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Having bipolar disorder could mean legal troubles. Here’s what could occur and how to handle these issues.
Bipolar Disorder and Legal Issues: In the Workplace
Angela Vickers, JD, who was diagnosed with bipolar disorder in 1988, knows firsthand about problems at work related to this condition. A Jacksonville, Fla., attorney and civil rights worker for those with mental illnesses, Vickers has been well and on daily medication since an episode of mania led to her diagnosis of bipolar disorder. She is now a full-time mental health advocate and national speaker.
“Because of the level of ignorance [about bipolar disorder], there’s blatant discrimination in the workplace,” says Vickers. “If you tell the truth on an application, you’re often faced with persecution.” Vickers found herself in this situation when she wrote down “lithium” — one of the oldest drugs used to treat bipolar disorder — on her health insurance form when starting a new job. “The company started to work real hard to make my life miserable and run me out,” she says. The reason her employer and others react in this way, according to Vickers, is out of fear that their insurance companies will charge them more for having someone who is mentally ill on the payroll.
If you are facing problems at work, it’s important to familiarize yourself with the Americans With Disabilities Act (ADA), which protects people with medical or other conditions (including bipolar disorder) from discrimination in the workplace. However, the ADA only covers companies with 15 or more employees, and there are other restrictions that may apply in specific circumstances.
Bipolar Disorder and Legal Issues: Treatment Preferences
Another aspect of bipolar disorder and the law concerns your preferences for treatment if you’re unable to give consent — for example, in the event that you’re experiencing an episode of severe psychiatric illness. Advance directives, which have been primarily used to make end-of-life decisions (a “living will” is an example of an advance directive), are now being used to document a competent person’s specific instructions or preferences regarding future mental health treatment. These are known as psychiatric advance directives, or PADs. Almost all states permit some form of legal advance directive for health care, which can be used to direct at least some forms of psychiatric treatment, and 25 states have adopted specific PAD statutes to date. Vickers says, “[An advanced directive is] basically a contract where you get to choose (and control) what happens to you if things get bad and you’re not thinking clearly. Instead of having some stranger make the decisions or have your family guess at your needs, you’ll get to list your preferences.” For more information, visit the Web site of the National Resource Center on Psychiatric Advance Directives.
Bipolar Disorder and Legal Issues: Trouble With the Law
Ankur Saraiya, MD, assistant clinical professor of psychiatry at Columbia University in New York, says people with bipolar disorder may run into problems with the law if they are in severe manic or mixed episodes. Often people will get arrested during episodes or take on financial burdens that later get them in trouble. “The courts don’t have a great way to deal with this,” says Dr. Saraiya, “so for minor crimes it’s often simplest to just pay the fine and serve the sentence.”
The good news is that most people with bipolar disorder can avoid these situations: “The symptoms are almost always manageable if the individual stays in treatment,” says Saraiya. “It’s a very treatable disease, but not getting the proper help can affect your money, your life, and your safety, and cause a host of other problems.”
Vickers adds that the legal community often doesn’t have accurate information about bipolar disorder and isn’t trained to handle these types of situations. “We do not have advocates to fight for us properly,” says Vickers. She’s stepping into this role by fighting the stigma and spreading the word: “We are very capable of holding jobs, being articulate and punctual, and not being volatile or unsafe.”