric mental health nurse practitioner) or someone related to them

2. An owner, operator, or relative of an owner or operator of your health care facility (e.g., OSH’s superintendent or someone related to them)

3. A person related to you through blood, marriage, or adoption.

No. In fact, lawyers are not or do not have to be involved at all.

• No. Your representative must follow your wishes. It is wise to talk to your representative about your wishes.

• Even if you have not made your wishes known, your representative must make decisions for you that are as close as possible to the kind of decision you would make yourself if you were capable of doing so.

• Your physician is not required to give you the medicine you have chosen in your Declaration form if your physician believes that it is not good for you. However, your physician must have your representative's permission to give you a medicine that is not listed in the Declaration.

• This is why it is important for you to choose someone who knows you well and whom you trust.

You don’t have to have a representative identified if you do not have someone you would like to identify. If you do not have anyone to ask to be your representative and you want a representative, have your treatment team contact OSH’s Legal Affairs department, and a group of people will work with you, community partners, and those familiar with Declarations of Mental Health Treatment to help find someone.

In order for your instructions to be followed, you or your representative must give copies of your completed Declaration form to your physician or mental health provider. Your representative should keep a copy. It is wise to keep a copy for yourself. There is a cut out card within the OHA form you can complete and have laminated to keep on your person once you’re discharged

Whether or not you have signed a Declaration form, if you are on an emergency psychiatric hold, or if you have been committed by a court, your physician may still give you medicine that you didn't want. Your physician can only do this under very strict legal guidelines.

No. A signed Declaration for Mental Health Treatment only will be valid for 3 years and

must be renewed. However, should you become incapable of making mental health treatment decisions during these 3 years the Declaration will remain until the time–whenever that may be– that you regain capacity to make your own decisions.

• Yes. As long as you are able to understand the information given to you about the choices that you may make for your mental health treatment, you may change your written mental health treatment instructions or cancel your Declaration form.

• Of course, in order to make sure that your wishes are followed, you must give your physician or mental health provider a new Declaration form that includes the changes you wish.

• However, if a court or two physicians decide that you are unable to understand your mental health treatment options and you are not capable of making choices about your mental health treatment, you will not be permitted to change your written instructions or to cancel your Declaration until the time that you regain capacity to understand your treatment options.

It depends on where you go. Each state has its own rules.

• No. No one. No insurer, no physician, no mental health treatment provider, or any other person is allowed to force you to make out a Declaration form. It should be your free choice to make out and sign the Declaration for Mental Health Treatment. Also, no one can force or keep you from completing a Declaration if you want one.

• Per Oregon law, OSH must document in a prominent place in your medical record about whether you have executed a Declaration. A copy of your Declaration should be placed in your unit chart. Staff will also send a copy of your Declaration to the Legal Affairs Office to be stored electronically.

• Your Declaration will be part of your OSH medical record. Members of your OSH treatment team or other OSH staff may access the information as needed. Your Declaration is subject to the same legal requirements for confidentiality, as well as the same limits to confidentiality, as other parts of your medical record. Your Declaration, like other parts of the medical record, may be provided to others if it is relevant to a court order or an investigation (e.g., Office of Training, Investigations & Safety [OTIS], etc).

• With your permission, you can have information from your Declaration entered into the Voluntary Medical or Mental Health Database so it can be available for first responders in the community.

• Anyone you provide a copy to will also have access, such as your representative, your community treatment providers, such as your therapist, your prescriber, and case manager.

• You can voluntarily disclose your medical information to your local Community Mental Health Program (CMHP). The information is accessible in a database shared with law enforcement agencies. This information helps them best work with you in the community should you come in contact with them during a mental health crisis.

• OHA has a consent form you can complete to have your Declaration information added to the Voluntary Mental Health Database. OSH staff can provide you this form and will submit it on your behalf to your local community mental health program.

This decision is entirely up to you. No one can force or coerce you into completing the consent form. Possible disadvantages are that law enforcement now has access to your mental health information, it may not result in access to treatment,

and you might still be arrested. A possible advantage to having the information accessible by law enforcement is for them to better serve you when in contact with them, such as helping you get access to the treatment you’ve already consented to rather than arresting you.