Anticipating Restrictions on Rights With Our Patients

Following the recent presidential and congressional elections, significant changes to laws related to healthcare, immigration status, family law, education, and employment may be forthcoming. In anticipation of these changes, some legal and medical professionals are already considering how to prepare, including how to advise their patients who may be negatively affected. Given that mental health professionals (MHPs) serve some of the most vulnerable individuals and groups in society, it is particularly important for them to be apprised of how possible law reforms may affect the people they serve. Although MHPs should not provide medical or legal advice, they may play crucial roles in helping patients identify potential legal and medical concerns, explore options, and link them with the appropriate experts for further guidance (Barsky, 2023).

Anticipated Changes

I do not claim to know exactly what legal changes are on the horizon; this is speculative. However, it is possible to glean examples from recent political campaign speeches and policy documents such as Project 2025 (Dans & Groves, 2023). The following list includes potential changes and ways that they may affect mental health patients and American society as a whole.

1. Healthcare: Various states have already enacted restrictions on access to abortion care, as well as gender-affirming medical care for transgender and gender-diverse patients. Other states may add restrictions to access to such care. There may also be attempts to pass federal restrictions or bans. If these restrictions or bans go ahead, then people needing such care will have greater difficulty accessing such care. Already, there are people considering whether to speed up gender-affirming surgery or other procedures that may be banned. Some people are also concerned about possible restrictions on contraception and surrogacy. People wanting IUDs, in vitro fertilization, or other procedures that may be banned may also want to make plans before such restrictions are in place. Access to healthcare, including mental healthcare, may also be disrupted if the Affordable Care Act is overturned. Many people may lose their source of healthcare insurance.
2. Immigration: Political rhetoric has included statements such as mass deportation of people who are in the United States without legal documentation. Laws such as temporary protected status for refugees from Haiti or other countries may also be revoked. If mass deportation begins, even immigrants with legal documentation may become anxious about their status being taken away. People with concerns about their legal status moving forward may benefit from legal advice, including whether there are any ways to expedite any immigration processes and secure their immigration or citizenship status.
3. Marriage, Family, and Estate Laws: Although same-sex marriage was recognized by the Supreme Court of the United States, it is possible that civil recognition of same-sex marriage could be overturned, either by the Supreme Court or by Congress. LGBTQ+ individuals may also be concerned about equal rights and protections in other areas of family and estate law, including rights to custody and access, foster parenting, adoption, and inheritance. Attorneys may be able to assist with protections such as cohabitation agreements, second-parent adoptions, living wills, advance directives, testamentary wills, or updating genetic markers on passports to ensure that LGBTQ+ individuals and their family members are legally protected if the current laws change.
4. Education: Another topic that arose during the presidential campaign was whether the federal Department of Education would be dismantled. This change could affect the way that public and private schools are funded, as well as policies affecting what can be taught in schools and nondiscrimination policies. Some states have already passed laws restricting the teaching of diversity, equity, and inclusion, as well as the use of state funds for diversity initiatives. These changes in policies and funding may have particularly negative consequences for students who identify as Black, people of color, or LGBTQ+. More people may opt for private education; there may also be greater availability for vouchers for people to send their children to private schools, including private religious schools.
5. Employment: Employment laws vary greatly from state to state. It is possible, however, that Congress may pass laws that change employment policies and practices. For instance, it is possible that the National Labor Relations Board will be dismantled. Law reforms could also make it harder for people to unionize. Other laws may prohibit employers from having diversity, equity, and inclusion policies (particularly for employers that have contracts with the government). MHPs may need to become more involved in supporting patients who experience discrimination in employment.

Prudence Rather Than Alarmism

The examples of potential legal and policy changes are not meant to be alarmist. However, it is important to be aware of potential changes so that MHPs may prepare themselves and their patients should particular changes be tabled, passed, and/or implemented. The ethical codes of various professional associations encourage MHPs to be aware of how policy affects their patients and to advocate on behalf of their patients, including mental health and social justice concerns (American Counseling Association, 2014; American Psychological Association, 2017; National Association of Social Workers, 2021).

MHPs need to be aware of the possible causes of anxiety and depression, which may be related to proposed or actual changes. MHPs can also help patients explore the sources of information that they rely upon, including how some sources may be more reliable than others and how some sources may be deliberately deceptive. Ideally, MHPs and the people they serve should be guided by prudence. Prudence requires staying informed, consulting with others, and aligning their actions with their professional ethics. MHPs may be involved in helping patients make adjustments in their lives, providing psychotherapy, and linking patients with support groups, community-based organizations, advocacy groups, legal advice, or medical advice as needed. MHPs should also invest in their own self-care, including supervision or consultation to reflect on their own cognitive and emotional responses to impending changes.

Conclusion

By approaching potential legal changes with a balanced and proactive mindset, MHPs can provide compassionate support and empower patients to make informed decisions that protect their rights and psychosocial well-being.