Patient's Rights

Right to Treatment

Many state mental hospitals suffer from chronic under-funding that may undermine their ability to deliver effective care and treatment, the very function for which they exist. Although psychotropic medication has become the treatment of choice for the major mental illnesses, other forms of treatment are needed to prepare patients for discharge and the resumption of life within the community with a high level of functioning. These include psychotherapy and other verbal approaches, behavioral therapy, occupational therapy, and social skills training. Psychotropic drugs should be used in conjunction with these other forms of treatment, not as an exclusive therapeutic intervention. Inadequate staffing and funding at many mental institutions, however, sometimes prevents this from occurring.

Can patients assert a right to more treatment than the hospital is delivering? Such a right to treatment is inherent in the fairness principles embodied in notions of due process and is supported by the often vaguely worded statutory right to treatment that state law typically protects. Due process requires a reasonable relationship between the nature and duration of commitment and its purposes. The purposes of commitment are to protect the best interests of patients who are incompetent to make hospitalization and treatment decisions for themselves or to protect the community from the patient's potential dangerousness. Although confinement alone might seem to satisfy this latter purpose, when those with mental illness who are predicted to be dangerous are confined in a mental hospital rather than a prison or a preventive detention facility, the rationale for hospitalization would seem to be the promise of treatment for mental illness designed to reduce the risk of dangerousness. Otherwise, the deprivations and stigma associated with hospitalization would be unnecessary and hence arbitrary, in violation of due process. If treatment can reduce the patient's dangerousness, it may reduce or eliminate the need for further hospitalization, thereby making hospitalization without the provision of such treatment an unnecessary and arbitrary deprivation of liberty. When commitment is justified on parens patriae grounds, the asserted justification is that hospitalization will provide treatment that is necessary to ameliorate the patient's condition that he or she would not choose for himself or herself as a result of his or her incompetency. If the hospital fails to provide adequate treatment tailored to the patient's needs, it would constitute an arbitrary deprivation of liberty in violation of due process.

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