Families for Depression Awareness
- keeping them safe
- getting them care to get well; and
- preventing suicides.
Sometimes people are in a state of mind that prevents them from making sound decisions. There are mental states (e.g., experiencing psychosis) and physical conditions (e.g., effects from a stroke) that can adversely affect a person’s usual good judgment. We agree with DBSA and others that, ideally, a person with a mental health condition will engage family members and friends as partners in wellness and in crisis. There will be a written plan and the legal documents necessary to ensure that care is pursued and provided according to the individual’s wishes as expressed when he or she was well. Mental health practitioners can make sure that families get information about this and should strongly encourage patients to bring a family member to at least the first appointment.
In our experience, all too often these conversations and pre-planning have not occurred, and the family member must navigate the complex medical, insurance, and legal systems to get emergency care for their loved one.
Family members are frequently excluded from mental health care decisions, despite being the ones who often have the most pertinent knowledge and the greatest motivation to get someone the care they need to get well.
Here’s an example from Nancy: her adult son was taken to the emergency room while experiencing a psychotic break. That hospital informed Nancy that he would be transferred to one of two particular hospitals, but they didn’t know which. After he was moved, Nancy was not able to get information from either hospital about whether he had been admitted. Even worse, the hospital would not take information from her about his current medication and psychiatrist, which she sought to provide in case he was at that hospital.
Finding a Solution
What do we do when there isn’t a prior plan in place? How do we find workable, fair alternatives to our flawed system of providing care to people whose mental state prevents them from making decisions in the way that they would if they were well? We need to include the variety of voices and stakeholders, including families, in this process.
If someone is suicidal, thinking of hurting themselves or others, or having cognitive impairment (e.g., in a psychotic state), then families should be able to
- learn the whereabouts and condition of their loved one from medical facilities and practitioners and
- interact with practitioners and staff to keep their loved ones safe, facilitate treatment and recovery, and get them well.
The laws of involuntary hospitalization, involuntary treatment, and patient privacy too often create barriers to securing medical care for loved ones who, due to cognitive impairment or mental state, are not in a position to make sound decisions at the time. We need to encourage the creation and implementation of mental health crisis plans, and we all need to participate in finding workable alternatives to these problems. Family members are ready, willing, and able to pitch in and resolve these issues.
Tell us about your experiences! Comment below, and fill out our survey so we can better understand the scope of the problem.