by Susan Resko, The Balanced Mind Foundation Executive Director

Imagine: You get a call from your 19 year old college freshman’s roommate.  He tells you that your son has gone off his meds, dropped his classes and was kicked out of the dorm.  The roommate has not seen him in several days.  This is the third time your son has gone off his meds, but unlike before, he is 500 miles away, and he’s an adult. From your experience, you know that he will quickly become manic and his life will continue to unravel.  You worry that he will wind up on the streets. Guess what?  You have no legal right to be involved with your child’s treatment.

If that thought isn’t frightening enough, did you know that in some states teen minors have the legal right to refuse treatment? For example, some states have laws that:

• set an age under 18 at which a teen may refuse medication or treatment.
• set an age under 18 at which a minor can obtain, without parental knowledge or consent, treatment for substance abuse (a condition that may coexist with bipolar disorder).
• give teens over a particular age the right to psychological treatment by a therapist without the parent or guardian's knowledge or consent.
• restrict the authority of a treating facility to use force to return a runaway teen to the facility.

 What’s a The Balanced Mind Foundation parent to do?  If your child is at or near the age of majority, consider the use of a mental health advance directive. This is a legal document in which a patient specifies what is to be done if that person is unable to make sound judgments concerning his or her own health care. It usually names another person to make decisions on that person's behalf. An advance directive also gives the parent the right to obtain information about the child’s treatment and condition. Without it, a parent can’t get any information.

An attorney in your state should be consulted to prepare this document. To learn more, and find information and forms specific to your state, visit the National Resource Center for Psychiatric Advance Directives.  You can also read more on NAMI’s website.

While you may tell yourself that this scenario would never happen to you, remember that one of the effects of bipolar disorder is impaired judgment.  Your son or daughter may not be capable of thinking clearly for him/herself because of the illness.  Also consider that the frontal lobe of the brain, the area responsible for judgment, does not stop growing until the age of 25.  (This is why auto insurance companies don’t rent cars to drivers under this age!) So, bam! Your transition age child with bipolar disorder has two strikes right out of the box! Don’t be among the would’ve/could’ve/should’ve crowd.  An advance directive could save your child from destroying his or her life and can be one of the greatest gifts you give.

 If you have had experience with advance directives, please share yours in the comments section so that other families might be helped.