The Patient Advocate Group Inc.

Speaking for you, when you can't!

Psychiatric Patient Advocate

Although the patient seeks help and care, sometimes this type of patient does not readily accept what is offered. Providers categorize these individuals into three catagories: difficult patients, care avoiders, consists of severely psychotic patients who do not consider themselves ill and who view mental health care as interference. The second group, care seekers, consists of patients who have chronic mental illness yet have difficulty maintaining a steady relationship with caregivers. The third group, care claimers, consists of patients who do not need long-term care but need some short-term benefit that mental health care offers, such as housing, medication, or a declaration of incompetence.

Certain difficult diagnoses evoke negative reactions from professionals, independent of the patient's actual behavior.

Patients who do not fit into the system, because their problems differ from those of the mainstream, run a high risk of being labeled as difficult. This situation also occurs with patients who have alternative, nonmedical explanations or solutions for their health problems, such as maintaining a healthy lifestyle instead of using medication


A wide variety of disorders fall under the umbrella of mental illness, and these range from mild to severe. People with mental illness suffer from disturbances in their thoughts and behavior, which may affect their ability to cope with ordinary life situations and obligations.

Mental illness can be caused by traumatic experiences that involve abuse, neglect or violence. Other factors may include genetic predisposition, biochemical imbalances or excessive stress brought on by debilitating medical conditions. Nurses may come in contact with patients who have these mental illnesses:

Bipolar disorder.

Eating disorders.

Major depression.

Obsessive-compulsive disorder.

Panic disorder.

Personality disorders.


Post-traumatic stress disorder (PTSD).


  • Misdiagnosis. The occurrence of misdiagnosis in mental health is notoriously prevalent. Misdiagnosis is distinctly dangerous in that it can both prevent proper treatment and worsen the root condition.
  • Lack of informed consent. In order for a patient to give consent to a procedure, they must be fully informed of relevant data, risks and benefits, and available alternatives. It is legally required in all 50 states that informed consent be obtained and documented.
  • Failure to treat. Delayed, insufficient, or nonexistent treatment of mental health problems can cause serious consequences and result in harm to the patient or others.
  • Risky or experimental treatment. If a physician does not stay at the forefront of emerging medical information, or administers experimental treatment options based on limited data, the patient may suffer severe harm. Failure to monitor a patient who has been prescribed a powerful medication can also lead to physical or psychiatric damage.
  • Unprofessional or inappropriate relationships. Violating, the professional boundaries of a patient-caregiver relationship can take on many forms. In a residential facility it is especially important to be vigilant in watching for signs of inappropriate behavior of staff toward patients.
  • Physical or emotional abuse. Victimization of people with mental illness is a very serious concern. If you suspect a patient in a mental health care facility may be a victim of abuse, seek outside help immediately.
  • Breaching confidentiality. Unless confidential information is disclosed for the explicit purpose of protecting the patient or others, a breach of doctor-patient confidentiality can be an instance of medical malpractice.
  • Improper use of restraints. The inappropriate use of physical restraint, restraining devices, or seclusion in mental health care can be dangerous and harmful to patients and their caregivers.
  • Failed duty to suicidal patients. If a mental health care facility fails in its duty to notice and reports warning signs of risk, appropriately monitor a suicidal patient, provide a safe environment, and prevent self-harm, the institution may be held responsible for the death of a patient.


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