Mental Health Treatment

Mental Health TreatmentLittle do most people know, but there exists a medical test that can evidence if mental health treatment, which is most often a drug, will predictably cause adverse reactions in a patient, prior to giving them the drug. Mental Health drugs carry strong FDA warnings of hallucinations, mania, psychosis, suicidal and homicidal actions and thoughts and more tragic consequences. The medical test is available through your physician and you have the right to ask for it. Mental health treatment is, by law, under the established legal boundaries of Informed Consent (the right to know the risks of the treatment and the right to know about the alternative treatment).

The scientific study of drugs (pharma) and genetics (inherited characteristics) is called “Pharacogenomics”. This study looks at how genetic characteristics influence medication response and can evidence the inability of a person’s body, to absorb and utilize a drug.

Individual’s responses to drugs are largely influenced by drug metabolism and the ability to metabolize is influenced by the activity of enzymes (electron transfer agents in pathways of the body that are responsible for metabolism). Added variables are the more than fifty different genes that affect the behavior of the metabolic enzymes. Even more variables exist and they include a group of enzymes that have several different versions of each enzyme due to one’s genetic make-up. There are, also, proteins, within the body that play a role in whether the body can break down and assimilate a drug or whether the drug will simply act as a toxin

Medical science has known about these variables for years and has had a way to test these variables to determine the dangers that the drugs may cause to the individual patient. The public is not made aware that this test exists. This includes testing for drugs that are prescribed for physical ailments as well as mental health symptoms

Ones hereditary characteristics adds up to a lot of variables that determine whether an individual can predict that they are likely to experience the FDA adverse effect warnings of mania, psychosis, hallucinations, sudden death, paranoia, delusions, suicidal thoughts and homicidal thoughts and more.

The absorption, distribution, metabolism or elimination of the drug is all influenced by hereditary factors.

Mental health treatment has no medical test done, prior to the prescribing of the drugs, to determine that an individual needs that drug. It is unlike medical science used for determining a physical ailment and this, most definitely, excludes mental health treatment from the realm of scientific fact. It is a field strewn with opinion. Individuals have the right to full factual information so that they can better their lives. (search through the site www.mentalhealthrights.org to find out more)

The following is a table, from the FDA, of the many factors that can influence whether a drug will cause an adverse response.

Factors Influencing Drug Response

Intrinsic
Genetic
  Absorption, distribution, metabolism, excretion
  Body weight
  Genetic conditions
  Genetic polymorphism of drug-metabolizing enzymes
  Height
  Race
  Receptor sensitivity
  Sex
Physiologic
  Absorption, distribution, metabolism, excretion
  Age
  Alcohol
  Body weight
  Cardiovascular function
  Diet
  Diseases/conditions
  Height
  Kidney function
  Liver function
  Receptor sensitivity
  Smoking
  Stress
Extrinsic
Alcohol
Climate
Culture
  Educational status
  Language
  Socioeconomic factors
Definition/diagnostics
Diet
Diseases/conditions
Drug adherence
Medical practices
Pollution
Smoking
Stress
Sunlight
Therapeutic approach

 

Source of Table: Adapted from the U.S. Food and Drug Administration, U.S. Dept. of Health and Human Services. International Conference on Harmonisation: guidance on ethnic factors in the acceptability of foreign clinical data; availability. Federal Register 1998;63(111):31790–31796. http://www.fda.gov/cder/guidance/2293fnl.pdf. Accessed October 17, 2007.

 

Other source of information: Drugs and Genes

Coriell personalized medicine collaborative https://cpmc.coriell.org/Sections/Medical/DrugsAndGenes_mp.aspx?PgId=216

 

 

How to fight the Baker Act

How to Fight the Baker ActMost people who contact a Mental Health Rights Advocate or a Baker Act attorney wonder how to fight the Baker Act. There are those who meet the criteria for involuntary examination and the legislator who enacted this law, Maxine Baker, had in mind to assist those individuals and to prevent any harm. Yet there are many who do not meet the criteria and still, they are Baker Acted.

How to fight the Baker Act, has everything to do with understanding the criteria as stated in the Florida Law. When that is understood, then the individual and their friends or family members can understand whether they have grounds to fight it or not.

Sometimes, individuals are perceived as having a disability or a mental illness because they have just received bad news and have a strong emotional reaction; or some people have had too much alcohol and start talking in a depressed manner; others may have a medical illness which symptoms are taken for mental health symptoms instead of physical. The individuals who do not meet the criteria are placed under the 72 hour hold and they cannot leave the facility just because they don’t think they belong there. It’s a law, and the law is very specific on this. To assist yourself in fighting the Baker Act, first get familiar with the criteria and then it may be very beneficial to work with a Mental Health Rights Advocate and/or a Baker Act attorney.

Involuntary commitment law exists in every state across the country and while some aspects of the law vary state-to-state, they all have commonalities such as the length of stay, the mandatory aspect of the stay and the fact that only a qualified mental health professional can grant release of the patient.

Afterwards, the involuntary examination becomes a part of the individual’s medical records and will follow them throughout their life. This is one aspect that should be considered when in the situation. Of course, if the person didn’t meet the criteria, it is a very irritating aspect. There is not a lot that can be done about it after the fact. You always have the right to file appropriate complaints to state agencies in regards to the Baker Act and specific aspects that you feel violated Florida law. Again, this is best accomplished with the help of an advocate or attorney.

Disabilities and/or abilities are determined by majority opinion in the field of mental health. They are not evidenced by medical tests in the way that Diabetes, Cancer or any other physical ailment is diagnosed. If an individual is “regarded as having a disability” there are certain legal actions that can be taken if the person is treated in an unfair way that violates the Americans with Disabilities Act. That’s interesting because the disabilities law allows for the fact that some people are “regarded as having disabilities” when they don’t and yet, the Baker Act law does not take this into consideration at all. Once someone is deemed to meet the criteria, they are determined to have a mental illness, per the criteria.

In a report, written by Risa M. Mish, titled, “Regarded As Disabled” Claims under the ADA: Safety Net or Catch-all?, Ms. Mish enlightens us as to what this legal concept of “regarded as disabled” actually means. On a rare occasion if someone was Baker Acted and during the stay at the facility, was treated in a way that violates the Americans With Disabilities Act, then a Disabilities Attorney might have reason to file suit on the patient’s behalf.

Per Ms. Mish’s report, “The ADA regulations provide that an individual is “regarded as disabled” if she: (1) has a physical or mental impairment that does not substantially limit major life activities but is treated by an employer as constituting such limitation; (2) has a physical or mental impairment that substantially limits major life activities only as a result of the attitudes of others toward such impairment; or (3) has none of the impairments specified in the ADA subsection, but is treated by an employer as having a substantially limiting impairment. Therefore, an individual will be “regarded as disabled” when others behave toward that individual as if she had a substantially limiting impairment, regardless of whether the individual actually has such an impairment.

This is offered as food for thought! If you find yourself in a situation where a friend of family member has been Baker Acted, you can keep this in mind. Additionally, there is a lot of information on this site that you may find helpful in asserting your rights and fighting the Baker Act.

My child, my husband, my daughter, my friend, my mother, my father, my sister, my brother was Baker Acted

My friend was Baker ActedMy child, my husband, my daughter, my friend, my mother, my father, my sister, my brother was Baker Acted and what do I do?

First and foremost, know that your friend or relative has all constitutional rights despite having been involuntarily committed. This right is assured by the Baker Act law, Florida Statute394.459 Rights of patients.

The law states: RIGHT TO INDIVIDUAL DIGNITY. A person who is receiving treatment for mental illness shall not be deprived of any constitutional rights.

The circumstances just prior to the person being taken to the psychiatric facility, largely determine if he or she met the criteria or were perceived to have met the criteria. An experienced Mental Health Rights Advocate or a Baker Act attorney can help you to sort that out. Each year, the state publishes an annual report in regards to how many Baker Acts there were, statewide, during the year. Startling as it may be, there were over 170,000, per the most recent annual report. That leaves a lot of people wondering what their rights are if their child, husband, daughter, friend, mother, father, sister or brother was Baker Acted. Family members have rights as well as the individual who is being examined.

Those rights include the right to visit their loved one during visiting hours. Visiting hours vary per facility and it may be one of the first things you want to find out so that you can ensure your right to see your loved one as soon as possible. The rights of the patient are, by law, supposed to be posted in a visible place within the facility and you can mention that to the person being held. They can get familiar with what options they have at the point they are admitted.

Additionally, you have the right to communicate with your friend or family member, at “reasonable times”. Again, this varies according to policies at each individual facility and you may want to find out when it is you can speak to your loved one over the phone.

You have the right to file a Writ of Habeas Corpus on behalf of the individual being held and that gets filed in the courthouse of the county where the facility is. The Writ is a formal request to find out why the person is being detained. You, also, have the right to help your friend or family member to report any violations of rights and privileges of the patient.

The law states:

VIOLATIONS.—The department shall report to the Agency for Health Care Administration any violation of the rights or privileges of patients, or of any procedures provided under this part, by any facility or professional licensed or regulated by the agency.

POSTING OF NOTICE OF RIGHTS OF PATIENTS.—Each facility shall post a notice listing and describing, in the language and terminology that the persons to whom the notice is addressed can understand, the rights provided in this section. This notice shall include a statement that provisions of the federal Americans with Disabilities Act apply and the name and telephone number of a person to contact for further information. This notice shall be posted in a place readily accessible to patients and in a format easily seen by patients. This notice shall include the telephone numbers of the Florida local advocacy council and Advocacy Center for Persons with Disabilities, Inc.

 

 

Protection and Advocacy—Mental Health Help

In order for someone to understand protection and advocacy in the area of mental health or to receive mental health help, it is vital to understand the legal concept of Express and Informed Consent.

Many of us may take iProtection and Advocacy--Mental Health Helpt for granted, understandably so, that a medical professional would naturally tell us, the patient, of the risks and the alternatives to any proposed medical treatment or procedure. Respect for the medical community can tend to blind us to the fact that most of the time, in regards to mental health treatment, the patient is not assured their right to Express and Informed Consent.

To begin with, Florida has its own law that assures protection and advocacy by the patient, if he or she is aware of this law.

Per the law, “It is the intent of the Legislature that health care providers understand their responsibility to give their patients a general understanding of the procedures to be performed on them and to provide information pertaining to their health care so that they may make decisions in an informed manner after considering the information relating to their condition, the available treatment alternatives, and substantial risks and hazards inherent in the treatment.”

Florida Statute 381.026, Florida Patient’s Bill of Rights and Responsibilities, assures each Floridian that they have the right to individual dignity and information. They have the right to be given information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.

The fact that the individual has the right to know of the risks and the alternatives implies he or she has the right to decide for him or herself and their children, whether they want to receive the treatment or an alternative treatment.

In the specific case of minors and the subject of involuntary commitment, through the Baker Act, a minor, therefore the parent still has the right to Express and Informed Consent to treatment. The typical line of treatment within a psychiatric ward is a psychiatric drug. These mental health drugs carry severe risks, listed by the FDA, of mental health symptoms such as hallucinations, delusions, paranoia, suicidal thoughts, homicidal thoughts and actions, psychosis and many more. Parents have the right to know these risks and the right to know that there are medical professionals, throughout the state and throughout the country, who specialize in medical testing for underlying physical causes of unwanted mental health symptoms.

 

Express & Informed Consent regarding minors and the Baker Act, per Florida Statute 394.459(3), the following:

“Prior to requesting consent to treatment, the following must be provided and explained in plain language:

  • The reason for admission or treatment,
  • Proposed treatment, including psychotherapeutic medications
  • Purpose of treatment
  • Alternative treatments
  • Specific dosage range for medications
  • Frequency and method of administration
  • Common risks, benefits and short- term/long-term side effects
  • Contraindications
  • Clinically significant interactive effects with other medications. Similar information on alternative medication, which may have less severe or serious side effects.
  • Potential effects of stopping treatment
  • Approximate length of care
  • How treatment will be monitored, and that
  • Any consent for treatment may be revoked orally or in writing before or during the treatment period by the person legally authorized to make health care decisions for the person.

Please note that in the 394.459(3) wording it says “similar information on alternative medication…” The individual, the parent and the child, still have the right to alternative treatment as stated in Florida Statute 381.026. You do have the right to decline any proposed psychiatric medication for your child while he or she is held under the Baker Act.

As a special note, parents, please be aware that ultimately the law supports your right as guardian, regarding the Baker Act, unless you are not available. Per Florida Statute 743.065(1) and (2), “Medical care or treatment includes ordinary care but excludes surgery, general anesthesia, psychotropic medications or other extraordinary procedures requiring a court order.

Emergency medical care or treatment can be provided by a physician or EMS for an acute illness, disease, or condition when parental consent cannot be immediately obtained.”

Emergency medical care to a minor refers to an individual who has “been injured in an accident or who is suffering from an acute illness, disease, or condition if, within a reasonable degree of medical certainty, delay in initiation or provision of emergency medical care or treatment would endanger the health or physical well-being of the minor.”

Again, this applies if the parent is unable to be reached in order to give consent. It is not beyond real-life terms that a physician would deem that psychiatric treatment falls in the category of Emergency medical care. Parents are able to assert their rights as long as they are aware that their child has been brought to a facility under the Baker Act.