Can I write down in advance how I want to be treated in a psychiatric crisis?

A: Yes, and it is worth doing — but not through a "psychiatric advance directive" as such, because California has no separate statute for one. You use the ordinary Advance Health Care Directive, which covers mental health care explicitly: the law defines health care as anything affecting "a patient's physical or mental health condition," and a health care decision includes approving or refusing "programs of medication, including mental health conditions."¹ The statutory form is printed in the Probate Code, and it must be either notarised or signed by two qualified witnesses — one or the other, not both.² An electronic directive must be notarised.²

What it does well. It names the person who speaks for you about mental health care if you cannot. It records which medications have helped and which have gone badly — worth writing down, because a facility is required to obtain your medication history where possible.³ It states preferences about hospitals and providers, contacts, and what tends to help you settle. None of that is legally binding on a clinician in the way people hope, but it is the difference between a stranger guessing and a stranger reading.

The five things it cannot do, by statute. A directive cannot authorise anyone to consent on your behalf to: commitment to or placement in a mental health treatment facility, convulsive treatment (including ECT), psychosurgery, sterilisation, or abortion.⁴ The state's own form says it plainly: your agent "will not be able to commit you to a mental health facility, or consent to convulsive treatment, psychosurgery, sterilization, or abortion for you."² You also cannot pre-consent to ECT: consent must be contemporaneous, capped at a set number of treatments over no more than 30 days, and revocable at any time before or between treatments.⁵

It does not stop a 5150. An involuntary hold rests on probable cause under the Welfare & Institutions Code, and the Health Care Decisions Law expressly leaves "the law governing health care in an emergency" untouched.⁶ Anyone who tells you a directive prevents a hold is wrong. What a 5150 hold actually is →

And it cannot bind your future self. People sometimes want a document that says ignore me when I refuse help. California does not permit it: you may revoke a directive, other than the naming of your agent, "at any time and in any manner that communicates an intent to revoke," and the law presumes you have capacity to do so.⁷ Two further limits worth knowing: a provider may decline to follow a directive for reasons of conscience, and may decline anything medically ineffective or contrary to accepted standards of care.⁸

Worked example: you write that quetiapine at night worked in 2023, that a named medication caused an intolerable reaction, that your sister is your agent and your employer is not to be called, and that you would rather be taken to a crisis stabilisation unit than an emergency department. All of that is useful and none of it is a promise. Then you give a copy to your therapist, your prescriber, your agent, and whoever you live with — a directive in a drawer at home does no work at 2am.

Do this: ask your prescriber for the state form, fill in Part 1 (agent) and Part 2 (your instructions), and get it notarised or witnessed by two people who are not your health care provider, not employees of a care facility, and not your agent — at least one of whom is not related to you and not in line to inherit anything.⁹ Then hand out copies.

Sources

1. Probate Code §4615 ("'Health care' means any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a patient's physical or mental health condition") and §4617(a)(2) ("Approval or disapproval of diagnostic tests, surgical procedures, and programs of medication, including mental health conditions"), within the Health Care Decisions Law, Probate Code §4600 et seq. — leginfo.legislature.ca.gov. California has no general psychiatric-advance-directive statute; the only statutory reference to one is Welfare & Institutions Code §5977.3(a)(3)(A), limited to a CARE Act graduation plan. A dedicated bill, AB 2352 (2023–24), passed the Assembly and then died in Senate committee.
2. Probate Code §4673(a)(3) — a directive is legally sufficient if "either acknowledged before a notary public or signed by at least two witnesses"; §4673(b) requires notarisation for an electronic directive; §4701 contains the statutory form and the quoted explanation of the agent's limits — leginfo.legislature.ca.gov.
3. Welfare & Institutions Code §5332(d) — the facility "shall acquire the person's medication history, if possible." Subdivisions (a)–(b) set out the right to refuse antipsychotic medication and the capacity hearing required before involuntary medication.
4. Probate Code §4652 — the division "does not authorize consent to any of the following on behalf of a patient: (a) Commitment to or placement in a mental health treatment facility. (b) Convulsive treatment… (c) Psychosurgery… (d) Sterilization. (e) Abortion."
5. Welfare & Institutions Code §5326.7(d) — written informed consent to convulsive treatment "shall be for a specified maximum number of treatments over a specified maximum period of time not to exceed 30 days, and shall be revocable at any time before or between treatments"; §5326.5(e) imposes a 24-hour waiting period after the required disclosures; §5325(f)–(g) establish the right to refuse convulsive treatment and psychosurgery, and those rights "may not be waived by the person's parent, guardian, or conservator."
6. Welfare & Institutions Code §5150(a) (probable cause) and Probate Code §4651(b)(2) — the Health Care Decisions Law "does not affect… the law governing health care in an emergency."
7. Probate Code §4695(b) and §4657 — revocation "at any time and in any manner that communicates an intent to revoke," and the presumption that a patient has capacity to give or revoke a directive.
8. Probate Code §4734 (conscience) and §4735 (medically ineffective care or care contrary to generally accepted standards).
9. Probate Code §4674 — witness requirements and disqualifications, including that at least one witness must be someone "neither related to the patient by blood, marriage, or adoption, nor entitled to any portion of the patient's estate"; the disqualification rules do not apply to a notary (§4674(g)).

All sections read 17 August 2026. This page describes the statute; it is not legal advice.