NEDA TOOLKIT for Parents
When Your Loved One is Over 18 and Refusing Treatment
Many of those with eating disorders are ambivalent about recovery. They may not believe there is a problem or
that the problem is serious. The thought of not engaging in eating disordered behaviors is often tremendously
anxiety-provoking, which can also lead someone to turn away from treatment. Regardless of why, it is important
to encourage your loved one to seek appropriate treatment, since an eating disorder can be fatal.
Identify your leverage
Many young adults still rely on their parents for
financial and other types of support. Some parents
have found that requiring their child to engage in
treatment as a condition for certain types of support
(car, cell phone, housing, paying for college) has been
enough to convince the sufferer to seek help. Other
parents and loved ones use different tactics, including
seeking professional help for their own well-being. You
will know which approach will work best for your loved
one and your situation.
The expectation that they will receive treatment and
recover from their disorder is powerful medicine for a
sufferer. Oftentimes, a person with an eating disorder
stops believing that recovery is possible. Having
supportive friends and family who believe that for
them can be a very strong message.
When leverage isn’t enough
Sometimes, a loved one is financially independent.
Other times, leverage simply isn’t effective. Although
the parents of minors can often seek treatment on
behalf of their child, it becomes exponentially more
difficult to require a loved one to seek care once they
have turned 18 and have the legal authority to refuse
treatment. Although your options are substantially
more limited if your loved one is over 18 and refusing
treatment, you have several legal options you can
pursue. These options are generally exercised as a last
resort, but can be effective and potentially life-saving.
Guardianship Seeking medical guardianship gives you the legal
authority to make decisions about a person’s physical
and psychological care. It doesn’t allow you to sign an
adult into a treatment program, but it does allow you
to be closely involved in the decision-making process.
To be granted, a judge must decide that a person isn’t
capable of making these decisions on his or her own.
To obtain guardianship, you will need to seek a court
order. As laws, definitions, and regulations vary by
state, contact a family law attorney in your state for
more guidance.
Conservatorship Conservatorship gives you the authority to manage
another person’s finances. It can be useful in eating
disorders to reduce access to funds that are fueling
the disorder and allowing a seriously ill individual to go
untreated. There may also be other circumstances in
which conservatorship is warranted. To be granted, a
judge must decide that a person isn’t capable of making
these decisions on his or her own.
To obtain conservatorship, you will need to seek a
court order. As laws, definitions, and regulations vary
by state, contact a family law attorney in your state for
more guidance.
Note: both conservatorship and guardianship are
governed under state law, and only effective in the
particular state where it is granted. If your loved one
seeks care in a different state, the guardianship or
conservatorship doesn’t automatically transfer, and
you may need to seek additional legal advice and
court orders in this situation.
Other legal actions
• “72-hour hold” or an emergency hold can be
given if a person is deemed an immediate danger
to themselves or others. This gives a hospital the
order to hold and treat a person until a judge can
evaluate the patient’s status and what should
happen next. This must occur within 72 hours.
• Longer-term holds are granted after an initial
hearing in which a person is found incompetent
to make their own medical decisions due to their
current mental or physical state. An individual
can be transferred to a county or state facility to
receive treatment for a certain period of time,
after which their case must be reviewed.
At these hearings, your loved one with an eating
disorder will be granted an attorney to represent their
cause and help look out for their best interests.
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