How Does an Unwilling Patient get Mental Health Treatment?

 

There are three legal criteria for compelling a person to undergo short-term mental health treatment and evaluation: 

 

 

1)       Is the person dangerous to others due to a mental disorder?

2)       Is the person dangerous to one’s self due to a mental disorder?

3)       Is the person gravely disabled?  In other words, is the person unable  to provide food, clothing and shelter for himself or herself due to a mental disorder? [California Welfare and Institutions Code (WIC) 5008(h)(1)] 

 

When a peace officer, member of a mobile-crisis team, qualified staff member at an evaluation facility or other designated professional person determines that a person meets any of the three criteria, a person may be taken into custody and placed in an approved facility for up to 72 hours of treatment and evaluation.  There is no patient right to a hearing during the 72-hour period.

 

Source: Welfare and Institutions Code 5150

 

If the mental health evaluation conducted during the 72-hours of treatment finds that the person is a danger to self or others or is gravely disabled, he or she may be held for an additional 14 days.  Within the first four days of that 14-day period, a mandatory review hearing is conducted in the facility by a Mental Health Hearing Referee from the Mental Health Court.  The person held for treatment will be represented by a patient’s advocate or private attorney at the hearing.  

 

Following the hearing, the patient leaves the facility or stays voluntarily if no probable cause is found, but remains for the full 14 days if it is.  Patients may appeal the decision through a writ of habeas corpus. A Physician can discharge a patient at any time during any of the holds if it is felt the patient no longer meets the criteria.

 

Source: Welfare and Institutions Code 5250.

 

 

POWERS A MENTAL HEALTH BENCH OFFICER HAS:

 

1)     Can hear any element of an involuntary civil commitment under WIC §§ 5250 or 5270.15 [Grounds for detention; Application -Cal Wel & Inst Code];

2)     Can compel mental health treatment pursuant to an involuntary civil commitment;

3)  Can order a mental health Conservatorship for grave disability under WIC § 5350 upon the filing of a petition for conservatorship by the Public Guardian. (The patient is referred to the Public Guardian by the physician/hospital.)

 

4)      Can order a psychiatric evaluation for purposes of continuing an involuntary commitment;

5)   Can compel a defendant to be evaluated for competency to proceed with criminal charges and to receive treatment to regain competency

 

POWERS A LICENSED PHYSICIAN HAS:

 

1)     Can order a 72-hour-hold on a patient IF the physician or doctor of psychology has treatment privileges at an LPS-designated psychiatric hospital, and can initiate 14 day and 30 day holds for further treatment if the treating physician in the mental health facility;

2)     Can request a mental health evaluation by a Psychiatric Evaluation Team (PET) or Psychiatric Mobile Response Team (PMRT);

3)   Can refer the patient to the Public Guardian, who has the authority to file the conservatorship petition.

 

 

POWERS THE FAMILY HAS:

 

     1)  Take the person to a hospital emergency room for a mental health evaluation;

     2)  Request a mental health evaluation from a PET or PMRT Team;

     3)  Request police assistance and evaluation if it is an emergency situation.

 

 

 

 

If the patient is being held on the grounds that he/she is a danger to self and or gravely disabled:

 

If the patient is suicidal, or making statements that he wants to kill himself, he can be placed on an additional 14 day hold. This is accompanied by two affidavits signed by medical staff who have personal knowledge of these statements. There is not a Certification Review hearing*, the patient would have the right to file for a writ**.

 

If the patient remains gravely disabled*** and the doctors feel that with a little more treatment he could be stabilized, they can place the patient on a 30 day hold.  There is a Certification Review hearing at the hospital within four days of the patient being placed on the hold. Typically, a social worker or treating physician testifies at the Certification Review hearing.  The fact of the hearing and results thereof are confidential. The patient would also have a right to a writ.

 

If the patient remains gravely disabled and the doctors feel it is long term, they would make an application for conservatorship to the Public Guardian.  The Public Guardian would simultaneously conduct an investigation, petition the court through County Counsel to become the temporary conservator over the person only for thirty days and for a hearing within 25 to 27 days on the need for a one year conservatorship.  The hearing would be held in Department 95A or Department 95B, at the Mental Health Court.  The Public Guardian would submit a written report to the Court.  The report would make recommendations for or against conservatorship. If recommending for conservatorship, it would include who should be conservator, what powers the conservator should have and what disabilities should be imposed on the conservatee.  

 

If the patient is being held on the grounds that he/she presents a threat of imminent danger to others:

 

A petition is filed by the District Attorney with an arraignment hearing set in Department 95 at the Mental Health Court. Following the arraignment hearing, a full hearing is held to determine if the patient meets the legal criteria as a danger to another person.

 

*Certification Review Hearing: WIC 5256.1

 

Also known as Probable Cause Hearings.
A facility-based hearing for persons on WIC 5250 or 5270 holds. The hearing is to determine if the psychiatric treatment facility has probable cause to detain the person for the remainder of the hold period. The facility is required to notify the Court (Mental Health Counselor's Office) when any person is placed on a 5250 or 5270 hold. The Certification Review Hearing is to be held within 4 days of the person being placed on the hold. A facility representative must present the probable cause information at the hearing. The representative of the facility must be a mental health professional designated by the director of the facility to present. The psychiatric treatment facility representative must show probable cause that the person is a danger to self or others or gravely disabled due to a mental disorder. The patient is usually represented by a Patients' Rights Advocate from the Los Angeles County Department of Mental Health but may be represented by a private attorney. The hearing is based upon the specific criteria certified on the hold.

 

**A writ is a written court order saying that certain action must be taken.  Writ of Mandamus (or mandate) – an order to perform any act designated by law to be part of a person’s duty or status; Writ of Prohibition – the opposite of a writ of mandate that orders that further proceedings or other official acts be stopped (usually issued from a higher to a lower court.)

 

 

** Writ

 

A writ is a written court order saying that certain action must be taken.  Writ of Mandamus (or mandate) – an order to perform any act designated by law to be part of a person’s duty or status; Writ of Prohibition – the opposite of a writ of mandate that orders that further proceedings or other official acts be stopped (usually issued from a higher to a lower court.)

 

 

 ***Gravely disabled

 

The definition of "gravely disabled" is contained in WIC Section 5008(h)(1)(A), and states:  "A condition in which a person, as the result of a mental disorder, is unable to provide for his or her basic personal needs for food, clothing or shelter." 

 

For additional information, please see California Welfare and Institutions Code (WIC) sections 5250, 5260, 5270.15, 5350, et seq.