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Every person is also entitled to be fully informed about specific medications and procedures and the risks, possible undesirable side effects of such medications and procedures, and other options. The risks and possible undesirable side effects of refusing treatment and what the alternatives are should also be a part of this information process. Every consumer has a right to be part of individual treatment planning. Every consumer has the right to be informed of all community services and supports. When an individual lacks capacity and competence because of his or her serious mental illness, however, the substitute judgment of others--subject to sufficient safeguards with frequent review--may be justified in determining treatment and possible hospitalization. However, NAMI is aware that there are individuals with serious mental illnesses such as schizophrenia and bipolar disorder who, at times, due to their illness, lack insight or good judgment about their need for medical treatment. The role of courts should be limited to review to ensure that procedures used in making these determinations comply with individual rights and due-process requirements. The role of the court does not include making medical decisions. With the advent of electronic medical record systems, NAMI supports having safeguards for patient confidentiality to prevent inappropriate access to psychiatric information and drug and alcohol information. These standards should serve as a floor, not a ceiling, for health privacy protections, and should apply to all entities, private and public, governmental and non-governmental which access health care records for any reason. States should be encouraged to add specific protections not provided under Federal law. Consumers have the right to inspect and amend their own healthcare records. Providers and managed care organizations should be allowed the use of aggregate data for purposes of quality assurance, and research. Lack of initial informed consent should not exempt providers and managed care organizations from providing emergency care, urgent care or medically necessary care to persons suffering from mental illnesses. Professionals are obliged to accept information from family members or others who function in a caregiving role. In the event a patient objects to disclosure, the provider should use best clinical judgment in determining how to proceed. When there is no formal referral, it is the responsibility of each treating professional to obtain information necessary to assure the provision of appropriate care and treatment. In all cases, the exchange of such information shall be treated confidentially and protected. The sharing of clinical information or refusal to consent to sharing of clinical information shall not be used to deny treatment, adversely affect services, or otherwise discriminate against persons with severe mental illnesses. These systems should be implemented in a way that assure the privacy and confidentiality of protected health information, in accordance with applicable federal and state laws. NAMI calls for Federal studies on the feasibility of linking such systems to housing, employment and other supportive services to ensure continuity of care and coordination of services. Judges, lawyers, other court personnel, police officers, correctional officers, parole and probation officers, other law enforcement personnel, and emergency medical transport and service personnel should be required to complete a minimum of 20 hours of training about serious mental illness. Individuals living with serious mental illness and family members should be a part of this educational process and training should be consistent with available model standards for crisis intervention training. Placement in solitary confinement frequently lasts for weeks, months or even years at a time. It is extensively documented that solitary confinement is used disproportionately in correctional settings for juveniles and adults with severe psychiatric symptoms. In some states, it is reported that more than half of all inmates in facilities utilizing the most extreme forms of solitary confinement and social isolation are diagnosed with serious mental illnesses. Instead, solitary confinement of persons with mental illnesses causes extreme suffering, has adverse long-term consequences for cognitive and adaptive functioning, disrupts treatment and exacerbates illness. The damaging effects of solitary confinement may be even more severe for juveniles with mental illnesses. The impact of extreme isolation on youth whose brains are still developing can be permanent. Studies show that the placement of juveniles in solitary confinement significantly increases the risk of suicide and other self-injurious behaviors. NAMI opposes the use of solitary confinement and equivalent forms of extended administrative segregation for persons with mental illnesses. NAMI calls upon federal, state and other correctional authorities to provide mental health care alternatives to solitary confinement that include enhanced mental health treatment, services and programs, crisis intervention training for correctional officers and mental health step-down units. States that have adopted such proactive efforts to eliminate solitary confinement have documented highly positive results that include reduced psychiatric symptoms, less violence, and significant cost savings. NAMI further calls upon federal, state and other correctional authorities to assure continued mental health treatment, including adherence to an individual treatment plan and access to qualified mental health care professionals, in conditions of short-term disciplinary or administrative segregation. Javascript must be enabled for the correct page display Skip to content. Share NAMI. Legal Issues 9. Donate Now. Keep up with NAMI news and events, or take the next step and become a member. Join NAMI. Inspire others with your message of hope. Show others they are not alone. Share your story. All Rights Reserved.

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