Helping mental health patients choose a personal representative

Selecting a personal representative is a personal decision for mental health patients, who have to entrust someone to make decisions on their behalf when they may be most vulnerable. By providing clear guidance, resources, and support, healthcare providers can empower patients to make informed choices that align with their needs.

Personal representative responsibilities

A personal representative serves as the patient's voice in situations where the patient is unable to make their own decisions, like in times of illness or incapacitation. The role involves making critical healthcare and legal decisions aligned with the patient’s values and wishes. By having a trusted individual in this position, patients can have peace of mind knowing that their interests will be protected and their care will be managed, even when they can’t communicate their desires directly.

Ultimately, according to the HHS, the Privacy Rule outlined in 45 CFR 164.502(g) mandates that covered entities recognize an individual's representative as equivalent to the patient regarding any utilization or exposure of their protected health information and adherence to their rights under this rule.

See also: HIPAA Compliant Email: The Definitive Guide

Helping a patient choose their personal representative

Mental health practitioners should approach the conversation with sensitivity, clarity, and support. Here are some steps and considerations that can help in the process:

Explain the role of a personal representative

• Definition: Clarify that a personal representative is someone the patient trusts to make decisions on their behalf if they are unable to do so, especially regarding healthcare and legal matters.
• Scope of responsibility: Discuss the types of decisions the representative might need to make, such as medical treatment options, managing finances, or handling legal documents.

Discuss the importance of trust

• Trustworthiness: Emphasize the need for the representative to be someone they trust completely and someone who understands the patient’s values, wishes, and beliefs.
• Communication skills: The representative should be someone who can communicate effectively with healthcare providers, family members, and other involved parties.

Evaluate potential representatives

• Make a list: Encourage the patient to list people they trust and are comfortable with as their representative. 
• Consider availability: Discuss the availability of potential representatives, as the role can sometimes require significant time and emotional investment.
• Assess ability to handle stress: Consider the potential representative's ability to manage stressful situations and make informed decisions under pressure.

Discuss the patient's wishes

• Document preferences: Encourage the patient to articulate and document their wishes regarding treatment preferences, end-of-life care, and other important decisions.
• Legal considerations: Ensure the patient understands the legal implications and that they may need to formalize their choice through legal documents, such as a power of attorney or advance directive.

Watch: Power of attorney vs personal representative under HIPAA

Involve the representative in the discussion

• Open communication: Once a potential representative is chosen, facilitate a conversation between the patient and the representative to ensure they understand the responsibilities and are willing to take on the role.
• Clarify expectations: Discuss the patient's expectations with the representative and ensure they are aligned.

Provide resources and support

• Legal resources: Offer information about formalizing the choice, such as contacting an attorney or using online legal resources.
• Support networks: Encourage the patient to involve other trusted individuals in decision-making, such as family members or close friends, for additional support.

Review and reassess

• Periodic review: Suggest that the patient review their choice periodically, especially if there are changes in their relationships, health, or wishes.
• Flexibility: Let the patient know they can change their personal representative if their circumstances or preferences change.

Ensure confidentiality and comfort

• Respect privacy: Ensure that all discussions are confidential and that the patient feels comfortable and safe throughout the process.
• Encourage open dialogue: Remain open to any concerns or questions the patient may have during the process.

Related: How HIPAA can affect estate planning

FAQs

Who can be a personal representative?

A personal representative can be a family member, close friend, or any trusted individual the patient feels comfortable with. It’s important that this person is trustworthy, responsible, and understands the patient’s values and wishes.

What happens if patients don’t have a personal representative?

If a patient does not have a personal representative, decisions may be made by healthcare providers, legal guardians, or the court system. These individuals may not know the patient or their wishes as well as a close friend or family member, which is why appointing a trusted representative is important.

How can patients revoke the authority of a personal representative?

Revoking the authority of a personal representative can be achieved by updating legal documents, such as the power of attorney or advance directive, and notifying the representative and any relevant parties. It’s advisable to consult a legal professional when making such changes.

Related: HIPAA Compliant Email for Mental Health Professionals