The headlines are bleak: Eight people have died in school shootings in the U.S. in just the last three weeks. In the wake of these tragedies, Congress is focusing on mental health issues, with renewed attention going to a 2013 bill that would loosen standards for patient privacy. But we shouldn’t let fear blind us to the need to protect the civil rights of people with mental illness – and to the fact that most of these people aren’t violent and never will be.
Since federal medical privacy protections took effect in 2003, health care providers have been barred from sharing information on a patient’s health without that person’s permission.
A measure proposed by Rep. Tim Murphy, R-Pa., would lift that ban and allow parents or other caregivers access to a patient’s medical information, even if the patient hasn’t authorized it. According to Murphy, a clinical psychologist, the bill would empower families of people with a serious mental illness – such as bipolar disorder or schizophrenia – to make treatment decisions for their loved ones.
Each year in the U.S., serious mental illness affects around 10 million adults, an estimated one-third to two-thirds of whom live with their families. Because family caregivers have such significant responsibilities, keeping them in the loop regarding treatment is key.
At the same time, though, it’s critical not to lose sight of the reasons for the movement to deinstitutionalize people with serious mental illness: They were being held against their will in inhumane conditions, such as restraints and seclusion, and many of them weren’t getting any better. Again depriving patients of any privacy about their care decisions won’t encourage them to get treatment.
But in Maine and many other states, there’s an alternative. The advance mental health care directive enables someone with a mental disorder to designate a friend or relative to act on their behalf in an emergency.
Families don’t have to worry helplessly that a loved one who’s temporarily unable to act in their own best interest will act out violently and wind up behind bars or worse. Instead, in certain circumstances, caregivers get the authority to insist on hospitalization or medication. And the directive doesn’t undercut the autonomy of someone with a mental illness when they’re lucid.
Scuttling medical privacy rules won’t improve the well-being of people with mental disorders, or reduce the already low risk that they’ll harm others. To meet these goals, politicians should expand funding for preventive mental health services and efforts to publicize measures, like advance care directives, that allow patients and their families to work together to ensure that the best course of treatment is carried out.