Advocacy, Inc. - IR3 — Rights Of People Receiving Involuntary Inpatient Mental Health Services

IR3 — Rights Of People Receiving Involuntary Inpatient Mental Health Services

November, 1997

All people have certain basic legal rights, including people who have mental illness and people who are in mental health facilities. In some cases, these rights can be restricted by a judge or your doctor. Your rights are summarized below.

Rights That Cannot Be Restricted

You have some rights that no one, not even a judge or a doctor, can take away from you:

The right to treatment in the least restrictive appropriate setting. This means you have the right to treatment in a place that restricts your day-to-day life only as much as is necessary to protect you and others around you. It also means that your treatment should interfere as little as possible with your thinking, with taking care of personal needs, or with your ability to work.
The right to a humane treatment environment that is clean and safe where you won't be harmed.
The right to proper mental health and medical treatment.
The right to an independent evaluation by another doctor of your choice, as long as you pay the cost.
The right to enough privacy for your personal needs, as long as this does not place you or other people in danger.
The right to be told about your rights within one day (24 hours) of your admission to the facility. You must be told about these rights both orally and in writing, in the language you understand best. If you are hearing or vision impaired, these rights must be communicated to you in the way you understand best. If you are a minor, or if you have a guardian, information about these rights must also be given to your parent or guardian.
The right to a written individual treatment plan based on your own needs that describes your diagnosis, specific problems and specific needs. It must also contain a description of the short-term and long-term treatment goals, and a projected timetable for their attainment. Individual staff responsibility must be stated, and criteria needed for release to a less restrictive environment must also be stated. The plan must be reviewed on a regular basis to make sure it is the best way to help you.
The right to participate in the development of your treatment plan, if you want to participate. If you are under 16 years old, or if you have a guardian, your parent or guardian can also participate in developing your treatment plan.
The right to information about the medications your doctor has prescribed, including the name of the medication, the dosage and schedule, the type of medication, the benefits expected from that type of medication, and the side effects and risks of the medication.
The right to refuse to be a part of a research program. You do not have to agree to try new, experimental drugs or treatment.
The right to be informed, in writing, at admissions and discharges of Advocacy, Inc.'s address and telephone number.
The right to send and receive uncensored mail.
The right to find a lawyer to represent you, and the right to talk with and to write to your lawyer.
The right to have your family notified of your discharge, if you want them to know.

Electroconvulsive Therapy

You have the right to refuse electroconvulsive therapy (ECT). However, if you are 16 years-old or older, and a judge has decided that you are incompetent, then your guardian can consent to ECT but only if you would have agreed to the treatment if you were not incompetent. If you are under 16 years-of-age, ECT may not be used under any circumstances.

If you have made an Advanced Directive (see Advocacy, Inc.'s handout, How to Make an Advanced Directive) and included information about ECT, the Advanced Directive must be followed when you become incompetent, regardless of what your guardian may desire.

Habeas Corpus

You have the right of habeas corpus. In certain cases, you can ask a judge to decide if it is legal to keep you in a mental health facility or jail against your will. If the judge decides that you should not be kept against your will, you must be immediately discharged from the facility. This might happen if, for instance, the judge thinks you are not likely to hurt yourself or others.

Rights That Can Be Restricted Only by a Judge:

Rights of People with Mental Illness
You have the rights listed below, unless a judge has held a hearing and made a written order restricting your rights. The court proceedings that can limit your rights are guardianship, child custody, and mental health commitment proceedings.

The right to register and vote in elections.
The right to buy and sell property and to sign contracts.
The right to sue and be sued.
The right to have a driver's license and other kinds of permits, privileges, and benefits under the law.
The right to religious freedom.
The right to have your treatment records kept confidential, unless you sign a release or file a lawsuit, or the court orders release of your records.
All rights concerning your family, such as the right to marry and have children. Unless a judge has taken custody of your children away from you, you can still make decisions for your children.
The right to give consent or refuse to give consent to treatment with medication. If you refuse to consent to medication and you are in a state hospital, the law says that you cannot be forced to take medication unless the hospital gets a court order, or you are having a medication-related emergency. A medication-related emergency is a situation in which it is immediately necessary to administer medication to a patient to prevent immediate and serious harm to you or someone else because of your actions or threats. The doctor must petition the court to order the medication, and the medication can only be ordered after a hearing. You have the right to be present at the hearing and be represented by an attorney at the hearing, at no cost to you. If the judge orders the medication, you can be required to take it.

If you have made an Advanced Directive and included information about medications and preferences in emergencies, the judge and doctor must follow your instructions in the Advanced Directive.

Rights That Can Be Restricted Only by a Doctor or Treatment Team

Additional Rights of Clients in Inpatient Mental Health Facilities
Your doctor or treatment team can restrict some of your rights while you are receiving involuntary mental health services in a mental health facility:

Only your doctor can order that physical restraints be used on you. If restraints are ordered, they must be taken off as soon as possible. Anytime physical restraints are used on you, it must be noted in your treatment record by your doctor.

Unless your doctor says in your records that you can't, you have these rights:

The right to wear your own clothes and use your personal belongings.
The right to have visitors in the facility, to talk by telephone, or write to people outside the facility. Your letters must not be opened, read, or changed by anyone in the facility unless you want them to be. The doctor can sometimes limit your right to have visitors and to write and talk with other people if the reasons for limiting these rights are put in your treatment record. Even if the doctor does set limits, you always have the right to talk with and to write with confidentiality a lawyer who has agreed to represent you.
The right to socialize with others, including the opposite sex; but your doctor may order these activities to be supervised.
The right to physical activity and grounds privileges.
The right, when you are discharged, to a plan for your continued treatment (if you need continued treatment) that covers both your mental health and physical needs. You have the right to refuse the services in this plan, unless a judge says you do not have this right.

If You Think Your Rights May Have Been Violated

If you believe any of these rights may have been violated, you should first contact your treatment team at the facility where you are located. Additionally, you have the right to talk to any of the following:

the Consumer Rights Officer, located at all mental health facilities,
the TDMHMR Office of Consumer Services and Rights Protection,
the Public Responsibility Committee, and/or
Advocacy, Incorporated.

For further information, see Advocacy, Inc.'s brochure, How To Make A Complaint About Inpatient Mental Health Services. Advocacy, Inc. also has available the following related material:

For further information, please contact any Advocacy, Inc. office.

Advocacy, Incorporated's goal is to make each handout understandable by and useful to the general public. If you have suggestions on how this handout can be improved, please contact Advocacy, Inc. at the address and telephone number shown on Advocacy's home page or e-mail Advocacy, Inc. at infoai@advocacyinc.org. Thank you for your assistance. This handout is available in Braille and/or on audio tape upon request. Advocacy, Inc. strives to update its materials on an annual basis, and this handout is based upon the law at the time it was written. The law changes frequently and is subject to various interpretations by different courts. Future changes in the law may make some information in this handout inaccurate. The handout is not intended to and does not replace an attorney's advice or assistance based on your particular situation.