An estimated 5.1% of adults in Minnesota live with a serious mental illness, such as schizophrenia, bipolar disorder, acute manic episode, or severe depression with psychotic features.[1] During a flare-up of such conditions, someone may be left temporarily unable to make treatment decisions for themselves.
Minnesota’s mental health treatment directive allows you to put your treatment preferences in writing in advance. You can also name a trusted decision-maker on your behalf for such situations.
The information on this page can help, as it explores:Â
Please note: The information on this page is for informational purposes only and does not constitute legal advice. If you have questions about mental health care laws in Minnesota, please consult a qualified attorney regarding your specific situation.
A mental health treatment directive in Minnesota is a legal document that lets you put your treatment preferences in writing before a mental health crisis makes it difficult to communicate these wishes in the moment.
You essentially record, in writing, that if you ever become too unwell to speak for yourself, there are set ways you want to be treated. If you’d like some structure to work from when writing your directive, the University of Minnesota Extension offers a free, downloadable Minnesota Health Care Directive Planning Toolkit.[2]
Some mental health conditions can temporarily affect a person’s ability to communicate treatment decisions. Examples of such conditions include a psychotic episode or a severe manic episode. The directive document serves to preserve your voice during a period when you may not be able to speak for yourself.
That said, the mental health treatment directive does not eliminate the need for informed consent or prevent emergency treatment in every circumstance.
In Minnesota, all adults 18 years and older have the right to make their own decisions about mental health treatment.[3]
If you’re an adult who understands the treatment being offered and communicates a clear choice, no one can force treatment on you without your informed consent. For example, a provider needs your written, informed consent before giving you electroconvulsive therapy (shock therapy) and antipsychotic medication.
The exception to the right to accept or refuse treatment occurs when a court determines that a person’s mental illness poses a danger to themselves or others. If a judge has authorized a treatment despite your objection, or a mental health emergency has been formally declared, a provider may proceed with treatment even against your wishes.
You also have the right to change your mind, at any time, about the treatment decisions you make as long as you are considered to have capacity to. Having this capacity requires you to:
There are three major types of Minnesota mental health treatment directives:
Under § 253B.03, subdivision 6d, any adult can make a written declaration of preferences or instructions specifically regarding “intrusive mental health treatment.”[4] Minnesota law defines intrusive mental health treatment as:
This type of advance directive explicitly does not include treatment for a developmental disability.
Within this declaration, a person can consent to or refuse ECT and/or neuroleptic medication in advance. They can also designate a healthcare proxy (someone they trust to make these specific decisions on their behalf). This person is authorized to make decisions about intrusive mental health treatment.
To make the declaration effective, the person must sign it and have two witnesses sign it. The witnesses must also state that they believe the person understands the nature and significance of the declaration.
Once you complete this declaration, your doctor is required to make it part of your official medical file. If a doctor doesn’t want to follow it for some reason, they have to tell you and write down why in your file, too.
You can also cancel or change this declaration at any time, as long as you’re currently able to make your own decisions. You just need to tell your doctor, and it takes effect right away.
A health care directive under Chapter 145C is a general-purpose advance planning document that includes both physical and mental health decisions, all in one place.[5]
Here’s what you can do with a Chapter 145C health care directive:
A legally sufficient Minnesota health care directive must be in writing, dated, identify the person making it, be signed by the person, and have the signature verified by witnesses.
Minnesota law also allows you to combine both mental and physical health directives in one document.[3] In fact, § 253B.03, subdivision 6d, states that a declaration about intrusive mental health treatment may include a Chapter 145C health care directive or a psychiatric directive.
In practice, most Minnesotans don’t bother filling out two separate documents. They use one combined form that covers all of the following at once:
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
A Minnesota mental health treatment directive is fairly flexible in terms of the information you can include in it. Here are some helpful clauses to include:
You need to be at least 18 years old and currently able to think clearly before you can create a mental health treatment directive. However, the process itself is fairly straightforward.
First, think about the decisions you would want made if you were experiencing a serious mental health crisis in which you would not be able to make any treatment decisions yourself.
Minnesota law allows you to write your own document as long as it clearly states your wishes. That said, using a template can make this process a lot easier. It could also help you avoid leaving anything important out. You can find free template forms through the Minnesota Attorney General’s office or the Minnesota Department of Human Services.
For the document to count legally, it must be written down (not just spoken), dated, and include your full name.
Then, you need it signed by two witnesses, at least one of whom cannot be your doctor or an employee of your healthcare provider. Once your document is ready, give a copy of it to your doctor (so it becomes part of your medical record), your named health care agent, and any close family members who should be involved if you are ever in crisis. Keep a copy for yourself as well.
Your treatment preferences may change as you gain new experiences, so you should revisit the directive every couple of years. Minnesota law, however, doesn’t require you to update your directive on any set schedule.
Your mental health treatment directive in Minnesota takes effect when you lose the ability to make your own decisions.
Under Minnesota law, a health care agent’s authority to make decisions on your behalf can occur only when your physician determines you lack the capacity to do it yourself. It is a clinical judgment based on your ability to understand your situation and communicate a clear choice.
Once the declaration is in your medical record, your provider generally must follow your instructions as much as possible.
However, the directive does not take away your right to make your own decisions. If you are able to understand and make an informed decision about a treatment, your provider must continue to ask for your consent.
And the moment you recover – when your doctor determines you’ve regained capacity – your health care agent’s authority to decide on your behalf pauses immediately.
In certain situations, however, Minnesota law allows a provider to act contrary to a mental health treatment declaration. This includes when:
A mental health treatment directive is useful for everyone aged 18 years and older who wants control over their treatment decisions. You do not need to currently be receiving mental health treatment, or have a diagnosed mental health condition, to create the document.
You may especially want to consider creating a directive if you:
Take a tour of our residential mental health facilities located in Minnesota. Our locations offer peace & comfort within a residential environment where you can relax and focus on yourself.
If you or someone you love is dealing with mental health concerns, compassion and support are available. At AMFM Mental Health Treatment (A Mission for Michael), we operate residential mental health treatment centers in Minnesota. We serve the greater Twin Cities area with comfortable, home-like residences that house just a handful of clients at a time.
Our team of expert clinicians believes in treatment persistence and will personalize your treatment plan so you can achieve lasting, life-changing outcomes. If you arrive at AMFM Mental Health Treatment with a mental health treatment directive already in place, our providers respect your documented decisions. Your directive will be made a permanent part of your medical record from day one.
Our Minnesota locations accept insurance and are in-network with many major providers. To check your insurance coverage for mental health care, simply complete our confidential online verification form.
Call us at 866-478-4383 if you would like to start the admissions process or learn more about how we can support your mental well-being. Our compassionate team is available 24/7 to answer your questions and provide guidance with no obligation.
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At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
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