As a mental health professional caution must be exercised when working with people who are legally incompetent. This includes people with mental illnesses, people who are developmentally challenged and people who are a danger to themselves or others. Mental health law and criminal law differ in the burden of proof required, purpose of confinement and length of confinement.
In order for a person to be involuntarily confined under mental health law the person must need treatment, must be unable to provide basic care for themselves, and must be a danger to themselves or others. Finding that a person is mentally ill is not in and of itself enough to involuntarily confine that person. It is important to note that even when a person has been involuntarily confined, they retain certain rights and expected standards of care that must be adhered to. It is important, also, to note that in cases where a person commits suicide the mental health professional could open themselves up to malpractice lawsuits for not recognizing and predicting suicide when someone under their care commits suicide. This fact is sometimes in conflict with the mental health professional belief in personal autonomy, and that a person has a right to make their own decisions about how to live their lives.
Mental health professionals must keep confidential records of those people they are treating who may not be competent. Confidentiality is very important because a person who is known to have been a mental patient faces prejudices. Violations of confidentiality, except where permitted by explicit exceptions, can result in criminal and civil penalties. Some exceptions to the confidentiality requirement are; disclosure to correctional agencies when the confinement was court ordered, disclosure to health care professionals to aid in treatment, when the patient gives competent consent, information required for insurance payments, and release of statistical data to researchers.
Mental health patients are also required to be granted conditional rights. If it is determined that one of these rights must be suspended it must be for good cause. Most state laws require a written report explaining why the rights have been suspended. There are usually procedures that need to be followed in order to take away mental patient’s rights. Mental health professionals need to know these procedures and understand the laws governing their state. These personal rights include; the right to have visitors, to have phone calls, to wear their own clothing, to be paid for any work they do, to refuse certain treatments, to get education, physical exercise and practice religious beliefs and to have dignity, privacy, and care free from harm or unnecessary confinement.
Symptoms are the fire alarms that our body gives us to wake us up and tell us that there is a fire on board.
If your fire alarm went off in your bed room one night, you wouldn’t just reach up and yank out the batteries and go back to sleep, but that is exactly what we do when we go to the doctor, get the medicine and continue on as usual without further investigation or change. Our response to those symptoms should be to not only call the fire department (the doctor), but get the fire extinguisher and investigate thoroughly what caused the fire so that it won’t happen again.
