The objective of the proposed study is to better understand the characteristics and processes of guardianship for persons with mental illnesses. The presence of persons with mental illnesses in the population of guardianship wards has policy implications because of (a) the need to design the guardianship determination and maintenance process so that it meets the needs of these individuals and (b) because of the coercive nature of guardianship and the considerable limitations to individual civil liberties involved. The intent is to generate information that will (a) aid decision makers in making choices that balance the pros and cons of guardianship for persons with mental illnesses and (b) serve as a heuristic device for future research. The limited evidence available suggests that 8 percent of the 300,000 to 500,000 individuals subject to guardianships at any one time in the United States are persons with mental illnesses.
The specific aims of the proposed study are as follows:
AIM 1 - to describe the demographic, clinical and functional characteristics of guardianship wards who are persons with mental illnesses;
AIM 2 - to explore the relationship of the Baker Act or emergency commitment system to the guardianship system;
AIM 3 - to explore research questions regarding the mental health service utilization of guardianship wards;
AIM 4 - to describe the experiences of wards, family and professional guardians, attorneys, judges and examining committee members with guardianships for persons with mental illnesses. Data will be collected from guardianship files for the 1,300 most recently filed, active guardianship cases in Hillsborough County, Florida and generated from interviews of guardianship wards, guardians, attorneys, judges and examining conunittee members involved with the policy formulation and or implementation of guardianships for persons with mental illnesses. Additional content from the guardianship files for the approximately 78 to 130 cases that will be identified as involving persons with mental illnesses will be collected. Statewide Baker Act or emergency conunitrnent data will be used to identify guardianship wards who have experienced emergency committment examinations in Florida and to look at the characteristics of these examinations. Medicaid and Medicare data from calendar years 1999 and 2000 will be analyzed to investigate the mental health service utilization of guardianship wards.
