The Patient Self-Determination Act (PSDA) has been in effect since December 1, 1991. The primary purpose of the PSDA is to promote patient awareness of advance directives. Many psychiatrists are unaware of the PSDA and its requirements or believe that the PSDA does not apply to psychiatric facilities and patients. In this article the requirements of the PSDA are reviewed. Potential applications of advance directives in psychiatric care are discussed and problem areas are identified. It is suggested that psychiatrists take an active role in the implementation of the PSDA.