This is a surprisingly common question. What do I do if the patient has autism and a mental disorder such as bipolar. As more and more research comes out data starts to suggest that some patients may have a concurrent diagnosis of autism spectrum disorder and bipolar disorder. This is a hard line to draw since there are many over laps between autism spectrum disorder and bipolar behaviour. Verbal and physical outbursts seen in co-morbid patients are consistent with sensory overload common with autisms but are also common with manic rages seen in bipolar patients. When the parents of an adult child find themselves faced with long term treatment, they may find themselves confused with legal terminology. They may hear about LPS conservatorship and limited conservatorships at the same time. They wonder which one is best for their loved one and which one they can obtain.
A simple and fast breakdown.
For autism spectrums disorders and developmental disorders
Standard of proof: clear and convincing evidence- lower
Referrals through regional center, self, conservatee, or family
Rights of conservator: right to make general medication decisions (NOT psych) right to decide education, control if conservatee can enter contracts, manage social sexual contacts, and where the conservatee can live (not locked)
The hearing takes place usually in a probate court in an very informal manner- bench trial
Lasts as long as the conservatee lives or until it the order is terminated.
For serious mental illness such as bipolar, schizophrenia, and schizoaffective
Standard of proof: proof beyond a reasonable doubt
Referrals through doctor then public conservator
Rights of conservator to make over conservatee: withold voting, can order psychotrop medication, can place in a closed locked facility, restrict firearms, withold driver's license
The hearing usually is heard within a criminal courthouse or a special courthouse for mental health matters and there is an option for a jury trial
So which one will the autistic patient have?
Depending on the patient's presentation to the court investigator, most likely a limited conservatorship. A limited conservatorship reduces the burden off the public conservator. The public conservator has a massive caseload and cannot manage extra work. It is considered that autism trumps any mental illness and the patient will be referred out to the regional center for further assessment. For the patient to even be considered for an LPS conservatorship, the referring party should make a bigger deal over the mental illness symptoms. In my experience it is wise to not even mention autism to the investigator. This way, you can increase your chances of having an LPS investigation opened rather than being pushed away. In all honestly, an LPS conservatorship will give you far more solid footing in demanding certain treatments for your loved one if they are unable to manage with some assistance. An LPS conservatorship grants you far more power than a limited conservatorship.
Juvenile Dependency and
Juvenile Dependency Court
2851 Meadow Lark Drive Dpt 10
San Diego, California 92123
Phone: (858) 634-1600
San Diego Central Courthouse
1100 Union St
San Diego, California 92101
Phone: (619) 844-2700
Office of the Public Conservator
5560 Overland Ave Ste 130
San Diego, California 92123
Phone: (858) 694-3500 ext 2