Advance directives are legal documents that formalize consumer psychiatric care preferences. This article examines the statutes and goals of US psychiatric advance directives within the framework of consumer self-determination, a priority in national mental health reform. It seeks to distinguish between state models based on the degree that consumer rights are integrated into advance directive statutes and goals. The data set contains information from legislative statutes and goals from the 24 US states that enacted explicit psychiatric advance directive regulations prior to 2006. Researchers grouped the data into categories based on the similarities in consumer self-determination. The findings include an examination of the spectrum of consumer self-determination in US advance directive statutes along with a comparison of the gaps between intent and policy in state statutes.