A Mental-Health Crisis Should Not Make Someone Disappear

Protect privacy without severing care, keep trusted people connected, and bring veteran support closer to home.

I have seen firsthand two different failures in the mental-health system: a person's long history discounted because they appeared composed during one brief evaluation, and a family left unable to learn where a relative had been transferred during a temporary psychiatric crisis.

Families who recognize a crisis, bring someone to safety, and remain ready to help should not automatically be treated like strangers. At the same time, family ties should never give someone automatic control over a competent adult's treatment or private life.

Ohio needs a careful middle path: help people receive voluntary care before a crisis, protect them and preserve a trusted connection during a crisis, and ensure no one leaves stabilization without a real handoff to continued care.

Build on the protections Ohio already has

Ohio law is not silent. It requires notice to specified people before certain transfers of an involuntary patient, subject to emergency and safety exceptions. A voluntary patient may request notice of a transfer. Ohio law also permits limited disclosure to family or others in defined circumstances when a physician determines it is in the patient's best interest, and federal privacy rules permit certain disclosures when a patient is incapacitated and a clinician uses professional judgment.

Those protections matter, but they do not create one consistent process across emergency departments, voluntary admissions, involuntary holds, transfers, and discharge. A right that depends on the door through which a person entered, or on whether one busy employee knows the rule, can fail when a family needs it most.

The answer is not to erase privacy. It is to make consent easier, continuity more reliable, and exceptions clear.

Preserve a chosen crisis contact through every handoff

Every emergency department and psychiatric facility should ask a capable adult to identify a crisis contact at intake. That designation should travel with the patient through admission, transfer, and discharge unless the patient changes or revokes it.

If a patient is temporarily unable to choose, the facility should first check reasonably available advance directives, crisis-partner designations, and recent records for a contact the patient previously selected. If none exists, the facility could provisionally record an existing caregiver or other known support person, and then the person who brought the patient to safety, when professional judgment indicates that doing so is in the patient's interest. The facility would have to ask the patient whether to confirm, change, or revoke that contact as soon as decision-making capacity returns.

The contact could receive only the information reasonably necessary for continuity and safe follow-up, such as:

Where the person was admitted or transferred and a general description of condition.
What practical support is needed for discharge and follow-up.
Medication or safety information the contact must know to help, when legally permitted.
Notice that the person is responsible for a child, older adult, animal, or other dependent whose care may have been interrupted.

The designation would not provide financial authority, access to psychotherapy notes, control over treatment, or a general right to inspect medical records.

All disclosures and contact procedures would remain subject to HIPAA, 42 CFR Part 2 for covered substance-use-disorder records, and other applicable state and federal confidentiality law.

A capable patient's refusal controls. Notice may be delayed or withheld when disclosure would create a credible risk of abuse, exploitation, stalking, retaliation, or another serious harm. Facilities should document the reason for withholding it and provide a prompt internal review process.

Let Ohioans choose a mental-health crisis partner before a crisis

Ohio already recognizes a detailed Declaration for Mental Health Treatment. That remains an important option, particularly for people who want to record treatment instructions or name a proxy who may make decisions during documented incapacity.

Many people will not complete a longer advance directive. Ohio should also offer a short, voluntary mental-health crisis partner form that is separate from treatment decision-making.

A person could authorize a chosen partner to:

Give clinicians relevant history, prior treatment information, medications, warning signs, and messages.
Receive admission, transfer, and discharge notices.
Participate in discharge planning when that person will provide transportation, housing, medication support, or follow-up care.
Receive the minimum information needed to carry out that agreed role.

The form should be easy to complete, revoke, and share with a primary-care practice, mental-health provider, hospital, or trusted person. It should explain in plain language that the partner is not a guardian and cannot dictate treatment. Only a properly appointed proxy or other lawful decision-maker may exercise authority during incapacity, and then only within existing safeguards and the patient's stated wishes.

Consider the history, not only one interview

A psychiatric evaluation should assess the person in front of the clinician. It should also make a reasonable effort to understand how the crisis developed.

When deciding whether to admit, discharge, or change the level of care, an evaluator should consider reasonably available evidence about the historical course of an illness. That can include prior records, recent medication changes, previous admissions, and information offered by family members, caregivers, first responders, and clinicians.

Outside information is evidence, not a verdict. Clinicians should assess its credibility, distinguish observation from speculation, and document what they considered. A relative would not gain power to force treatment merely by making an allegation. But a person's ability to appear composed for a short interview should not erase a documented pattern of delusions, repeated deterioration, medication refusal, or inability to function safely.

Keep care close to home and protect due process

State standards should make communication and handoffs consistent while county alcohol, drug addiction, and mental health boards continue planning and contracting for local services.

Ohio should measure whether every region has a workable continuum: mobile crisis response, appropriate stabilization, inpatient capacity, timely outpatient appointments, medication access, peer support, and transportation. Discharge is not a plan if the next appointment is weeks away and nobody responsible for the handoff knows whether it occurred.

Clermont County already has a probate-court process for assisted outpatient treatment in qualifying cases involving severe, recurring illness. Families should receive plain-language information about voluntary services, emergency options, and existing court processes before a situation becomes unmanageable.

Court-supervised treatment must remain a last-resort, least-restrictive option. It requires independent representation, judicial review, periodic reassessment, and a meaningful opportunity to challenge the order. A capable patient's express refusal controls unless Ohio law authorizes intervention under a valid emergency or court process.

Families should have a voice, not an unchecked veto.

Bring Vet Center services closer to rural veterans

I served in the Army National Guard. I have also lost fellow service members to suicide. Veterans should not have to wait for a crisis, or drive across a region, to find someone who understands military service.

The Cincinnati VA has announced a new Clermont Outpatient Clinic opening August 31, 2026. That is welcome progress and should bring more VA medical care closer to veterans in Clermont County.

VA Vet Centers are different from ordinary hospital clinics. They provide confidential, community-based counseling, outreach, referrals, and support in a non-medical setting. Their services can reach eligible veterans, service members, members of the National Guard and Reserve, and families, and many staff members are veterans themselves.

That model is valuable precisely because some veterans who would never begin at a large medical campus will walk into a small community counseling office. For rural veterans who live far from a permanent Vet Center, distance remains a real barrier.

The State of Ohio cannot simply create a new federal Vet Center or hire its federal clinical staff. It can, however, remove practical barriers and make a strong, evidence-based offer to the VA.

I support an Ohio Vet Center Access Partnership that would:

Ask the Ohio Department of Veterans Services, county veterans service commissions, and the VA to map rural drive-time, transportation, outreach, and service gaps.
Identify secure, accessible public space in a county veterans service office, armory, health facility, or other appropriate location that a community can offer for counseling and outreach.
Provide limited, one-time state grants for private rooms, soundproofing, broadband, accessibility, signage, parking, and other fit-out costs needed to make donated space usable.
Coordinate regular Mobile Vet Center visits, virtual appointments in genuinely private rooms, and local outreach while the VA evaluates demand.
Formally offer qualified space to the VA as a community access point and use documented demand to seek an outstation with a full-time counselor or, where justified, a full Vet Center.

The state should publish aggregate measures such as communities served, outreach events, appointment availability, referrals completed, and progress toward a permanent presence, without exposing any veteran's identity or counseling record.

This is a practical partnership: counties contribute trust and a familiar location, Ohio removes facility barriers, and the VA provides the specialized counseling and clinical supervision it already knows how to deliver. We should begin with rural communities facing the longest trips and expand where the evidence shows veterans are using the service.

A system people can trust

Mental-health policy has to protect dignity at the hardest moment. That means privacy rules patients can understand, trusted contacts who do not disappear at the hospital door, decisions informed by the full available history, care close to home, and real due process whenever liberty is at stake.

It also means meeting veterans where they are. No Ohioan should become invisible because of a psychiatric transfer, and no veteran should be left alone because the right front door is too far away.

If you or someone you know is in immediate danger, call 911. For crisis support, call or text 988. Veterans and service members can call 988 and press 1, text 838255, or use the Veterans Crisis Line chat.