Involuntary Commitment: What Is the Process?
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Involuntary Commitment: What is the Process? 2020 Edition LawPracticeCLE Unlimited All Courses. All Formats. All Year. ABOUT US LawPracticeCLE is a national continuing legal education company designed to provide education on current, trending issues in the legal world to judges, attorneys, paralegals, and other interested business professionals. New to the playing eld, LawPracticeCLE is a major contender with its oerings of Live Webinars, On-Demand Videos, and In-per- son Seminars. LawPracticeCLE believes in quality education, exceptional customer service, long-lasting relationships, and networking beyond the classroom. We cater to the needs of three divisions within the legal realm: pre-law and law students, paralegals and other support sta, and attorneys. WHY WORK WITH US? At LawPracticeCLE, we partner with experienced attorneys and legal professionals from all over the country to bring hot topics and current content that are relevant in legal practice. 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LawPracticeCLE does not seek approval in Illinois or Virginia, however the necessary documentation to seek CLE credit in such states will be provided to the registrant upon request. ADVERTISING WITH LAWPRACTICECLE At LawPracticeCLE, we not only believe in quality education, but providing as many tools as possible to increase success. LawPracticeCLE has several advertising options to meet your needs. For advertising and co-sponsorship information, please contact the Director of Operations, Jennifer L. Hamm, [email protected]. CHECK US OUT ON SOCIAL MEDIA Facebook: www.facebook.com/LawPracticeCLE lnstagram: www.instagram.com/lawpracticecle Linkedln: www.linkedin.com/company/lawpracticecle Twitter: www.twitter.com/LawPracticeCLE INVOLUNTARY COMMITMENT – I’VE HEARD THE TERM, BUT WHAT IS THE PROCESS? Rachel V. Rose, JD, MBA July 2020 Disclaimer THE INFORMATION PRESENTED IS NOT MEANT TO CONSTITUTE LEGAL ADVICE. CONSULT YOUR ATTORNEY FOR ADVICE ON A SPECIFIC SITUATION. Copyright 2018- Rachel V. Rose - Attorney at Law, PLLC. Presentation highlights ◦ Fundamentally, involuntary commitment can be thought of as a process that can be initiated when a person poses a risk or danger to themselves or to others. ◦ Typically, in the United States in particular, patient autonomy and decision making are cornerstones of our medical system. ◦ One can think of involuntary commitment as an exception to these general rules. The process that follows is complex and the laws vary by state (and different countries). Copyright 2018- Rachel V. Rose - Attorney at Law, PLLC. Overview ◦ What the definitions of involuntary commitment are in different states and countries; ◦ Who can be involuntarily committed and what criteria must be met; ◦ What is the legal process after the initial commitment; and ◦ How do HIPAA and other advanced directives come into play? Copyright 2018- Rachel V. Rose - Attorney at Law, PLLC. WHAT IS INVOLUNTARY COMMITMENT? Copyright 2018- Rachel V. Rose - Attorney at Law, PLLC. Definition ◦ “Involuntary civil commitment is the admission of individuals against their will into a mental health unit. Generally speaking, there are three reasons why an individual would be subject to involuntary civil commitment under modern statutes: mental illness, developmental disability, and substance addiction. In the case of mental illness, dangerousness to self or others defines the typical commitment standard, with almost all states construing the inability to provide for one's basic needs as dangerousness to self. In terms of process, every state provides for a hearing, the right to counsel, and periodic judicial review, while most states have statutory quality standards for treatment and hospitalization environment.” Copyright 2018- Rachel V. Rose - Attorney at Law, PLLC. Types of Involuntary Commitment ◦ Three forms of involuntary treatment are authorized by civil commitment laws in 46 states and the District of Columbia. ◦ Two forms are available in Connecticut, Maryland, Massachusetts and Tennessee, where court-ordered outpatient treatment has not yet been adopted. ◦ Three Forms of Involuntary Treatment ◦ Emergency hospitalization for evaluation is a crisis response in which a patient is admitted to a treatment facility for psychiatric evaluation, typically for a short period of fixed time (e.g., 72 hours). "Psychiatric hold" or "pick-up" and other terms may be used to describe the process. ◦ Inpatient civil commitment is a process in which a judge orders hospital treatment for a person who continues to meet the state’s civil commitment criteria after the emergency evaluation period. Inpatient commitment is practiced in all states, but the standards that qualify an individual for it vary from state to state. “Involuntary hospitalization” or another term may be used to describe the practice. ◦ Outpatient civil commitment or “assisted outpatient treatment (AOT)“ is a treatment option in which a judge orders a qualifying person with symptoms of mental illness to adhere to a mental health treatment plan while living in the community. AOT laws have been passed in 46 states, but the standards for its use vary from state to state. “Outpatient commitment,” “involuntary outpatient commitment,” “mandated outpatient treatment” and other terms may be used to describe the practice. Copyright 2018- Rachel V. Rose - Attorney at Law, PLLC. TARASOFF & PUBLIC POLICY Tarasoff v. Regents of Univ. of Cal., 551 P.2d 334 (Cal. 1976) Copyright 2018- Rachel V. Rose - Attorney at Law, PLLC. Public Policy ◦ National Alliance on Mental Illness ◦ (9.1.2) With adequate professional consultation, every person with a serious mental illness who has the capacity and competence to do so should be entitled to manage his or her own treatment. When an individual lacks capacity and competence because of his or her serious mental illness, however, the substitute judgment of others--subject to sufficient safeguards with frequent review--may be justified in determining treatment and possible hospitalization. ◦ (9.2.4) Methods for facilitating communications about treatment preferences among individuals with serious mental illnesses, family members, and treatment providers should be adopted and promoted in all states. (9.2.5) Involuntary commitment and court-ordered treatment decisions must be made expeditiously and simultaneously in a single hearing so that individuals can receive treatment in a timely manner. The role of courts should be limited to review to ensure that procedures used in making these determinations comply with individual rights and due-process requirements. The role of the court does not include making medical