Emergency Commitments
** Maryland permits short term emergency hospitalization for three days or less without court review. Similarly, California is limited to three days exclusive of Saturday, Sunday, holidays.
** Procedures to initiating emergency commitment differ among states; It starts with an Application or petition. The Application for commitment must set out the reasons why the moving party wants commitment.
** To start the process there must be two petitioners. A doctor, police officer, or relative of the person can complete an application.
** The petition must be based upon personal examination of the individual by a professional, I.e. a doctor, or the personal observation by a peace officer (police man), and if by a doctor, must include diagnosis, an opinion that the individual needs inpatient care, and opinion that admission is needed to protect the individual or another, with clear detailed evidence of dangerousness.. If by a police officer or relative, then a diagnosis is not necessary.
** In Maryland, if the petitioner is a relative, then a court must review the petition, and find probable cause that the person has shown signs of a mental disorder and imminent danger of harm in order to have the person taken to an emergency room, ER.
** If the petitioner one of the two petitioners is a physician, then the filing will result in immediate confinement of the person for an evaluation of certifiability by the ER doctor.
** Once the petition is completed, the person is taken to an ER for a second opinion as to his admissibility into a hospital. If the ER doctor concurs, and the person is medically cleared, meaning that there are no somatic medical problems to prevent hospitalization, then the person waits in the ER until he can be transferred for admission into a state hospital.
** At the ER a special criteria used by the petitioners. The criteria for admission is basically is dangerous to self or others as a result of mental illness, but there are six criterion measures.
** Once in mental hospital, a hearing occurs before a hearing officer within ten days of the admission. notice shall be provided to the family, and invited to testify at the hearing. At the hearing, the hearing officer determines whether a finding of mental disorder coupled with immediate danger is made by clear and convincing evidence.
Six Criterion measures for involuntary admission to a state mental hospital in Maryland (summarized)
** Opportunity to sign a voluntary admission (assent to treatment)
Least restrictive alternative
Person must benefit from inpatient care
Danger to self or others
Suffer with mental illness
Special review if older than 62
Maryland’s definition of mental illness
** Mental disorder is a behavioral or emotional illness that results from a psychiatric or neurological disorder
** A mental illness that substantially impairs the mental or emotional functioning of an individual so as to make care or treatment necessary or advisable for the welfare of the individual or for the safety of the person or property of another.
** This definition does not include mental retardation or a primary diagnosis of alcohol or drug abuse.
Pre-requisites can avoid commitment
** First, Maryland requires as a precondition for involuntary commitment,
** That is, the person be advised of, and given the opportunity for, voluntary admission to a hospital. Specifically, the person is given the opportunity to voluntarily enter into the hospital. If the person is capable of assenting to treatment (which is distinguished from consenting to treatment), then the person is able to be voluntarily admitted, if he or she agrees to it.
Maryland’s least restrictive alternative
** Second, Maryland requires that commitment in a hospital be the “least restrictive alternative” or “least restraint” that will meet the patient’s needs.
** The treatment team is required to explain why other alternatives, such as a nursing home, outpatient treatment center, etc. would not be adequate in a particular case.
** Third, Maryland requires the person to benefit from the institutional care offered within a hospital setting, that his disorder is at least susceptible to treatment in the hospital.
Dangerousness analyzed
** Courts have required a person be “a danger to himself or others” prior to commitment. In Maryland a person must pose “an immediate danger to the life or safety of the individual or others.”
** The danger required must be the danger of personal including physical or bodily harm or injury, not property damage.
** Some statues require that the harm or danger be imminent or immediate, while most do not. Maryland’s law refers to immediate danger, uses the words clear and imminent danger, but does not define them, and relies upon clinicians for its application.
** Finally, states generally require that the person has engaged in an overt act, attempt or threat before he may be involuntarily committed for dangerousness.
** To assess the dangerousness criterion look to: the magnitude of harm, the probability that harm will occur, the frequency within which the harm will occur, and the imminence of the harm.
Danger to Self, Gravely Mentally Ill
** In some jurisdictions, not Maryland, danger to oneself can be established by demonstrating an individual’s extreme neglect of his basic needs, such as needs for food, shelter, clothing. This is not the case in Maryland because the law does not refer to “a need of care and treatment” criteria. Rather Maryland’s law refers to danger to self, suggesting danger to self means the person is suicidal, and the suicide threat is immediate.
Other issues: Commitment of Minors
** In Maryland a parent or legal guardian can act to “voluntarily” commitment a minor to the hospital if the minor has a mental disorder which is susceptible of care or treatment.”
** The length of this commitment is only twenty days.
** In Parham v. J.R. the U.S. Supreme Court held that, in addition, to any procedures that state law may prescribe, the federal due process clause requires that a parental decision to commit a minor child must always be reviewed by an independent and neutral physician.
08-16-2007 08:56 AM you don't know as much as you think
If you are trying to say I'm not all that, well Amen to that! I don't think I'm all that either, in fact, I know I'm not.
If your karma was reference emergency commitments, read above.
If a person isn't commitment, the process to get mental health treatment takes a great deal longer. Pathways and the Mental Health Authority are 3-4 months in the arrears on taking new patients. If you think the stock market looks sad, personal in many of these public servant jobs look sadder. Hopefully, somebody will come along and make me look bad by denying that allegation, and I certainly hope so. I feel that when you are dealing with a person who is suffering from mental illness, those time frames are entirely too long and detrimental to their recovery or managing of their symptoms. They say the longer you stay in sadness, in addiction, the longer it is to get yourself out. I have found that to be true.
I believe change begins on the inside. You have to change the people, places and things that cause the destructive behavior. Faith based services have been incredibly active in providing all sorts of services to citizens of the community. Knock it if you must (to my other karma hater), but without churches and those giving people, who the hell knows what our community might look like. Pastoral counseling services is one of the major players in our area. Many of your Sex Addict group meetings, NA/AA, call on a high power, other than yourself (i.e. GOD), in order for them to recover or deal with the triggers that can cause them to stroll back down the road of destruction (whatever destructive behavior that may be). Well guess where their road map came from? The Bible. It is all there. BTW, those meetings only ask for a $2.00 donation and if they don't have it, they can still attend. See if a doctor will take you without some cold hard cash.
In California, the gang problem was so severe that the police were completely frustrated with how to handle the crime. One desperate official decided to gather up a group of officers in his office with the same desperate desire, reduce crime. They went to the area churches and begged for help. They were able to put on a concert in which many Christian bands performed for free, along with motivational speakers. These churches were from various denominations; yet, worked together for a common goal, reduce crime. They were able to get many of the street dwellers, mostly teens, into the churches assisting with the set up and (this was 2-years ago) but many of those teens became active with the church. It worked; it reduced crime.
In today’s world, we have millions upon millions of people on anti-depressant drugs. What good does it do to walk into a doctor’s office and say, well, I’m feeling this way, that way, blah blah blah and the doctor says, ok, here is some Prozac and if that doesn’t do the trick, we’ll add some Lexapro into your cocktail. In the meantime, lets see which shrink accepts your insurance.

Oh, no mental health coverage, guess you are left to your own device.

And, if somebody truly has a mental disorder, those drugs could in fact, and will, make them worse. The world, in many ways, has lost the ability to cope. No wonder it takes 3-4 months to get an appointment with a Mental Health provider. But I am sure there isn't a wanting list to go to a Sunday service.

eaceout: