Jane, a successful attorney, has a serious mental health condition. She has significant ups and downs regarding how her mental health impacts her functioning. During some periods, Jane is mi
Jane, a successful attorney, has a serious mental health condition. She has significant ups and downs regarding how her mental health impacts her functioning. During some periods, Jane is minimally impacted by her mental health condition and performs at a high level in all aspects of her life, professional and personal. In other moments, Jane’s functioning is severely impacted, and she experiences periods marked by significant impulsivity, poor interpersonal judgment, and inflated notions of her own importance. During such moments, Jane’s behavior towards work colleagues can be inappropriate. Even during these periods, however, the quality of Jane’s legal work remains high, though her workflow tends to slow down and to be more disorganized.
Jane has a high-quality insurance plan paid for by her wealthy employer. She has a loving partner who is well aware of Jane’s mental health condition and how best to support Jane. Jane lives in an area that is a service priority for the local hospital, which is attracted to the high proportion of residents with rich insurance plans that pay top dollar to the hospital for mental health services.
Jane has just experienced an acute mental health episode, more severe than any in her past. Jane is yelling, running around her kitchen, and fixated on disassembling all of her appliances. Even so, Jane is able to recognize, based on her prior experiences, with the input of her partner, and after a brief call with her psychiatrist, that she should go to the mental health hospital. She does so voluntarily. During the hospital admission process, Jane is unable to answer most questions and, instead, repeats the serial numbers of her kitchen appliances. During the admission, the following exchange occurs between the nurse and the Doctor, who has stopped by for 5 minutes:
Nurse: she’s pretty unstable.
Doctor: yes, I see that. When did she come in?
Nurse: about an hour ago. Hey, I have to mark here whether she’s able to agree to treatment. What do you think?
Doctor: Are you kidding me? She can’t doanything at all. I mean, just listen to her. Just mark it all as a “no.” She’s got a great insurance plan, anyway.
Jane stays in the hospital for three weeks, having a positive experience and leaving after stabilizing her mental health.
23 A) Is the Doctor’s analysis of Jane’s competence to agree to treatment sound? Why or why not? Explain, using key course ideas and facts from the above.
23 B) What factors enabled or contributed to Jane’s positive experience in the hospital? Name at least two and explain their significance. Hint: in your answer, focus on factors external to Jane. What would you call such factors?
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