ust this year, a patient in a state
of catatonia was admitted to
a medical hospital. Her family
members had active guardianship.
Following medical stabilization, the
woman required admission to an inpa-
tient psychiatric facility. Due to the extent
of her medical and psychiatric illness, no
psychiatric hospital was willing to accept
her, even with her guardian’s consent. The
staff of the medical hospital tried to file a
petition for involuntary psychiatric admis-
sion, but the agency tasked with approving
petitions declined, stating that there was no
need for a petition because the patient had a
guardian with mental health powers.
The family hired a mental health lawyer
and a psychiatrist to assist in transferring the
ward to an appropriate treatment setting.
After months of effort and delays in mental
health care, a petition was finally accepted
and the woman was admitted involuntarily
to a government psychiatric facility.
These situations and others in the state
of Arizona occur frequently, costing time,
money, and opportunity to improve the
quality of life of individuals suffering from
In Arizona’s mental health community,
legal guardians and agents often encounter
roadblocks when attempting to use conferred authority to seek psychiatric treatment for an incapacitated individual. These
challenges are reported by medical providers, lawyers, agents, guardians, and even
persons requiring mental health treatment.
A frequent example is that of a treatment
facility refusing to honor a guardian’s or
agent’s authority when an attempt is made
to obtain mental health assistance for a
person needing treatment. As the result of
obstacles, guardians and agents are forced
to seek other avenues to obtain psychiatric
treatment for the individual, which delays
the provision of care and may escalate psychiatric crisis. All too often, the guardian
“gives up” fighting the system, and the person requiring treatment fails to obtain timely intervention.
of the Powers
The types of powers that can be conferred
on an agent or guardian and the processes
that are involved are complex and potentially
confusing—especially at the moment when
a ward requires a mental health intervention. (For more detail on the processes and
tools available, see the sidebar on p. 60.) To
illustrate just how complicated these legal
powers and processes can be, researchers1
GWEN LEVITT, D.O., is currently Attending Psychiatrist and Director of Research for the Department of
Psychiatry for District Medical Group, the provider organization for Maricopa Integrated Health System.
She has been practicing psychiatry in Arizona since 1994. Dr. Levitt also has a private practice specializing in forensic psychiatry. She is a mental health expert for Maricopa County Superior Court, adult and
juvenile divisions, performing competency and other criminal case-related evaluations. Other areas of
practice include guardianship matters, fitness for duty, and civil commitment issues.
JENNIFER WELLER, Ph.D., is a licensed clinical psychologist and neuropsychologist who serves as
Research Director for Child Psychiatry at the Maricopa Integrated Health System and District Medical
Group. In her private practice, Dr. Weller provides neuropsychological evaluations and consultation on
forensic and non-forensic matters.
JOSH MOZELL practices in the areas of estate planning, mental health law and elder law at Frazer,
Ryan, Goldberg & Arnold. In the four years prior to becoming a lawyer, he worked in Maricopa County’s
SMI public mental health system at the Regional Behavioral Health Authority. He now serves on the board
of governors of Mental Health America of Arizona, the National Alliance on Mental Illness (NAMI) of
Arizona, and of Recovery Empowerment Network.
The authors thank Charles Arnold and James McDougall for their guidance and assistance in this project.
BY GWEN LEVITT, JENNIFER WELLER & JOSHUA MOZELL
Power of Attorney
Efficacy & Barriers J