If you or a loved one has schizophrenia, you may have questions about mental health treatment rights. Can someone with schizophrenia be treated against their will? What decisions can they make about their care?
While laws differ from one state to the next, the basic framework is similar in most. You can be committed against your wishes in some cases, such as when you pose a danger to yourself or someone else. Other people sometimes have the right to make care decisions for you.
But U.S. law says your liberties can be restricted only enough to meet your treatment needs and comply with legal orders. Even if you’re hospitalized against your will, you have the right to help plan your own schizophrenia treatment. And you have the right to appeal any involuntary treatment or commitment.
If you think your rights or those of a loved one have been violated, you have the right to raise concerns. Staff at the facility where you were treated might be able to help. Your county’s mental health agency may have a professional patient rights advocate. Or you can contact an advocacy group like the National Alliance on Mental Illness, which has chapters in most states.
When Can You Be Held Involuntarily?
If a court finds you’re a danger to yourself or others, officials can take you into custody for a limited time while you’re evaluated. This period of time differs from state to state, but is usually about 3 days. The most common length for a psychiatric hold is 72 hours.
What happens during the hold may vary depending on your state. But your treatment team will probably assess your situation. They’ll review your medical and psychological health as well as your ability to pay for treatment.
When your hold begins, you must be informed of your rights, such as your right to:
- See visitors each day
- Keep most personal items
- Refuse electroconvulsive therapy (ECT)
You also have the right to refuse medication, in most cases, and to see your own medical records.
Can You Be Treated Against Your Will?
After a hold that lasts a few days, a judge could assign you to further involuntary treatment, for reasons such as:
- You are still a danger to yourself or others
- You were offered voluntary treatment, but declined it
In some cases, you’ll get this treatment at a hospital or facility. This is known as “inpatient civil commitment.” Your state may limit how long you have to stay in the facility.
Less often, you may need to complete outpatient treatment, which allows you to live in the community while you get treated.
If you don’t want to stay in treatment, many states give you the right to a review hearing. Most of the time, you can choose a patients’ rights advocate or someone else to represent you at the hearing.
The person in charge of the hearing (often a judge) will decide whether you’re a danger to yourself or to others, as well as whether you’re disabled due to your schizophrenia. If you’re not, you have the right to be released.
How Do Conservatorships Work?
If you’re mentally disabled (unable to make sound decisions about your treatment), a court may assign you to a conservatorship. A conservator is a person appointed to be responsible for your care and to help you with finances and/or tasks of daily life, if you’re unable to do so. They may have this responsibility permanently or for a limited time.
With court permission, your conservator can make decisions about your treatment, such as which medications you must take, without your consent. Conservatorships are usually for disabled adults. Similar arrangements called guardianships are more common for minors.
Your conservator may be:
- A family member or friend
- A state-appointed public guardian
- A private professional conservator
You may be able to choose your own conservator, in court or in an advance directive document. If you’re in a conservatorship you feel is not right for you, you have the right to hire an attorney to dispute it.
How Do Guardianships Work?
If a mental health professional decides you’re unable to make some kinds of decisions about your mental health, you may be assigned to a guardianship, especially if you’re a minor.
The laws about guardianship and conservatorship aren’t the same in every state. In some places, the terms are used interchangeably. In others, a conservator only handles finances for someone who is unable to, while a guardian can make a range of medical and personal decisions.
In either case, the long-term goal should be to have your rights restored when you're able to make good decisions about your care. You should get a regular, perhaps annual, review in which a court considers restoring your rights.
What Are Psychiatric Advance Directives?
In 25 states, you have the right to create a psychiatric advance directive. This is a legal document that lists your mental health treatment preferences. In this document, you can name someone to make treatment decisions for you if you’re in crisis and can’t make these decisions yourself.
If you’re concerned your rights may be restricted if you become disabled in the future, consider creating an advance directive. It informs not only doctors but also hospitals, law enforcement officials, and caregivers about what you want for your care. In this way, it helps you stay in control of your treatment.
Court-Ordered Treatment: What Are Your Rights?
In some cases, if you’re arrested for a nonviolent offense, a judge could sentence you to court-ordered mental health treatment instead of jail or probation. They might give you this kind of alternative sentence, for example, to get you in a treatment program if you’re dependent on drugs or alcohol.
As a condition of the sentence, you may be required to take any mental health medications your doctor prescribes and to follow the rules of your treatment program. But you still have basic patient rights, such as the right to have legal representation and to help plan your own treatment.
Where to Find More Information
If you have concerns about the legal issues surrounding schizophrenia, you or a caregiver should research your legal rights and options in the state where you live. You can find state-by-state information about mental health at the website for the nonprofit Treatment Advocacy Center.