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Treatment Delayed is Treatment Denied.
Jhilam Biswas1, Eric Y Drogin2, Thomas G Gutheil2
1Dr. Biswas is the Director of Psychiatry, Law and Society, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA and a forensic psychiatrist in the Department of Psychiatry, Bridgewater State Hospital, MA. Dr. Drogin is a lecturer, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Dr. Gutheil is Professor of Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center and the Massachusetts Mental Health Center, Harvard Medical School, Boston, MA. jbiswas@bwh.harvard.edu.
The Journal of the American Academy of Psychiatry and the Law
|December 30, 2018
Summary
Procedural delays in mental health law, like Rogers Guardianship, can harm patients by prolonging illness and increasing hospitalizations. A more efficient system is needed to protect patient autonomy and well-being.
Area of Science:
- Mental Health Law
- Human Rights in Psychiatry
- Legal Procedures in Mental Healthcare
Background:
- The evolution of mental health jurisprudence emphasizes human rights, self-determination, and personal autonomy.
- Current legal procedures, particularly in institutional psychiatric care, can lead to unintended negative consequences for patients.
- Rote procedural approaches may inadvertently prolong acute illnesses and create long-term dependency on psychiatric services.
Purpose of the Study:
- To critically examine the impact of current legal procedures on patient outcomes in mental healthcare.
- To identify systemic issues within mental health jurisprudence that may hinder patient recovery and liberation from illness.
- To propose improvements to legal frameworks and advocate for a more effective system that supports patient well-being.
Main Methods:
- Analysis of court-based procedures in mental health law, focusing on potential delays.
- Examination of specific legal models, such as the "Rogers Guardianship" in Massachusetts.
- Discussion of the challenges faced by legal advocates in navigating medical treatment decisions within legal constraints.
Main Results:
- Court-based procedures can introduce significant delays, potentially worsening acute mental illnesses and leading to chronic conditions.
- The "Rogers Guardianship" model exemplifies how legal frameworks may inadvertently impede timely and effective treatment decisions.
- Legal counsel and courts face challenges in second-guessing medical decisions, leading to delays that contradict the goal of patient liberation from illness.
Conclusions:
- Current legal procedures in mental health can paradoxically harm patients by causing delays that undermine recovery.
- There is a critical need to devise improved systems and legal options for advocates to better serve patients' rights and well-being.
- Reforming legal frameworks is essential to ensure that procedural safeguards genuinely support, rather than hinder, the goal of mental health treatment and patient autonomy.
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