By the time I was 32, I had created my first Will and Testament with a Mental Health Declaration. I had experienced neglect, abuse, and my friends and family were learning how to handle a mental health crisis situation. Often times, I was living in the 4Fs – Fight, Flight, Freeze, and Fawn zone as my body elevated into survival mode as it is reacting to a life-threatening situation.

I have a disclaimer that every episode brings new lessons learned and experiences for each individual that has a mental illness diagnosis. There are many stigmas around experiences as sometimes situations do escalate and why there are mental health care facilities and trained professionals. As much as we try to prepare and protect ourselves, mental illness episodes can be unpredictable. It needs to be a priority to monitor and document patterns with a licensed therapist for prevention. My support group constantly asks in a serious tone, “What is the standard operating procedure for THAT (i.e. some new unexpected situation occurred)”?! After much collaboration, experience, and unfortunate events, I produced my first Mental Health Declaration.

I had to build a Declaration of Mental Health treatment plan. Due to my physical disorders, I had to clarify what I DO and DO NOT consent to in terms of medication administration. Please note that I have medical conditions that require a mental facility that has close access to a hospital. For example, stabbing with a needle is not recommended due to low platelet count for bruising and stabbing can be a risk. When you have family that was born in the 1920’s-1960’s, you often hear discussions of conversion therapies or convulsive therapies. I knew right away these discussions were not of the modern viewpoint of mental illness. I made sure that if I become incapable of giving or withholding informed consent for mental health treatment, my wish regarding convulsive treatment and electroconvulsive treatment is that I DO NOT consent.

In most cases, law enforcement is required to assist in transporting the patient to the hospital, I always noted to please call 911 and request a Crisis Intervention Team (CIT) officer from the local police department or a mental health deputy from the local Sherriff’s department to escort to the hospital. These professionals are specifically trained in handling individuals with mental disabilities. These officers wear a brown suit in the state of Texas. I have had traumas and physical assault with the blue because they thought a crisis call was a domestic violence dispute and took immediate aggression toward me. I highly recommend notifying your local police department and have them flag your home as a household with disabilities to avoid physical altercations with the blue.

I would not participate in anything experimental, I specifically noted that my Medical Power of Attorney (POA) agent is NOT authorized to consent to my participation in experimental studies, even if, after consultation with my treating physician and any other individuals my agent deems appropriate, my agent believes that the potential benefits to me outweigh the possible risks to me.

Here are some examples of requirements you can include in your declaration. Please note the declaration must be a list of self-care and emergency steps for the first 24-72 hours. The first three days of having a mental health episode or break is critical to the amount of recovery time you will need to heal.

• Please ensure a balanced diet and proper daily nutrition.
• Provide medications upon physicians’ orders.
• Please limit release or disclosure of my mental health records to my acting agent on my Medical Power of Attorney, my treating psychiatrist, or anyone else authorized in my HIPAA Release & Authorization.
• Assist with outpatient program post hospitalization.
• Provide a list of medications you can and cannot take. For example, please be aware that steroids produce symptoms of psychosis, NSAIDS thin the blood, Ambien causes nightmares, or any medication that you have adverse symptoms such as vomiting, rash, allergy, or have deemed not adequate.
• List food allergies.
• Sleep for 8-10 hours a day.
• Goal to regroup back into structure/routine.
• Journaling, coloring, puzzles, games are activities that help symptoms.
• Use a paper calendar for logging meals, lists, and daily reminders.
• Recover in a calm environment.
• Staying off electronic devices.
• Being at home or peaceful environment.
• Keep in a stable and familiar environment.
• Provide steps or daily care rules and provide an achievable list of activities or goals for the day.
• Disrupt obsessions, mania, depression, substance use withdrawals, compulsive behavior or any adverse reaction by changing thought process to alternative topic and use psychotherapy.
• Surround self with people that are familiar (i.e family, friends, therapists).
• Use therapy dogs or animals.
• Remind of things to be thankful for, practice mindfulness.
• Have someone read a book.
• Keeping a diary of information to stay organized.
• Candlelight is calming. Stay away from blue light.
• Ensure moderate to mild exercise.
• Have a slow progression of mental activities and problem solving until becoming stabilized.
• Do not strike, restrain, or force medications without a trained mental health professional present, such as a psychiatric nurse or CIT Officer trained in mental health procedures. Please consult with a medical professional on how to administer medications to a non-compliant patent.
• Stay away from the television.
• Limit decision making until stabilized.
• If you have a pet, ensure proper instructions for their care or boarding.
• Inform a support person of the location of your medications.
• Inform a support person to contact your employer.
• Have a support person that has access to your home to pack for hospitalizations in case of emergency.
• Make appointments with all phycologists and psychiatrists.