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Why Is it Important to Establish Guardianship Over Adult Children With Mental Disabilities?
What is guardianship?
Each state has laws indicating when a person is of "legal age" to make their own choices without interference from parents or other adults. Until that time, parents are held accountable for the actions of their children, and children are tried as juveniles when laws are broken.
Once the legal age of adulthood is reached, however; individuals are held accountable for their own actions and are able to be tried in "adult court." They are given the same consequences as other adults when they have broken the law.
Guardianship is basically court ordered parenthood. When an adult individual is incapacitated to the point that they are unable to make legal and appropriate decisions concerning their own medical care, finances, residency, and/or possessions - regardless of their legal age - guardianship can be established through petition to the resident court.
The guardian is responsible to the court and society for helping the individual manage their affairs. Guardians can be parents, other relatives, human services personnel, or members of organizations that provide guardianship as a professional service (see resident state government human services website for state guidelines, for example: North Dakota).
Guardianship can be all encompassing or limited, depending upon the needs of the individual in question (the "ward"). Prior to the hearing for guardianship, the circumstances of the ward are reviewed from different perspectives, including their own, the person petitioning for guardianship, and medical providers. The findings are presented to the court and the judge determines the need for, and extent of, the guardianship, establishes parameters, and sets a course of action.
At what point is mental illness considered a disability?
The Americans with Disabilities Act (ADA) defines a person with a disability as "a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment."
Major life activities are those things that enable a person to function normally in society such as breathing, walking, seeing, hearing, sleeping, and talking. A person may be physically or mentally impaired, and yet function normally in society with the use of medication, equipment, and/or the assistance of loved ones. It is not until functioning in society is severely limited that the impairment becomes a disability and entitles the person to protection under the law.
The ADA website answers the question "Does a person with depression have a disability under ADA?" by responding: "You might think the answer would be 'no' because depression does not seem to substantially limit any specific major life activity. However, someone who has had major depression for more than a few months may be intensely sad and socially withdrawn, have developed serious insomnia, and have severe problems concentrating. This person has an impairment (major depression) that significantly restricts his ability to interact with others, sleep, and concentrate. The effects of this impairment are severe and have lasted long enough to be substantially limiting."
Individuals with mental illnesses that are unable to be financially responsible, medically self sufficient, and socially appropriate may need ongoing assistance. Parents, relatives, and other responsible individuals can be court assigned to assist them through guardianship. In this way, legal protection is given to the incapacitated individual by allowing responsibility for their care to be placed on others.
Guardianship enables social programs to be accessed
Once guardianship is established, the ward can access a variety of social programs. State sponsored human services agencies provide heating and fuel assistance, food stamps, dependendent respite care, foster care, vocational rehabilitation, case management, substance abuse treatment, and mental health services.
Adults who are incapacitated are not in a position to advocate for themselves, or to complete the necessary paperwork to obtain these services. The guardian can legally stand in the place of the ward and sign documents in their behalf. Depending upon the provisions of the guardianship, they can complete financial transactions, make residential placement decisions, receive confidential information from health care providers, apply for Social Security disability benefits using the online application system, communicate with entities providing services, and make other important decisions when the ward is not in a position to do so.
Guardianship provides a great deal of protection to the individual ward and their family. Should the ward refuse treatment when it is in their best interest, the guardian can legally step in and see that treatment is obtained. This includes both the taking of medications for mental illness and mental health hospitalization. In all aspects of the guardianship, the guardian is to consider what is best for the ward by asking the following questions (taken from page 5 of the Guardianship Handbook found on the North Dakota Government Human Services website):
- Is this decision within the limits of the guardian's authority?
- What, if any, are the alternatives?
- What is the risk to the ward if the action is taken?
- What is the risk to the ward if no action is taken?
- Is it in the best interests of the ward?
- Is it the least restrictive or intrusive action or treatment available?
- What are the ward's feelings about it, and what are his or her preferences?
- Is the action or treatment congruent with the values and beliefs of the ward?
- What are the possible outcomes or consequences of each of the proposed actions or treatment options?
When the guardianship includes financial jurisdiction, the guardian can step in if the ward makes decisions that are financially irresponsible. The ward can be protected from those who would prey on their vulnerability. Other types of social irresponsibility can also be avoided; however, the guardian must always do what is in the best interest of the ward. The guardian reports on a regular basis to the resident court, and should the court find that the guardian acted in a manner to harm the ward, the guardianship can be legally revoked.