Guardianship for Adults with Dual Diagnoses: Is It the Right Choice?

When someone you love lives with both a developmental disability and a mental health condition, decisions about support can feel layered and complicated.

• Maybe your adult daughter in Rexburg has autism and is also experiencing severe anxiety that affects her ability to make safe decisions. 
• Maybe your adult son in Twin Falls has an intellectual disability and bipolar disorder, and you’ve noticed that during certain times, he refuses treatment.

Families in these situations often ask the same question: Is guardianship the right step, or is there another option that would work? 

The answer depends on the individual; it is always important to remember that guardianship is not appropriate for everyone with unique needs, or a dual diagnosis. Let’s start with some of the basics of guardianship in Idaho. 

Guardianship Is Not Based on Diagnosis Alone

Having dual diagnoses alone does not necessarily mean guardianship is an appropriate approach. The court looks at whether an adult can:

• Understand information and consequences
• Make informed decisions
• Communicate those decisions consistently
• Remain safe without court-ordered authority
• Not be taken advantage of without parental intervention

Some adults with dual diagnoses manage well with structured support. Others may struggle during periods of instability. The key question is whether informal tools provide reliable protection.

Guardianship should be viewed as a protective legal framework when less restrictive options are not enough to keep them safe, or no longer provide the needed support, not as a default response to complexity.

When Other Tools May Be Enough

In many cases, families start with less restrictive options.

A Living Will and Durable Power of Attorney for Health Care may allow medical decision-making when incapacity occurs. A financial power of attorney may allow help with bills. Supported decision-making may work when cooperation is steady and providers are willing to honor consent. For example:

• A young adult in Moscow who consistently accepts guidance may do well with carefully drafted powers of attorney.
• A parent in Mountain Home may only need a representative payee arrangement to manage Social Security benefits.

These tools rely on understanding and cooperation. When cooperation is stable, they can work well. The difficulty often arises when cooperation becomes inconsistent or other circumstances arise. Because supported decision making does not currently have legal backing in Idaho, it relies on the person needing help and their support team agreeing and working together.

When Guardianship May Be Considered

Guardianship may be appropriate when:

• Consent is currently or would be frequently revoked
• Safety is at risk
• Medical decisions cannot be made consistently
• Informal tools have failed or cannot be relied upon

In Idaho, the court will evaluate real-world functioning. Medical evaluations, documentation, and evidence of risk are reviewed carefully. The focus is protection balanced with dignity.

In some situations, limited guardianship may be granted, giving authority only in specific areas while preserving independence elsewhere.

What Guardianship Does Not Do

It is equally important to understand the limits. Guardianship does not:

• Guarantee cooperation
• Automatically provide financial control
• Remove all personal decision-making rights

It provides legal authority for certain decisions. It does not replace treatment, support systems, or relationship dynamics.

Families might find better structure through having clear authority, but they also must understand that guardianship is a responsibility.

Thinking Through the Right Level of Support for Families in Idaho

When dual diagnoses are involved, the conversation should not be framed as control versus independence. It should be framed as: What level of legal protection is truly necessary right now?

• Sometimes the answer is structured powers of attorney.
• Sometimes it is representative payee status.
• Sometimes it is guardianship.
• And sometimes the answer changes over time.

That is why careful planning matters.

Start with a Thoughtful Conversation

If you are supporting an adult with dual diagnoses and wondering what Idaho law allows, the most important step is not filing paperwork. It is evaluating the full picture.

At Alan R. Harrison Law, we approach these situations through our Collaborative Legal Planning Process™. We look at capacity, cooperation, benefits, long-term planning, and family dynamics together before recommending a path forward.

If you are in Blackfoot, Sandpoint, Boise, or anywhere across Idaho and have questions about whether guardianship is appropriate, we are available to meet in person or virtually.

Planning thoughtfully today can set you up for tomorrow’s success.