The report indicates that many people receive more aggressive care 
than they desire at end-of-life and that advance directives are under 
used, with only 18% to 36% of adults having completed the document.

"Whether persons with mental illness have the capacity to engage in 
advance care planning and complete an advance directive is controversial. "

<http://aspe.hhs.gov/daltcp/reports/2008/ADCongRpt.htm>http://aspe.hhs.gov/daltcp/reports/2008/ADCongRpt.htm 



"People Who experience mood swings, fear, voices and visions"