Mental Health Law Needs a Family Bill of Rights

Dogmatic defenses of patient autonomy can cause harm when applied strictly to individuals with mental illness. A Family Bill of Rights for relatives of patients with serious mental illness would create a limited but meaningful role for families in legal determinations. The proposal centers on three rights. Families should have the right to be aware through required notification of close relatives when involuntary commitment occurs, with an exception for relatives with a history of domestic violence. Families should have the right to be present at commitment and treatment hearings unless a court finds specific risk of harm. Families should have the right to be heard by sharing information about history, functioning outside care, adherence to prior treatment, and capacity to manage safely.

"Using the federal Crime Victim's Rights Act as a model, the Hastings Center for Bioethics proposal would allow "a limited but meaningful role for families in legal determinations for certain patients with severe mental illness." It puts forth three essential concepts, all necessary based on my decades of experience as a family-focused mental health attorney:"

"The right to be aware: With the exception of family members with a history of domestic violence, laws should require psychiatric hospitals to notify close relatives when individuals are involuntarily committed. The right to be present: Unless a court determines that their presence would create a specific risk of harm, close relatives should be permitted to attend commitment and treatment legal hearings. The right to be heard: To help courts and clinicians make better decisions with regard to involuntary detention or treatment, relatives should have the right to share information with the courts about the patient's history, functioning outside of clinical care, adherence to prior treatment, and capacity to manage safely outside structured care."

"These basic concepts require some specifications, as noted below. But overall, they are all necessary, overdue, and common sense, given that the nature of mental illness often limits a person's insight and judgment."

Read at Psychology Today