Monthly Archives August 2013

Depression and Bipolar Support Alliance

When an individual with a mental health condition in need of intensive psychiatric care is hospitalized, whether voluntarily or involuntarily, the individual, family, and friends may have mixed reactions. They may feel relief that the individual is safe, but they may also feel emotionally, physically, and potentially financially drained. Yesterday on CFYM, Dr. Sederer shared his expertise in navigating what can be daunting legal and medical legalities on patient psychiatric hospitalization treatment rights. DBSA believes that patient protections are important to ensuring individuals are the lead decision-makers in their own wellness. The best wellness outcomes are achieved when individuals living with mental health conditions and their family and friends are educated and prepared for crisis.

Education is Power

DBSA encourages individuals to become knowledgeable about (1) mental health laws in the states in which they reside; (2) options for treatment centers and outpatient programs other than hospitals; and (3) the rules and regulations regarding admission and release in hospitals and treatment facilities, both for voluntary and involuntary entry.

Whether hospitalized voluntarily or involuntarily, individuals have the following rights:

1. to have treatment explained;
2. to be informed of benefits and risks of treatment;
3. to refuse treatment the individual feels is unsafe;
4. to be informed about any procedures that the individual feels may be unnecessary; and
5. to refuse to take part in research and experimental treatments, and to disallow students or observers.

DBSA supports adherence to these patient rights in all circumstances.

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Lloyd I. Sederer, M.D.
Adjunct Professor, Columbia/Mailman School of Public Health
Medical Editor for Mental Health, Huffington Post/AOL

All patients have both a right to treatment and a right to refuse treatment. These rights sometimes become the centerpiece of debate and dispute for people who are hospitalized with an acute psychiatric illness.

The Right to Treatment

There is a long legal history on the right to treatment. Much of the law derives from court cases in the previous century involving people who were admitted to state psychiatric hospitals where they languished without proper treatment, sometimes for many years. Laws compelling a right-to-treatment law developed and became instrumental to the quality-controlled public psychiatric hospitals that exist today. In fact, in order for public psychiatric hospitals to receive Medicare and Medicaid (and other third-party) payment, they must obtain the same national certification as academic medical centers and local community hospitals. For patients and families, this means that a person admitted to a public psychiatric hospital has a right to receive—and should receive—the standard of care delivered in any accredited psychiatric setting.

The Right to Refuse Treatment

It may seem odd that a person can be involuntarily admitted, or “committed,” to a hospital and then refuse treatment. But the right to refuse treatment is also fundamental to the legal requirements for psychiatric treatment.

Someone who enters a hospital voluntarily and shows no imminent risk of danger to self or others may express the right to refuse treatment by stating he or she wants to leave the hospital. But a person admitted involuntarily, due to danger to self or others, cannot leave, at least not right away. However, despite having the authority to keep the patient in the hospital, the professional staff cannot treat the person against his or her will, except by court order.

The concept of a right to refuse treatment was built on basic rights to privacy, equal protection under the law, and due process. In other words, involuntarily hospitalized patients still have a right to decide what happens to their bodies.

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On Tuesday, our Expert Perspective advocated for integrated care. Integrated primary and behavioral health care attempts to mold the care system to the whole individual, thereby increasing access to health services by making them more convenient and increasing the quality of care by requiring better communication, coordination, and collaboration among health care providers.

Resources on Integrated Care

To help you learn more about integrated care, we’ve compiled some of the web’s best available resources:

1. The National Association of County Behavioral Health and Developmental Disability Directors wrote of integrated care as being the key to bringing together mind and body.
2. SAMHSA provides a lot of information in their webinar, Integrating Behavioral Health into the Person-Centered Healthcare Home.
3. You can also see how, even five years ago, agencies in the federal government were involved in integration of primary care and mental health care.

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