Expert: Libby Bonner - 7/6/2006

Question
I have a sister that was diagnosed approx 2 years ago with bipolar. She was a stay at home mom of a 6 and 2 year old and within the last 2 years has gone through a divorce and lost custody of her kids. Her divorce was a result of a extreme manic episode she went through and then a severe depression which was helped by having ECT. I dont believe that she is on any medication other then for a sleep disorder. Her ex hired a guardian of liem that is still involved.  She was given supervised visitations with her children (i was one of the supervisors-another one was a paid supervisor)and then approximately 6 months ago was given unsupervised visitaion with her children at her home (approximately 6 hours a week) Up until 2 weeks ago she was able to hold down 2 jobs, keep an apartment and deal with the little bit of time she was given with her kids She was perfectly capable of taking care of her kids but i fear now that she is going manic again and that she will lose everything again.  She unfoirtunately has not excepted that she is bipolar nor that she needs any help which i understand is usually the case. I guess i would like to know if she will ever get joint custody of her children or if this is something that even when she is doing well will not matter. I am having a hard time dealing with this because i am the only one that they have allowed to be a supervisor besides the one that she has to pay and her children are so young that i cant imagine doing this for the next 10 years even though i love her and her children.  I am 51 years old myself.  I also believe that she is probably going to lose her job soon as she has not been going to work which means she will lose her health insurance as well and probably her apartment as she won't be able to financially pay for it.  What are her rights as a mentally disabled person regarding her kids, her job, etc.  I want to help her before she loses everything again but most importantly her kids.  
Thank you.  

Answer
PS - just received your reply.  Do ALL that you can to see that her health ins continues through work under the COBRA program.  Someone will have to pay, but meanwhile she can take meds and maybe get busy, w/ help, applying for disability.
******************************

You need an atty - get any involved persons to pool their money for one, if you cannot afford it.  I would ask him about:  contacting her work, to get her put on med leave of absence; whether it is wise to contact the guardian ad litem w/ a Heads Up and/or the ex-husband; whether she can be committed or have someone declared her guardian....and/or find out if she has a medical power of atty, tho it may not work here.

IF she loses job, BE SURE she signs up for [can't think of name ] - the program that will continue her health insurance for 18 months.  ---COBRA is the name.

Also check www.psychlaws.org to find out if they have 'assisted out-patient treatment' in your state.

You and/or atty might also alert the sheriff or police of the likelihood of problems to find out what their usuual course of action would be.

I am not sure why she is taking no meds for mood stabilization.  Possible she has meds but stopped taking them?  If never had mood Rx, may want to steer her to a different doc as soon as possible.

She has no rights as a mentally disabled person because, so far, legally, she isn't one.  If she were, she might still be battling for kids....  

Get in touch today w/ your state and local NAMI affiliates, www.nami.org, to ask some of the questions you need answers to.  Immediately start going to a NAMI support group if there is one in town/city.  IF more than one, go to several and choose the best.  [When you make a contact today w/ a local NAMI person, ask if s/he can help answer some of your questions about involuntary hospitalization, etc., or if they can put you in touch w/ anyone else who can.  State and local laws sometimes impact how things are done, where is the best place to go, etc.... so do talk to local people ASAP.]  IF you are in a large city, you may have a branch of the Mental Health Assoc.....don't know web address and can't stop and get it or I will lose this.  But they are definitely another source of help, support and information.

WAIT - before contacting work, find our if you first need to announce that she is in need of Amer w/ Disabilites protecions, and THEN ask for the leave.  [If she says she has a mental illness, in theory, employer, maybe depending on size of the business, must offer some modifications to her work situation to assist her in being able to continue working.  This will be no help today, but it might help save her job.  But ask atty.]

Call county bar assoc to see if anyone specialized in disability rights.

What you all need to figure out FIRST is:  who, legally, can speak for her.  Could be that there is no one - atty will advise.

Joint custody ever?  Perhaps, if this episode can be cut off w/ hospitalization and/or out-pt treatment RIGHT NOW.  Divorce attys may have to enter into a new agreement:  that she has to show proof of compliance w/ med orders, take meds, no manic episodes for X years.....then maybe reconsider joint custody.  [You can certainly remove yourself as one of the monitors.]

You, or atty, can try to talk w/ current psychiatrist but, unless she has already signed a release permitting this, it is doubtless that they will talk to you ABOUT her.  They might be willing to advise you, since you are involved w/ the children, about what treatment options would be open to 'someone in your postion' whose relative [not this particular relative] were entering a manic state:  they could give info about hypothetical persons.

These are tough tough situations.  Believe me, the kids and their future supervision is NOT today's question.  Question is how to get her health re-stablized NOW.

If you are working, arrange for some time off - or family leave, or whatever - if you are going to be the person carrying this ball.  It will take a couple hours/ day, perhaps...for awhile.

I wish you the very best luck, and your poor sick sister as well.     [After the dust settles, someone can decide whether you have a basis for a negligence or malpractice suit against psychiatrist if she really only has 'sleep meds.']