Legal Rights and Hospitalization

Eighty-eight percent of patients who enter a psychiatric hospital do so voluntarily, according to the National Alliance on Mental Illness. The 12 percent who are committed involuntarily must first be certified by a physician as needing hospitalization. The details of this process vary from state to state.

It is not easy to have someone involuntarily committed to a mental health facility or to force someone to undergo treatment. Strict laws protect the rights of people who resist hospitalization.

Evaluating the Need for Hospitalization

Check with local mental health services to find out if a mental health care provider will come to your home to conduct an evaluation. Be sure to talk to the visiting mental health worker privately to explain symptoms and changes in behavior you have observed. This is important if the patient might hide symptoms from the visiting professional.

The course of action becomes clearer — but not necessarily easier — when someone is having a psychotic episode. Because this situation obviously poses a threat to the patient and perhaps others, the police or other emergency responders can help you get the patient to a doctor who can perform an emergency psychiatric evaluation.

Involuntary Admissions

A doctor usually has the option of placing a patient into a hospital without her permission for an evaluation. This confinement is usually limited to a few days or a few weeks.

A judge should be informed of the involuntary admission. This requirement is mandated in many states. In some states, the testimony of one or two psychiatrists may be enough to involuntarily commit a patient who is too ill to appear in court. In all cases, it is crucial that a court of law be informed of an involuntary commitment and that the legal rights of the patient are protected before, during, and after hospitalization.

Question

What is the procedure for committing someone to a psychiatric hospital?

It varies according to state. If you think it might be necessary to involuntarily commit someone, check with the patient's psychiatrist or other mental health adviser about the procedure for your state.

If a more thorough evaluation of the patient's mental health in the hospital indicates that the patient needs continued observation and/ or intensive medical care, the hospitalization may be extended after a court hearing. The patient, a legal guardian, or a court-approved representative must be present at this court hearing.

The judge will decide whether or not hospitalization can be extended for a longer but finite period of time. After this time has elapsed, another court hearing will be required to extend the involuntary stay. Usually by this time, antipsychotic medications and/or therapy will have produced some positive results that allow a treatment plan to be developed so extended hospital stays can be discontinued. If the doctors recommend long-term commitment, they must justify their decision to the court. Psychiatrists might also determine that the patient can be treated adequately with partial hospitalization, providing the patient's mental condition will allow this less restrictive treatment option.

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