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Guest Author – Aaron Sperbeck

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Legal and Ethical Challenges Associated with Mental Health in the Last Frontier: A Primer for Alaskan Families

Alaska is home to over 739,000 people from many different and unique walks of life.[1] Mental health continues to be a matter of public concern in Alaska’s ever-growing and aging population.  In 2014 alone, more than 33,000 Alaskans self-reported suffering from a Serious Mental Illness (“SMI”).[2] It is estimated that one in five Alaskans continue to silently suffer from other less severe forms of mental illness which go unreported.[3] The Alaska Department of Labor predicts that the number of Alaska residents aged 65 and older will more than double from 63,832 in 2012 to 140,340 in 2042.[4] An increase in Alaska’s elderly population will mean a dramatic expansion of the number of residents requiring medical and other health-related services, such as informal caregiving and assistance with daily living activities.[5] This increase also translates into a surge of mental illness and mental health related issues that Alaskans and their families will likely encounter.

Proper diagnosis of mental illness or dementia, including Alzheimer’s disease, in the elderly is vital in order to ensure that appropriate treatment is provided as soon as possible. Misdiagnosis of mental illness in seniors can easily occur since symptoms are so similar to dementia, such as confusion and erratic behavior. While dementia does affect mental health, it is not classified as a mental illness, but rather a disorder of the brain that causes memory loss and trouble communicating.

Most people are not comfortable making plans for a time when they will be unable to make decisions and not have control of their own lives. Discussing personal values in relation to illness and death, finances and living arrangements, for example, is difficult. It is critical to remember how important decision-making can be to maintain a person’s confidence and self-esteem. As a person loses the ability to make decisions, decision-making will involve others, such as family members, substitute decision-makers and health-care professionals. Making decisions on another person’s behalf can be difficult and highly stressful, especially when the values and wishes of the person with the mental health issue are unknown, unclear, or impossible to follow.

More often than might be expected, lawyers encounter mental health issues in their everyday practices. In some instances, lawyers work directly with clients who suffer from mental health disabilities or with the family of a loved one who suffers the misfortune of age-related mental health decline. Lawyers are often responsible for drafting important legal documents which authorize individuals to act on another’s behalf with regard to an individual’s private or business affairs. It is not only fundamental, but critical, that lawyers understand the legal and ethical challenges faced when working with mentally ill clients and their families. The normal client-lawyer relationship is based on the assumption that the client, when properly advised and assisted, is capable of making decisions about important matters.  The fact that a client suffers impairment does not diminish the lawyer’s obligation to treat the client with attention and respect, protecting the confidences and secrets of that client pursuant to the professional rules of conduct.

If you have questions regarding how to address mental health issues in your life, or the life of a loved one, please take time to understand the issues involved and seek the advice and counsel of medical and legal professionals for further resources.

Aaron D. Sperbeck
Birch Horton Bittner & Cherot


Mr. Sperbeck’s practice is primarily focused on private and multi-party commercial litigation but also includes insurance defense, municipal law, and criminal defense. As a former district attorney, Mr. Sperbeck has conducted numerous jury and bench trials throughout Alaska, as well as administrative board and appeal hearings in both state and federal jurisdictions.

Mr. Sperbeck advises employers regarding best employment practices and counsels employers concerning regulatory compliance over a broad array of legal areas, including but not limited to personnel policies, internal practices, hiring, discipline, and termination decisions. For more information you may visit https://www.birchhorton.com/.


[1]           United States Census 2016
[2]           National Survey on Drug Use and Health – Alaska Mental Health Board (2015)
[3]           Alaska Behavioral Health System Assessment 2016
[4]           Alaska Department of Labor and Workforce Development, Research and Analysis Section. Alaska population projections: 2012 to 2042. 2014. [cited 2015 Dec 29].
[5]           RM Rosich and SR Thompson, Gerontological Knowledge and Elderly Health Care Services in Alaska: Aging in the Last Frontier. Educational Gerontology 1997; 23:443–52

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