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“We’re compatible and we love each other … and have the same interests — fighting for people’s rights,” said Dorio, who, along with Clough, pushed for legislation — signed by Gov. Gavin Newsom — giving families more authority to determine medical decisions for loved ones even in the absence of an advance directive.

Swanson recently encountered a woman with schizoaffective disorder who wrote on her mental health advance directive that she was willing to be hospitalized and that electroconvulsive therapy was the only treatment that worked when she was in crisis.

Lack of awareness is a problem across states that have tried to strengthen the role of mental health directives, said Dr. Marvin Swartz, a psychiatrist and professor of psychiatry at Duke University Medical Center who runs the national mental health advance directive center with Swanson.

Virginia, for instance, funneled funding into a campaign to train health providers and peer recovery specialists and built an online, interactive map showing where people could get help filling out an advance directive.

His words, written as part of a so-called mental health advance directive, hold legal weight.