Informed consent and tardive dyskinesia

Tardive dyskinesia presents a variety of problems and dilemmas to mental health professionals who treat the seriously mentally ill. Of utmost concern is the significant prevalence of this disorder in the chronically mentally ill, in conjunction with the continuing need of these patients for antipsychotic medication. Doubt about the ability of seriously mentally ill individuals to meaningfully participate in the informed consent process has been raised. Nevertheless, it is reasonable to expect mental health professionals to attempt to engage a mentally ill patient in the informed consent process, although there is uncertainty about the timing and manner of this effort. Several strategies to maximize patient understanding of the risks of antipsychotic medication can be used. The clinician who fails to do so risks liability for failure to obtain informed consent to treatment, which has been adjudicated in some cases.