Dedicated to Targeted Individuals




Psychiatric Living Will

The psychiatric declaration is your statement and can be changed to fit your situation. Please read it to make sure you agree with all the statements you will make. If you don't understand the word, please contact someone who can help you understand what it means.

You should be signed and witnessed by a notary public, clergyman, attorney or at least by a trusted friend or reliable family member. Make several copies of the signed document and keep the original in a safe place. Give one copy to each of the persons named below (see pg. 2, item #6). Provide a copy to your attorney, if you have one.

If someone is trying to arrest you for a psychiatric evaluation, BE SURE AND ALERT SOMEONE WHO WILL BE ON YOUR SIDE. Any of the non-profits may be able to give you support. If someone is outside your door, DO NOT ANSWER THE DOOR!  You do not have to open your home. GET ON THE PHONE to your friends, your doctor's office. Make sure they will support your right to an independent evaluation. Make sure the doctor knows that you are perfectly fine and he/she may be able to take you in their care instead of the police.

The main thing is:  MAKE SURE YOU ARE NOT ALONE!  GET SOME FRIENDS! They will try to take advantage of your being alone. They think they will get away with mistreating you because of your ignorance of your rights. BE PREPARED!

Should you be in a position where you are subject to unwanted psychiatric treatment and/or hospitalization, ensure that the person(s) attempting such are shown and are aware of this signed and witnessed declaration. Immediately let your attorney and all other persons in your confidence know so that they may come to your aid.

The more people you have to support you, the better you will fare.  Try not to be alone when someone tries to grab you. You have rights. You have the right to see your own doctor. The calmer you are the better off you will be.  The more pleasant you are, the better off you are.

At no time do you have to take medical treatment.  Being arrested for evaluation for 72 hours is not medical treatment. That must be adjudicated and you have the right to an advocate and attorney to go through those procedures since they will affect your freedom.

Such things as apparent or undetected physical illnesses, diseases and deficiencies can manifest in mental or behavioral symptoms which can be mistaken by emergency medical personal, hospital staff and others as “psychiatric” illness. For this reason, during any attempt at involuntary hospitalization or psychiatric treatment by another, repeatedly declare your desire for a clarification of your condition of physical health. Explain that you wish to have this declaration abided by, however, do not physically resist or become aggressive. Demand to see a doctor for an independent evaluation.  You may be deficient in minerals which can make you act in strange ways.

A copy of your signed declaration should also be sent to the local or international branch of Citizens Commission on Human Rights® (CCHR®). The International address is: CCHR, 6616 Sunset Blvd., Los Angeles, California, United States, 90028.