Arizona Revised Statute Titles 14 and 361 delineate the provisions of guardianship. A guardianship refers to a legal
relationship that is created when a person or institution is named in a will or appointed by a court to make all decisions regarding the health and welfare of an incapacitated adult or minor child. A guardianship may be pursued
when the individual has serious mental health issues, moderate or severe cognitive impairment, incapacitating
substance abuse, and/or significant and debilitating medical conditions that impair the ward’s ability to make
reasonable informed decisions about his/her health and welfare. A guardianship may be temporary, permanent,
general (applicable to all aspects of the ward’s life), or limited to specific identified needs of the ward. 2
Mental Health Guardianship or Guardianship with Mental Health Powers (MHG):
A guardianship without additional specific authority granted by the court authorizes a guardian to consent to
psychiatric care or treatment for a principal/ward only if that treatment occurs somewhere other than in a Level
1 mental health facility (i.e., an inpatient psychiatric hospital). 3 In Arizona, a guardianship conferring additional
mental health authority is typically granted by a Probate Court based on a Petition for Appointment of Guardian
requesting the additional authority under Title 14. In proceedings for involuntary mental health treatment under
Title 36, however, if the Court finds that the principal/ward has a general guardian without mental health authority and that principal/ward meets the standard for involuntary psychiatric care, the Court can, with notice, confer
on the existing guardian the additional mental health authority and duties pursuant to § 14-5312.01.
Medical Power of Attorney:
Power of Attorney (POA) is a written document in which a principal designates an agent to make informed medical decisions for the principal when the principal is unable to make those decisions. 4 The document delineates
the type of authority conferred on the agent. Typically, a POA is invoked at the time that the ward is deemed not
competent to make decisions about medical care. An example of a situation in which a POA is used is when the
principal is comatose.
Mental Health Power of Attorney (MHPOA):
A medical POA is typically interpreted to extend only to medical care decisions and cannot be used to obtain mental health care. Under Title 36, the state of Arizona permits a principal to designate an agent to seek treatment for
and make mental health decisions for the principal using MHPOA. 5 Specifically, the agent may consent to hospitalize a principal/ward, compel a principal/ward to take psychiatric medication or receive other forms of mental
health treatment, and/or place the principal/ward in a residential treatment setting. The MHPOA may limit the
authority of the agent to consent to certain types or modalities of psychiatric treatment.
An Advanced Directive ( AD) is a document that allows a person to specify explicit instructions about medical
treatment to be administered when he/she is terminally ill, permanently unconscious, or not competent to make
medical decisions for himself/herself. It is not specific to mental health decisions. 6 An AD is similar to a medical
POA, but an AD describes in detail the specific medical interventions that the person does or does not want when
incapacitated. For example, the AD could specify if the person wants to be placed on a ventilator, provided with
a feeding tube, or be cardioverted (“shocked”) to save his/her life. An AD is often referred to as a “Living Will.”
In some states, ADs can be used to make mental health decisions, but this process is not used in Arizona.
There are several processes by which someone can be granted legal authority to make decisions for an
There are some excellent online resources that may help to further clarify MHG and
MHPOA. In 2011, Gary Strickland wrote an informative presentation on the topic, and
his notes can be found at www.maricopa.gov/pubfid/documents/presentations/
The State Bar of Arizona also has a guide that is also quite useful: www.azbar.org/
1. Arizona Revised Statutes,
Title 36, Article 4 and Article 5.
2. A.R.S. § 14-5304.
3. Id. § 14-5312.01.
4. Id. § 36-3221.
5. Id. § 36-3281.
6. Id. § 36-3251.