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Hospital Mental Health Care

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Hospital Mental Health Care

Most hospital stays for mental health treatment are just long enough to resolve the need for 24/7 care. There are two main types of hospital admission for mental health care, voluntary admission and involuntary commitment.

 

Voluntary Admission...

is when the person chooses to enter hospital care. Most people want help in a safe place when they are in a mental health crisis. Choice helps the person feel more involved and get better value from care.

Learn more about voluntary admission

Who can apply for voluntary hospital admission?

If a person chooses to be in hospital and the hospital treatment team decides the person would benefit from hospital care, the person will be admitted if a bed is available.  The person can ask for discharge at any time (§ 33-6-206), but if the risk is high and more care is needed, the hospital may begin the commitment process (Title 33, Chapter 6, Part 4).

Involuntary Commitment...

is when a person is admitted to hospital for mental health care even though they refuse to go. This action is a serious legal matter that should only be done to protect safety.  A multi-step process must be followed to make sure commitment is needed.

The main steps of involuntary commitment are:

Emergency Detention

Emergency Detention (§ 33-6-401/402) is when an officer of the law, licensed doctor, psychologist or qualified crisis worker, takes the person into custody to see if they meet standards for commitment.

First Certificate of Need (CON)

IF the person has a mental illness AND may need hospital care, a physician, psychologist or crisis worker (Mandatory Prescreening Agent) will do a mental health exam and may complete a first Certificate of Need (CON) (§ 33-6-404) stating that the person is at high enough risk to need emergency mental health care in a hospital, even without their consent (§ 33-6-403).

Second Certificate of Need (CON) and Admission

Second Certificate of Need and Admission: After the first Certificate is completed, the person is sent for a second Certificate of Need (§ 33-6-407/408), which may mean going to another hospital for treatment. A senior mental health clinician will do the second exam. If the risk is still high enough for commitment (§ 33-6-403), and the person still refuses mental health care, the clinician will complete the Certificate and the person will be admitted for up to 5 business days.

Probable Cause Hearing and Commitment

Probable Cause Hearing and Commitment: To be committed to a hospital without consent, court hearings are required at certain points to decide whether the hospital is the least restrictive place for the needed treatment.

  • If the person is admitted, the court is notified within 24 hours (§ 33-6-413).
  • If the court finds that the person meets involuntary standards (§ 33-6-403), the person may be committed to hospital for up to 5 days for diagnosis, evaluation and treatment.
  • A Probable Cause court hearing (§ 33-6-418/ § 33-6-422) must take place within that time. The person, their attorney and the next of kin or guardian must be notified of the hearing. The person has the right to a lawyer, either their own or one appointed by the court.
  • At the hearing (§ 33-6-422) the mental health team states the need for treatment. The judge decides whether or not the person meets commitment standards and whether to commit them for up to 15 days.
  • If committed, before the 15 days are up there is another hearing to decide whether the person should be released or stay in the hospital for a longer time under a Non-Emergency Commitment.
Judicial, Non-Emergency Commitment

Non-Emergency Judicial Commitment (33 Chapter 6 Part 5) is a court order for hospital mental health or substance use disorder treatment for up to six months. Judicial commitment may begin in a hospital after an emergency commitment or when the person is in the community.

  • If Judicial Commitment starts from the community a written complaint must be filed with the court by a family member, mental health clinician, officer of the law or certain officials (§ 33-6-504). The complaint states why the person should be committed. It will be heard by the court only IF and only if:
    • The person has, or appears to have, a mental health disorder
    • AND is at risk of serious bodily harm to self or others
    • AND may need mental health treatment in a hospital.
  • Certificates of Need (CON): The complaint must be filed along with two Certificates of Need (CON) from a physician or psychologist, stating that the person poses substantial likelihood of serious harm (§ 33-6-501) and should be committed.
  • Exam Location: For Judicial Commitment, the mental health exam usually takes place at the clinician’s office. If the person will not come in, the judge can order the police to bring them.
  • Length of Time: If the Court finds that the person meets standards for commitment, the judge will order the person admitted to a mental health hospital for up to six months. If not, the Court will dismiss the case and the person is released.
  • Available Suitable Accommodation or ASA (§ 33-6-509): With a non-emergency (judicial) commitment, a person with a mental health disorder cannot be admitted until there is a mental health hospital that can provide a bed and the required treatment. The person must wait in the community until a bed is open.
  • Release or Extension: At six months or before, the person may be released if the Court decides they no longer pose a serious risk to self or others. If commitment is still needed, another exam and court hearing must be held to decide whether the person meets standards for involuntary care and whether the hospital is still the least restrictive place to provide the care.
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