title: Voting rights for psychiatric patients: compromise of the integrity of elections, or empowerment and integration into the community?
abstract: BACKGROUND
  Participation of the mentally-ill in elections promotes integration into the community. In many countries, individuals with compromised mental incompetence who have legal guardians are denied the right to vote. In Israel, mental health consumers are eligible to vote. We evaluated the capacity of psychiatric inpatients with and without legal guardians to understand the nature and effect of voting.
  
  
  METHODS
  Fifty-six inpatients with/without legal guardians were recruited to the study. Participants completed the Competency AssessmentTool for Voting (CAT-V), Brief Psychiatric Rating Scale and the Mini-Mental State Exam.
  
  
  RESULTS
  Cluster analysis determined voting capacity using CAT-V as a continuous variable. Subjects who scored >1.6 on the CAT-V (59%) had high capacity to vote. Subjects without guardians revealed significantly higher capacity to vote. Voting capacity positively correlated with cognitive state and negatively correlated with severity of illness. Among patients with legal guardians those who scored >1.6 on the CAT-V maintained the capacity to vote.
  
  
  CONCLUSIONS
  The right to vote is an important basic right for individuals coping with mental disorders.However, it is important to evaluate the capacity to understand the voting process among individuals with mental disorders who have legal guardians. Thus, the integrity of the elections would be preserved by eliminating the risk of undue influence or manipulation of individuals who lack the capacity to understand the nature and meaning of voting, while preserving the right to vote for those with the capacity to do so, whether or not they have guardians.
authors.affiliation: Lev Hasharon Mental Health Center, Netanya, Israel, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Adiel
authors.initials: A
authors.lastname: Doron
authors.affiliation: Sha'ar Menashe Mental Health Center, Sha'ar Menashe, Israel.
authors.forename: Rena
authors.initials: R
authors.lastname: Kurs
authors.affiliation: Lev Hasharon Mental Health Center, Netanya, Israel, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Stolovy
authors.affiliation: Lev Hasharon Mental Health Center, Netanya, Israel, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Aya
authors.initials: A
authors.lastname: Secker-Einbinder
authors.affiliation: Lev Hasharon Mental Health Center, Netanya, Israel, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Alla
authors.initials: A
authors.lastname: Raba
mesh_terms: D000328:Adult; D002961:Civil Rights / Q000331:legislation & jurisprudence*; D006801:Humans; D007557:Israel; D016743:Mental Competency / Q000331:legislation & jurisprudence / Q000523:psychology; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000523:psychology; D011057:Politics; D011209:Power, Psychological