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Legal document that allow mental health consumers to state their medical and mental health care wishes in advance for occasions when they are incapacitated to do so.

Legal Nature:

- Requires signature of consumers stating that the Advance Directives reflect their wishes 

- Requires the signature of two outside witnesses confirming that consumer is of sound mind at the time requesting an Advance Directive

- Witnesses are not employees of health care provider; at least one witness must be related by blood, marriage, adoption; and to the best of their knowledge, not entitled to any part f the consumers estate

Why are Advance Directives Important?  Required by Dixon Exit Criteria and MHRS Certification Standards as an option to consumers for crisis planning.

May be helpful for consumers proactively to state their treatment wishes during times they may be incapacitated

Can serve as a tool to help consumers and their treatment provideres work as partners in treatment planning according to recovery principles.


National Resource Center on Psychiatric Advance Directives

National Empowerment Center

National Alliance On Mental Illness

In 1950 the National Mental Health Association chose a bell as their symbol. Two years later, the Mental Health America issued a call to asylums across the country for their discarded chains and shackles. Volunteers at the Mental Health Association’s National Headquarters in New York collected the metal restraints from hundreds of mental hospitals across the country and piled them in the building’s lobby. These restraints were then shipped to the McShane Bell Foundry in Baltimore, Maryland, where on April 13, 1956 they were dropped into a crucible and cast into a 300-pound bell. Nothing could proclaim hope for those who have mental illness more dramatically than a bell cast from the actual chains and shackles used as restraints for persons with mental illnesses.

The Story of the Mental Health Bell

During World War II, future leaders of the National Mental Health Association worked in state mental hospitals. There, they witnessed the deplorable and inhumane treatment of patients with mental illnesses who were chained by their wrists and ankles to the hospital walls. This experience inspired the men to devote their time to improving the lives of all those who suffer from mental illnesses, and changing the way America thinks about persons with mental illnesses. They believed with better understanding and treatments, the cruel practice of using shackles and chains to restrain people with mental illness would eventually stop.

To many, a bell symbolizes freedom and liberty, for the 40 million Americans affected by mental illnesses. The bell serves as a powerful reminder that the invisible chains of misunderstanding and discrimination continue to bind people with mental illnesses.

Over the years, national mental health leaders and other prominent individuals have rung the Bell to mark the continued progress in the fight for victory over mental illnesses.

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