Mental illness affects one in five adults in the United States, the National Institute of Mental Health reports. The severity of mental illness varies. Serious mental illnesses are mental, behavioral, or emotional disorders that cause significant life impairment and limit major life activities. In 2021, 14.1 million American adults had a serious mental illness. 

Severe mental illnesses typically affect thinking, understanding, and perception. For example, a person with a psychotic disorder may hallucinate or experience delusions. A person with bipolar disorder may be vulnerable to scammers during a manic episode. When mental illness becomes severe, it can impair decision-making. 

Watching a loved one experience a mental illness can be distressing. Family members often worry about access to mental health services. They may also worry about whether their loved one is receiving treatment. Other concerns include access to basic necessities like food, clothing, and housing. 

People with severe mental illness are also at risk of financial exploitation, the National Library of Medicine reports. Exploitation can be an additional concern for family members. 

Guardianship can provide protection for people with severe mental illness. The guardian makes decisions for the individual. 

When Is Guardianship of an Adult with Mental Illness Appropriate? 

Many people with mental health challenges can live independent lives. However, those with severe impairments may need additional help. 

Serious mental illnesses can cause incapacity. When a person with behavioral health issues cannot make personal or financial decisions or becomes unable to care for themselves, the court may step in to appoint a guardian. 

Often, a loved one will serve as the guardian. However, some states have public guardianship systems or social service agencies that offer guardianship services. Some professional guardians provide such services and receive compensation. 

Guardianship requires a finding that the person is unable to manage some or all of one’s affairs independently. Some states also consider whether the person has trouble with activities of daily living (ADLs), which include basic daily tasks such as bathing, dressing, using the toilet, and eating. 

In a guardianship case, the court determines the appropriate type of guardianship for the situation. In total guardianship, the guardian can decide where the person lives and receives care. The guardian can also make financial decisions. This is also known as plenary guardianship. 

Sometimes, the court decides that a person needs help only in certain areas. For instance, the court may permit the guardian to manage money and financial affairs but not make other decisions. A financial guardian is called a guardian of the estate or conservator, depending on the state. A guardian of the person oversees the individual’s physical well-being. 

Additional Considerations 

Although guardianship may protect a person with severe mental illness, asking the court to appoint a guardian can come with challenges. 

Proving that someone is unable to manage their affairs can be difficult. For example, a person with bipolar disorder may have severe impairment during a manic episode. However, their behavior can change. Behavioral changes can make it more difficult for the court to determine whether the individual needs the help of a guardian. 

Serving as a guardian of a loved one with a severe mental illness can also make family relationships more complex. Conflicts can arise when a loved one takes on dual roles as a family member and decision-maker. For this reason, some families prefer to use third-party guardians, such as a guardian for hire, a public guardian, a friend, or another family member. 

The goal of guardianship should be to support the individual’s autonomy. If the court appoints a guardian, the guardian should consider the person under guardianship’s wishes, to the greatest extent possible, when making decisions. 

People with mental illness and their families may also want to explore alternatives to guardianship. A less restrictive alternative, such as an advance directive, can support the autonomy of the person experiencing mental illness. A Power of Attorney is another document that may serve as an alternative to guardianship. 

Our firm has a long history of working in guardianship matters and legal services to help vulnerable individuals. Please contact our office for assistance.