Optimal Treatment for Optimal Wellness

The mission of the Depression and Bipolar Support Alliance is to provide hope, help, support, and education to improve the lives of people who have mood disorders. In alliance with this mission, DBSA values community, inspiration, wisdom, and responsibility. The mission and values of DBSA serve to drive the organization's stance on many urgent mental health concerns. As a leading voice on depression and bipolar disorder issues, DBSA identifies the significant issues surrounding individual mental health wellness regimens, crisis prevention and management, and treatment rights as essential priorities for DBSA to address.

Non-crisis Management

DBSA represents a balanced voice, reflecting our belief that all people should have access to whatever type of treatment they determine best, in partnership with their clinicians, to achieve their wellness goals. Further, individuals may include trusted and supportive family or friends who prioritize the individual’s best interests in conversations regarding their wellness regimens.

Most individuals find all or a combination of the following treatment options helpful: therapy, medication or technological treatments, a strong support system including peer support, and personal wellness strategies. DBSA advocates education on the part of the individual and their support network. To facilitate this, DBSA provides quality materials on personal experiences, wellness tools and strategies, and information on symptoms and signs of depression and bipolar disorder that bring the human experience to the fore.

DBSA believes the following:

  • Any person with a mental health condition has the right to timely, quality, and affordable access to mental health care, and, as such, DBSA does not support any regulation or policy that would restrict such access.
  • While it is the clinician’s responsibility to propose appropriate evidence-based treatment options, along with any potential benefits and drawbacks, it is the individual’s right and responsibility to make the final decision regarding their own treatment.
  • A strong support network is essential for achieving and maintaining success. This may include one or more trusted and supportive family members and/or friends, a support group of peers, and/or a spiritual companion or community. Support networks provide practical and emotional support, can help an individual recognize triggers and symptoms, and can play an important role in crisis support. The strength of DBSA is in the peer support group, where honesty, vulnerability, wisdom, and humor bring humanity to the forefront of the conversation and create a safe space in which to express pain, share triumphs, and encourage others.
  • The shared lived experience is an invaluable tool to help individuals achieve wellness. Trained peer facilitators and peer specialists (also known as peer coaches, peer mentors, etc.) have been proven cost-effective and successful in helping individuals to reduce hospitalization, increase adherence to treatment plans, and achieve a greater sense of independence, self-esteem, and overall wellness.1 As such, DBSA supports expanded vocational opportunities for peer specialists, and inclusion of trained peer specialists within treatment plans to supplement, not replace, clinical professionals.
  • Advocacy at the local, state, and national levels is essential to raising awareness of the critical needs of the mental health community for the funding of research, access to mental health care, and improved quality of social and medical services.

 

Crisis Management

Individuals should direct their treatment whenever possible, both before and during hospitalization. Individuals should be as proactive as possible before a crisis or hospitalization to ensure adherence to their wishes should the need arise. Individuals should become knowledgeable about local hospitals or other treatment options and about the state laws regarding admittance and release.

Mental health education programs should prioritize information and resources to help individuals write crisis management plans, create advance directives, and understand the legal process for assigning power of attorney. DBSA supports the individual's decisions and wishes which dictate appropriate steps to avoid a crisis or hospitalization, as well as preferences regarding hospitalization alternatives. To foster positive outcomes, all crisis management documents should be shared with a trusted family member and other appropriate medical/legal personnel.

DBSA supports the right of individuals to leave a treatment facility if they do not pose a threat to themselves or others. When exercising this right, DBSA strongly encourages individuals to leave a treatment facility with a written treatment plan that includes referral and access to continuing mental health care and professionals, as well as resources on community and peer support group networks.

Involuntary hospitalization should be a last resort. DBSA acknowledges that there are times when an individual may not be capable of making appropriate treatment decisions due to acute symptoms of a mood disorder, or that the individual may pose an immediate danger to themselves or to others. In such instances, involuntary hospitalization may be a life-saving course of action that protects against the tragedy of suicide and enables the individual to regain a sense of hope.

DBSA supports increased funding, ongoing training, and access to current resources for police, emergency response teams, and emergency room personnel to better prepare and enable them to respond to mental health related crises in ways that preserve and ensure the individual’s dignity and rights. Further, responses to mental health crises should be expeditious and appropriate for the immediate safety of the individual.

Too often, individuals in crisis do not have an advance directive or crisis plan. To ensure optimal wellness outcomes, there is urgent need for dialogue regarding ways that trusted, supportive, and educated family can alleviate some of the feelings of frustration and helplessness that occurs in the absence of a crisis management plan. All parties—individuals, loved ones, police, emergency room personnel, hospital and treatment facility decision-makers—need to be at the table in conversation. DBSA recognizes that the rights of the individual on treatment decisions should be kept at the forefront of the ongoing conversation.

Resources

Understanding Hospitalization for Mental Health (for Patients)
Family Guide to Psychiatric Hospitalization
Patient Rights
Sample Advance Directive
Bazelon Center for Mental Health Law
Treatment Advocacy Center

References

1. Bergeson, Sue. (2011) Cost Effectiveness of Using Peers as Providers.