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Kathy’s Story

Kathy has been diagnosed with schizo-affective disorder. Unfortunately, Kathy has not been taking her medications and is highly paranoid.  

Recently, Kathy’s psychotic symptoms escalated. Thinking that her neighbors were monitoring her, Kathy tore out all the electrical wiring in her apartment building costing thousands of dollars to repair. All 45 people in Kathy’s building were without power for a period of time. As a result, Kathy is facing both criminal vandalism charges and eviction.

It’s impossible to get a full mental health evaluation because Kathy rarely answers the door. The only time Kathy will answer her door is when her case aide comes over.

Kathy’s case aide does visit her weekly. Recently, the case aide reported that Kathy hasn’t been showering or changing her clothes. Although the case aide repeatedly asks Kathy to see a medical doctor and her psychiatrist, Kathy refuses.

You are Kathy’s guardian and have medical decision making authority. You’ve unsuccessfully tried to get Kathy to voluntarily enter a psychiatric unit to get her back on her meds and stabilized.


Knowledge Check

Would you use your medical decision making authority to force Kathy to go to a psychiatric unit for evaluation and treatment?


Your medical decision making authority doesn’t mean you can physically force Kathy to go to treatment.


If Kathy is in immediate danger, you should contact law enforcement for emergency commitment. Kathy would be transported to a hospital ED for evaluation. If the hospital says she’s in danger of harming herself or others, Kathy would be hospitalized. An “emergency mental health commitment” is a legal proceeding separate from the guardianship process and involves separate court hearings.

If Kathy is at risk for serious harm to herself or others, you should contact your County State’s Attorney’s office and ask to begin an “involuntary mental health commitment proceeding.”

Kathy’s Story, Part 2

Kathy was hospitalized. After receiving treatment and antipsychotic meds, Kathy became stable and was discharged. As long as she keeps taking her meds, Kathy’s psychosis should stay under control.

Unfortunately, two months later, Kathy didn’t like the way the meds made her feel, so she stopped taking them. Kathy’s paranoia is back and you fear Kathy is going to become destructive again.

You try to talk to Kathy, but she makes threats and says: “Stay away. I’m doing what’s best for me.” Even the psychiatrist couldn’t get Kathy to voluntarily take her meds.


Knowledge Check

Would you use your medical decision making authority to force Kathy to take her antipsychotic meds?


Depending on the medical authority given in the guardianship order, you can’t physically force Kathy to take her meds, and usually can’t allow others to force Kathy to take her meds.


If you have Full Authority in the area of Medical Treatment, and the Court has not specifically removed the authority for you to authorize “forced medications”, you can consent to allow a treating physician, physician assistant, psychiatrist, or advanced practice registered nurse force Kathy to take her meds. One of these people must determine that:

  1. Kathy requires treatment.
  2.  The medication is clinically appropriate and necessary to effectively treat Kathy.
  3. Kathy was offered that treatment and refused it, or she lacks the capacity to make or communicate a responsible decision about that treatment.
  4. Prescribed medication is the least restrictive form of intervention necessary to meet Kathy’s treatment needs.
  5. The benefits of the treatment outweigh the known risks to Kathy.

Your consent to forced treatment is only effective for 90 days. After that, you must get a new approval.