Involuntary Commitment Procedures

How is a Person Forced into a Psychiatric Hospital or Treatment Facility?

A. The exclusive method of involuntary hospitalization is through the Mental Health Code

1. Mental Health Code, Section 403, provides that persons shall be hospitalized only pursuant to this Act.
2. A Guardian may not sign a person into a psychiatric hospital.
3. An attorney, in fact, may not sign a person into a psychiatric hospital.
4. A patient may be hospitalized as a formal voluntary patient when the individual assents and the full guardian of the individual or the limited guardian with authority to admit executes an application for hospitalization.

B. Preadmission Screening Units

1. Each community mental health must establish one.
2. Individuals who seek hospitalization at hospitals operated by the Department of Mental Health or under contract with community mental health must be screened to determine if they are clinically appropriate for hospitalization.
3. A preadmission screening unit shall assess and examine, or refer to a hospital for examination, an individual who is brought to the unit by a police officer or ordered by a court to be examined.
4. If the individual meets the requirements for hospitalization, the preadmission screening unit shall designate the hospital to which the individual shall be admitted.
5. An individual's choice of hospital must be honored if the individual is private-pay and the hospital is willing to accept the individual.

C. Admission by Medical Certificate

1. Hospital may hospitalize an individual presented to hospital pending certification by a psychiatrist, if an application and a physician's or a psychologist's certificate have been executed and if authorized by a preadmission screening unit unless patient is private pay.
   
   a. Application executed not more than 10 days prior to its filing with hospital.
   b. Physician or psychologist certificate executed
   
   1) Within 72 hours of filing.
   2) After personal examination.
2. Peace officer shall take individual into protective custody for transport to designated preadmission screening unit when presented with application and certificate.
3. Peace officer may transport to designated preadmission screening unit without application or certificate if he personally observes conduct which reasonably leads him to believe the individual is a person requiring treatment under Sec. 401.
   
   a. Must be a reasonable belief.
   b. Must testify from personal knowledge.
4. Application may be presented to Court and Court requested to order examination and transport of patient to a preadmission screening unit if:
   
   a. Unable to secure examination after reasonable effort.
   b. Application complies with Code requirements.
5. Under either a peace officer's application or an examination Order, the individual must be examined within 24 hours of being received by hospital by physician or psychologist:
   
   a. If they do not certify--release immediately.
   b. If they do certify--held at hospital pending certification by psychiatrist.
6. A psychiatrist must examine individual within 24 hours of either admission to hospital by application and certificate or execution of certificate at hospital upon police officer's application or examination order.
   
   a. Excludes Sundays and holidays.
   b. If does not certify--release immediately.
   c. If does certify--keep until hearing.
7. Within 24 hours of certification by psychiatrist, the director shall transmit to Court notice that individual is hospitalized by sending Court the application and two certificates.

D. Admission by Petition

1. Petition is filed with Court (original)
   
   a. Must be accompanied by certificate of physician or psychologist or affidavit as to why no examination could be secured.
   b. May be accompanied by two certificates, one of which must be a psychiatrist's.
   c. Any certificate must be executed within 72 hours of filing petition and after personal examination.
2. 2. Examination

   a. If one certificate--Court orders examination by psychiatrist.
   b. If no certificate--Court orders examination by psychiatrist and either physician or psychologist.
   c. Individual may be detained for 24 hours for such examination.
   d. If physician or psychologist will not certify, the Court may dismiss or order examination by a psychiatrist if available. If not available, it may order examination by physician or psychologist. If third examiner will not certify, Court shall dismiss.
   e. If individual will not comply with examination, Court may order peace officer to take into protective custody and deliver for examination.
   f. Individual to remain home before and after examinations unless the Court finds he requires immediate hospitalization in order to prevent physical harm to self or others. If examinations and certificates are not completed within 24 hours, the individual must be released.

E. Difference Between Application and Petition Procedures

1. Original Petition stay with the Court while original Application goes to hospital.
2. Under Petition, individual released unless Court finds he is dangerous to self or others.
3. Under Petition, Court order examination by named doctors' while under Application, examinations are just ordered by the hospital.
4. Most commitments are by Application.

F. Problem Areas

1. 401(c) criteria for commitment may only be used with Petition procedure and not Application procedure at initial hearing.
2. Certificates must state information and opinions in reasonable detail to support conclusion. Need to state facts observed or refer to facts on Petition/Application. May be thrown out if only state conclusions.

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