Health Care Decisions of the Mentally Ill

The mentally ill are an extremely vulnerable group when it comes to receiving adequate health care as well as being “allowed” to make those critical decisions that affect their lives. Although the perception exists that as a whole the mentally ill are ill equipped if not downright incapable of making those decisions, the reality is not so carved in stone.  The stereotypes of the mentally ill both lessen their ability to “participate in the management of their illness and achieve desired treatment outcomes,” and “encourages pessimistic and non-therapeutic attitudes and behaviors among clinicians making them receptive to the requests of their mentally ill patients.” (National 2006 p. 80).
The perception is that the mentally ill pose a danger to both themselves and society, therefore need to have all “important” decisions made for them, just as a child would. The mentally ill are often coerced into making decisions that are neither true to their wishes, or good for their lives. In reality, the majority of the mentally ill are quite capable of making their own health care decisions, and only rarely does their illness
affect those decisions, requiring a family member or friend to step forward.

Research has shown that the mental health population has “elevated rates of some disease and health complications from psychiatric medication,” and, in fact tend to die at significantly younger ages than the general population. (Mental 2006 p. 1).  There are, of course, circumstances where intervention by another party becomes a necessity.  In the more severe mental illnesses such as schizophrenia or severe bi-polar disease, the ability to make rational decisions can become severely impaired, requiring a guardian ad-litem to make decisions that are in the best interest of the patient.
Our current system of HMO’s also put the mentally ill patient at a further disadvantage because “psychiatric disorders leave people ill-equipped to handle the bureaucratic roadblocks inherent in managed care.” (Perina 2002 p. 1). Because there are no concrete routine blood tests or CAT scans that definitively say that a person is ill, the science is much more subjective, therefore more fraught with stumbling blocks.
As stated, in most cases, the mentally ill are still quite able to make their own health care decisions and should be allowed to do so without the stereotypes and hardships to make those decisions more difficult.
Works Cited:
Mental Health Articles (March 15, 2006). Creative Strategies Improve Medical Care for
Mentally Ill. Retrieved May 31, 2006 from:
National Academics Press (2000). Improving the Quality of Health Care for Mental and
Substance Abuse Patients. Retrieved May 30, 2006
Perina, Kaja. (Mar/April 2002). Battling for Benefits. Retrieved May 31, 2006

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