Involuntary Commitment Process for Mental Health Rights

Demystifying the Involuntary Commitment Process Nicole Durose, MSW Disability Rights Advocate

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Agenda Defining initialisms Involuntary Commitment Process Overview ECO Process Preadmission Screening TDO Process Involuntary Commitment Process What Are Your Rights & How to File Complaints Mental Health Advisory Council

Initialisms ECO Emergency Custody Order TDO PSC CSB DBHDS VDH OSIG Temporary Detention Order Preadmission Screening Clinician Community Services Board Department of Behavioral Health & Developmental Services Virginia Department of Health Office of State Inspector General

Process Overview Voluntary Admission Involuntary Commitment Voluntary Treatment TDO Civil Voluntary Admission Commitment Process Preadmission Screening Clinician Emergency Department Voluntary Admission ECO Mandatory Outpatient Treatment No Admission

ECO ECO: Emergency Custody Order (Va. Code 37.2-808.) Magistrate order used by police to place individuals in temporary custody (of police) in order to be evaluated for treatment Can be paperless Expires 8 hours after executed Individual must remain within eyesight of the police

ECO ECO Criteria: Probable cause to believe the person I. Has a mental illness that will result in a) Serious physical harm to themselves or others, or b) Individual suffering serious harm due to lack of capacity to protect themselves II. Needs hospitalization or treatment and, III. Unwilling to or incapable of voluntarily going to the hospital or getting treatment

ECO Other criteria to consider: 1. Recommendations from treating licensed provider 2. Past actions of the person 3. Past mental health treatment of the person 4. Relevant hearsay as evidence 5. Medical records 6. Affidavits (written statement that the signer swears is true) 7. Any other available information relevant to determining probable cause

Preadmission Screening CSBs are responsible for preadmission screening (Va. Code 37.2-505.) Must be evaluated by a Preadmission Screening Clinician who is trained and certified in screening Preadmission Form collects following information: o Demographics o Contact information to collect additional information o Healthcare (including if person has advance directive) o Risk assessment o Preadmission screening summary o CSB Recommendations o Notifications o CSB Report to Court and Recommendations for Placement/Treatment

Preadmission Screening Outcomes Voluntary community treatment Involuntary Admission/ inpatient treatment Mandatory Outpatient Treatment No treatment needed Voluntary admission* *If the person is believed to require hospitalization, but they agree to go voluntarily, must agree to stay up to 72 hours and give facility 48 hours notice to leave in lieu of involuntary admission

TDO TDO: Temporary Detention Order Preadmission screening clinician (PSC) petitions a Magistrate for a TDO PSC has 72 hours to find placement (and initiate stabilization treatment to avoid involuntary commitment) o Va. Code 37.2-814. If no private hospital will accept, state hospital must accept individual

TDO Police, or approved transportation company, provide transportation to the facility Commitment hearing takes place at end of 72 hours, unless 72 hours ends on weekend or legal holiday (hearing will take place by close of next business day) oVa. Code 37.2-805. PSC submits Petition for Involuntary Admission for Treatment

Bed of Last Resort If no private hospital accepts person, state hospital must accept them State hospitals cannot refuse to accept a person under a TDO, even if the person doesn t need psychiatric treatment (such as medical conditions, neurocognitive/neurodevelopmental conditions) Unintended consequences: o Longer hospitalizations o Less beds available o Police dropping off people at state hospitals o Delayed medical and psychiatric treatment

Involuntary Commitment Hearing Judge s Voluntary Involuntary Responsibilities: (Va. Code 37.2- 814.) Informs person of their right to ask for voluntary admission for inpatient treatment AND provides them with the opportunity (if appropriate) Informs person of right to commitment hearing and right to counsel (attorney) Asks if person has counsel representation and if not, appoints counsel

Involuntary Commitment Hearing Counsel s Responsibilities (Va. Code 37.2-814.) Interview their client, petitioner, examiner, CSB staff, and other relevant witnesses Examine relevant reports, present evidence and witnesses Actively represent their client and their wishes (as much as possible) Gives/explains written explanation of the involuntary admission process which includes the person s right to: o Retain private counsel or receive a court-appointed attorney o Present any defenses o Be present during the hearing and testify o Appeal the order for involuntary admission to the circuit court o Have a jury trial on appeal

Involuntary Commitment Hearing Outcomes (Va. Code 37.2-817.) Judge can order involuntary admission to a facility up to 30 days from date of the court order Once order expires, person must be released UNLESS o Provider petitions the court and another court order extends the involuntary admission up to 180 days from the day of the second court order o Person requests voluntary treatment, or o Court ordered mandatory outpatient treatment

What Are Your Rights & How to File Complaints

Human Rights Regulations A set of rules for providers guaranteeing a basic rights while receiving services (Va. Code 37.2-400.) Applies to providers who are operated, licensed, or funded by DBHDS Examples of some of the rights Free from Abuse & Neglect Participate in Decision Making Treatment in Least Restrictive Environment Treated with Dignity Talk in private to attorney, treatment staff, dLCV, OSIG Send and Receive Sealed Mail Live in humane, safe, sanitary environment Practice a religion

How to File Complaints Call your local police department to submit a complaint Department of Justice (DOJ) Civil Rights Division Website: civilrights.justice.gov Phone: 202-514-3847 Local Police Department Virginia State Bar (VSB) Website: vsb.org Phone: 804-775-0500 Attorney Virginia Department of Health Professionals (DHP) Website: dhp.virginia.gov/PractitionerResources/enforcement Phone: 800-533-1560 or 804-367-4691 Licensed Providers

How to File Complaints DBHDS VDH OSIG Community Service Boards Private Hospitals Private Hospitals State Hospitals State Hospitals Community Mental Health Centers Community Mental Health Centers Children s Institutions State Hospitals Children s Institutions

Mental Health Advisory Council Interested in Mental Health Advocacy? The MHAC advises dLCV on mental health in institutions through... Collaboration on yearly objectives Recommendation on policy changes needed Identifying and alerting dLCV to abuse, neglect, and/or rights violations Providing perspectives from consumers and providers For more information: dlcv.org/advisory-councils To complete an application: dlcv.org/paimi-council-application

CONNECT WITH US Call your local police department to submit a complaint Department of Justice (DOJ) Civil Rights Division Website: civilrights.justice.gov Phone: 202-514-3847 ADDRESS 1512 Willow Lawn Drive Suite 100 Richmond, VA 23230 PHONE 1-800-552-3962 (toll-free) | 804-225-2042 Spotify Logo Png - Free Transparent PNG Logos Social, media, instagram, circle Free Icon of Social media (color) Icons Facebook icon - Free download on Iconfinder WEBSITE dLCV.org dlcv.org/podcast @disAbilityLawVA @disAbilityLawVA facebook.com/ disAbilityLawVA