Conservatorships Explained
The idea of a conservatorship can be unsettling. It often brings to mind dramatic headlines or pop culture portrayals of abuse and control, such as the widely publicized case of Britney Spears or the dark narrative in The Girl with the Dragon Tattoo. These stories understandably raise concerns about the potential for overreach or misuse.
But in clinical psychiatric practice, conservatorships are often not about control. They are about protection. For individuals who are unable to manage their own basic needs or finances due to serious mental illness, a conservator can mean the difference between chaos and stability, or even between life on the streets and a return to dignity and safety.
What Is a Conservatorship?
A conservatorship is a legal arrangement in which a court appoints a person or entity to make decisions on behalf of an individual who is deemed unable to do so for themselves. These decisions may involve medical care, finances, housing, or other essential aspects of daily living.
There are two main types of conservatorships.
A conservator of the person is responsible for making decisions about the person’s health care, living arrangements, and overall well-being.
A conservator of the estate manages the individual’s financial affairs, including paying bills, managing income, and making sure funds are used appropriately.
In some cases, the same person serves as both. In others, different individuals or organizations manage each domain separately.
Voluntary and Involuntary Conservatorships
A voluntary conservatorship is established when a person recognizes that they need help and willingly agrees to have a conservator appointed. This may happen when someone is struggling with decision-making but is still capable of understanding the benefit of assistance.
An involuntary conservatorship is put in place when a court determines that the individual lacks the capacity to manage their own personal or financial affairs. This process is typically initiated by a physician, family member, or social worker and involves medical evaluations and legal proceedings.
In both cases, the conservatorship must be approved by a judge. The conservator is accountable to the court for their decisions and must act in the best interest of the conserved person.
Who Can Serve as a Conservator?
A conservator can be a trusted family member, a close friend, an attorney, or a court-appointed official such as a professional conservator. In Connecticut, the Office of the Probate Court Administrator helps assign conservators when there is no suitable private individual available.
Conservators must follow strict legal standards. They are required to act in the best interest of the individual, file annual reports, and sometimes obtain court approval before making significant decisions.
Real-Life Examples from Psychiatric Practice
In my work as a psychiatrist, I have seen conservatorships make a profound difference in the lives of patients who were otherwise unable to function independently. One patient in particular comes to mind.
He had a long history of severe depression. When he was stable on medication, he was engaged, thoughtful, and kind. But when he stopped taking medication, his symptoms quickly returned. He would miss appointments, stop picking up his prescriptions, and ultimately become homeless, sleeping outside and disconnected from support. Although he clearly qualified for disability benefits, the process of applying and navigating the system was simply too overwhelming in his depressed state.
Once a conservator of person and estate was appointed, everything began to change. His conservator helped submit disability paperwork, arranged for transportation to appointments, ensured his medications were picked up on time, and helped him secure safe housing. With this stability, his depression eased. His life was no longer dictated by desperation, and he remained connected to care.
I have also worked with individuals who struggle with substance use disorders. In some cases, every paycheck triggered a relapse. The patient would spend most or all of their money on drugs and be unable to afford rent, food, or other necessities. With a conservator managing their finances, money was allocated to essentials first, making it possible to break this destructive cycle and support recovery efforts.
Conservatorships Are Serious
Despite the positive outcomes I have seen, I do not take conservatorships lightly. They involve a significant loss of personal liberty and should never be imposed without careful consideration. However, it is important to understand that conservatorships are not always permanent. Individuals who are under a conservatorship have the right to petition the court to have it lifted if they can demonstrate that they are able to manage their own affairs again. The goal is always to support independence whenever possible.
The negative portrayals seen in media are not fictional. Abuse can happen, and strong oversight is essential. Conservatorships must always be guided by a commitment to the well-being, dignity, and autonomy of the person involved. They should only be used when necessary, and only as long as they are needed.
