Britney Spears’ conservatorship is bringing to light mental illness conservatorships for disabled people. Many people are screaming that Spears shouldn’t be under a conservatorship. This then leads people to start screaming that no one should be under that kind of control. This is a mistake. While the Spears case may be an example of abuse (maybe, I don’t know), that doesn’t mean that conservatorships, in general, are abusive and it doesn’t mean that conservatorships don’t offer huge value to people who are disabled by a grave illness.

Update July 7, 2021

This post was written under the assumption that Spears is under a mental health (LPS) conversatorship. This appears not to be the case. She appears to be in a probate conservatorship. According to NPR, “[Probate] conservatorships are often used for people who have a severe cognitive impairment. Often those people are older, such as those with severe dementia. Guardianships are also appointed for people with significant developmental disabilities.” Probate conservatorships, thus, are not for those with mental illness, but rather “cognitive impairment.” I apologize for the confusion. The thrust of the piece remains, however.

What Is Conservatorship?

According to the Supreme Court of California:

A mental health (LPS) conservatorship makes one adult (called the conservator) responsible for a mentally ill adult (called the conservatee). These conservatorships are only for adults with mental illnesses listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The most common illnesses are serious, biological brain disorders, like:

* Schizophrenia,

* Bi-Polar Disorder (Manic Depression),

* Schizo-affective Disorder,

* Clinical Depression, and

* Obsessive Compulsive Disorder.

LPS conservatorships are not for people with organic brain disorders, brain trauma, retardation, alcohol or drug addiction, or dementia, unless they also have one of the serious brain disorders listed in the DSM.

In other words, and this should be no surprise to anyone, people can’t go around and get conservatorship over others willy-nilly. And, in fact, while the above mental illnesses are the ones that are commonly involved in conservatorship, most people with those illnesses absolutely are not under conservatorships.

(Note that “conservator” can also refer to a guardian of a person with another type of illness in other states. It gets a bit confusing, though, so I’m just going to stick with California.)

Again, from the California Supreme Court, a conservatorship is established when:

The Court will not let you establish an LPS conservatorship unless it finds beyond a reasonable doubt, that the mentally ill person, is gravely disabled. Gravely disabled means that, because of a mental disorder, the person cannot take care of his/her basic, personal needs for food, clothing, or shelter.

If you or another adult can provide for the person’s basic needs, the Court cannot find the person to be gravely disabled. This means you may not need to establish a conservatorship.

Certainly, some people with mental illness meet these requirements. And these people are literally dying to have someone care for them.

In Defense of Conservatorship — People with Mental Illness Need Conservatorships

See, many, many people with serious mental illness cannot take care of themselves and a large number of them end up on the street, in prison or dead.

There are approximately 8.3 million people in the United States who have bipolar disorder or schizophrenia. Some of them are like me. Some of them have places to live, food on the table and clothes on their backs. The trouble is, many of them aren’t. And the people who aren’t are typically the people who are refusing treatment for their mental illness. Many times this is due to a condition known as anosognosia, which is a neurological condition that makes it impossible for the person to understand they have a serious illness that needs treatment.

Overall, approximately 47 percent of people with bipolar disorder and schizophrenia are not getting treatment for their illness (see here). This results in tragedy after tragedy.

Consequences of non-treatment include:

  • 169,000 homeless people with serious mental illness
  • 383,000 inmates with mental illness in jails and prisons
  • 50% – estimated percentage of individuals with schizophrenia or bipolar who attempt suicide during their lifetimes
  • 44,193 suicide deaths in 2015
  • 10% – estimated percentage of homicides involving an offender with serious mental illness
    (approximately 1,425 per year at 2014 homicide rates)
  • 29% – estimated percentage of family homicides associated with serious mental illness
  • 50% – estimated percentage of mass killings associated with serious mental illness

The above means that 14 percent of people with untreated bipolar disorder or schizophrenia are on the street or in prison. This is an unacceptable number.

And while conservatorship in the Spears case may have been driven by money (again, I don’t know), that decidedly isn’t the case most of the time. Most of the time, conservatees have no money and all the conservator is trying to do is keep the conservatee alive and away from the tragedies mentioned above. I wish more people cared enough to become conservators. I wish more people with serious mental illness had people in their lives to fulfill that role. It could prevent so many of the horrors that befall my mentally ill brothers and sisters.

Can Conservatorship Be Abused?

Of course, a conservatorship can be abused. This is true of any kind of control. This may be the case in Britney Spears’ life or it may not, I don’t know, but certainly, it does occur.

But, as they say, don’t throw the baby out with the bathwater. Just because one horrible, unscrupulous, greedy person decides to take advantage of a disabled individual doesn’t mean this is what happens in all, or even most, cases. Rather than saying conservatorship shouldn’t exist, what we should be doing is saying more oversight needs to exist. If, indeed, it is determined that the Spears conservatorship is inappropriate or even abusive, what we should be saying is how can we prevent that from happening to others in the system, not let’s throw out the system entirely.

People with Serious Mental Illness Aren’t Protected Enough

Keep in mind that the numbers from above include all the conservatorships that are currently in existence. If we were to remove conservatorships as a tool for helping people with serious mental illness, all that would do is increase the number of people not getting treatment and increase the number of tragedies like homicides and suicides, not to mention hospitalizations and imprisonment. Because bad things tend to happen when you have an untreated serious mental illness. Even I know that without treatment, I’m only a few heartbeats away from my own tragedy. That’s the knife’s edge on which people with serious mental illness live.

So, please, please understand that one terrible conservatorship shouldn’t tar and feather all conservatorships. Most conservators are just trying to do the best they can for a loved one. That is to be commended, not derided.

Image by Jen from USA, CC BY 2.0, via Wikimedia Commons.