View Full Version : just what constitutes mentally ill or unfit?


sarahsweets
01-22-13, 06:31 AM
This subject has been on my mind recently because of the gun control thing. NOW, this is not actually about gun control or whether or not guns are bad or good or anything political so please PLEASE keep that out of this so it doesnt get closed. Its just what made me think of it.

There are many laws being proposed lately about mentally ill people having access to certain things or privledges. With gun control as an example(an EXAMPLE not for DEBATE) the guidelines of mental evaluations are vague and invasive. If someone in NJ were to attempt to get certain permits, you would have to sign a form that allows the state to view your records to find out if you have ever been in a psychiatric institution, received mental health care etc. This is just an example, not meant to open pandora's box. These sorts of requests are allowed to circumvent the HIPPA laws and are meant to protect the public. In some instances here in NJ you can not get a job with the state without allowing a records check for mental illness/treatment.

So where do you draw the line? Bipolar is a mental illness....that doesnt mean I am going to kill someone. Schizophrenia is a mental illness that doesnt mean every schizophrenic thinks the government is plotting to get them. My nephew is schizophrenic and while he did have a major issue pre-meds hes very stable now. I was never involuntarily committed but I did go inpatient for bipolar. So what rights (not necessarily political, in fact not political at all) would I lose?

This goes beyond kids or jobs but to me, is part of fundamentally being a human. When(if ever) is it ok to deem someone mentally unfit? And who gets to make that decesion? Is it doctors? Well some could say they are profit motivated. Is it family? some could say THEY are profit motivated or at least controlling. Just who gets a say so? Obviously if you are an immediate to yourself or others(like a man in a mall with a knife) this questions is much trickier to answer. I would really like a good dialogue that is NOT going to get anyone put in the naughty corner.

tudorose
01-22-13, 06:36 AM
I take it to mean that it's about the demonstrated behaviour rather than the diagnosis.

As for the decision maybe that would be made by the courts. After all it's the courts who get to decide if someone is fit to stand trial for their crimes.

TygerSan
01-22-13, 12:06 PM
My understanding is that for particular cases, the federal law is so vague and outdated that almost nobody is impaired enough to be denied. This is because almost nobody these days is involuntarily committed. Even people in the throes of a severe episode are able to sign in *themselves*.

How they change the law? That's what makes me feel vaguely uncomfortable. I think you're right to question who gets to make those types of decisions. It seems like an invasion of privacy, and I think it really speaks to how low people with mental heath diagnoses are viewed on the scale of human worthiness within our society. We're simply distrusted and viewed as mentally inferior by default.

It reminds me a bit of how people with cognitive/intellectual disabilities are treated when it comes to relationships/sexuality. People who are developmentally delayed are still people, and when they grow up they are *adults* with adult urges and adult sensibilities. They may have trouble with comprehension; they may need certain forms of support, but contrary to certain assumptions, they don't remain children forever.

silivrentoliel
01-22-13, 03:18 PM
I have been wondering the same thing, Sarah. Especially now about all the chatter about mental health checks, gun control, blah blah blah. It makes me twitchy just thinking the ways something like that can go wrong, or open doors that ought never be opened when it comes to someone other than your doctor or yourself forcing decisions on you. (That was a hard thought to get out w/o tossing in politics, btw :lol:)

saturday
01-22-13, 03:24 PM
In light of this discussion its interesting to note that now in the US your medical expenses through your employers insurance will now show up on your W2s. Whats next, will they start requiring itemized summaries of our medical expenses?

silivrentoliel
01-22-13, 03:41 PM
In light of this discussion its interesting to note that now in the US your medical expenses through your employers insurance will now show up on your W2s. Whats next, will they start requiring itemized summaries of our medical expenses?

seriously?! :doh:

TygerSan
01-22-13, 05:20 PM
In light of this discussion its interesting to note that now in the US your medical expenses through your employers insurance will now show up on your W2s. Whats next, will they start requiring itemized summaries of our medical expenses?


Umm. . . no, not medical expenses, medical *insurance*, more specifically, the cost that your employer pays for your insurance.

saturday
01-22-13, 05:38 PM
Umm. . . no, not medical expenses, medical *insurance*, more specifically, the cost that your employer pays for your insurance.

Thanks for the correction. Yes, what is summed up on the W2s is the premiums that both the individuals pay and what the company pays. Also if a company offers programs specifically for mental health that cost will also be a part of what is on the W2s.

What I take issue with is the possibility that in the future these PPACA (Patient Protection and Affordable Care Act) reportings could become more detailed.

silivrentoliel
01-22-13, 07:55 PM
Umm. . . no, not medical expenses, medical *insurance*, more specifically, the cost that your employer pays for your insurance.

*whew* That makes a LOT more sense.

I have to admit, I'm suddenly seeing a plus side to HIPAA :lol:

Fortune
01-22-13, 08:29 PM
Mod note:

Just a reminder that the forum guidelines do not allow political discussion outside of the private debates forum:

http://www.addforums.com/forums/showthread.php?t=15842

Banned Topics:
* The main focus of ADD Forums is to provide a safe supportive place for people affected by AD/HD, and other co-morbid disorders. To do this, sometimes we must limit the scope of the permitted topics, to foster such a supportive environment.

* We have had issues arise here that have prevented this from happening - primarily members voicing their opinions about religious and political matters. While everyone is allowed their own opinions, there really is no other way to prevent such issues from "disturbing the peace", except to keep these things completely out of the ADD Forums in the first place.

* It is against ADD Forums Guidelines to discuss religious and political matters on the ADD Forums.

peripatetic
01-23-13, 03:42 AM
i think your question is too general to answer as is, unless i'im missing something...?

what imean is, declared unfit for what?

unfit to stand trial?

unfit to be granted custody in a separation?

unfit to...?

if you mean what constitutes being deemed mentally unfit such that you're involuntarily detained... barring some criminal activity that might result in arrest/incarceration, if we're strictly talking about being involuntarily committed, an admitting psychiatrist concluding one is a clear, immediate threat to self or others can get you a seventy-two hour involuntary hold, which amounts to saying you're "mentally unfit". to extend it beyond that typically takes a court order, which, unless you've been deemed a threat to others, is more difficult.

as far as what, more specifically, constitutes being deemed a threat to self/others... the three sorts of "events", let's say, that seem to land a person in the psych ward regardless of consent: 1. suicide attempt; 2. psychotic break; 3. significant substance usage complication (one that results in presenting #2 and/or appearing to be #1, especially).

peripatetic
01-23-13, 04:18 AM
since you brought up violence in your thread start, i think it's important to consider that substance abuse is greater predictor of violence than (if you consider substance abuse a mental health concern) other mental illness.

if we're deeming someone "mentally unfit" based on potential for being a risk to community/others... that seems like a better starting point than what i've seen batted around in other places as the groups to worry about.

there are numerous studies on what, if any, link exists between mental illness and violence and how that differs from violence in the general population,and what the markers of potential for violence are. this one came up and i thought pertinent to this discussion:

This paper evaluates the relationship of mental illness and violence by asking three questions: Are the mentally ill violent? Are the mentally ill at increased risk of violence? Are the public at risk? Mental disorders are neither necessary nor sufficient causes of violence. Major determinants of violence continue to be socio-demographic and economic factors. Substance abuse is a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not. Therefore, early identification and treatment of substance abuse problems, and greater attention to the diagnosis and management of concurrent substance abuse disorders among seriously mentally ill, may be potential violence prevention strategies. Members of the public exaggerate both the strength of the association between mental illness and violence and their own personal risk. Finally, too little is known about the social contextual determinants of violence, but research supports the view the mentally ill are more often victims than perpetrators of violence.

full paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/