Involuntary Mental Health Commitments

I. What Does Involuntary Commitment Mean?
Individuals suffering from mental disorders are sometimes unable to understand the severity of their illness, may refuse to take their prescribed medications, or are unable to recognize their need for medical assistance. Family members and friends may try to help or heal their loved ones who suffer from mental illness, but there are instances when their watchful eyes and efforts are simply not enough. Sometimes, the only alternative is to seek legal assistance to help someone you care about deal with mental illness.

The law provides a process known as Involuntary Commitment. Involuntary commitment is the use of legal means to commit a person to a mental hospital or psychiatric ward against their will or over their protests. This civil procedure can be an extremely difficult process emotionally, but it may also be the ultimate life-saving choice. Committing an individual does not mean that you are giving up on them, if anything it shows that you are committed and determined to help them get onto a path of healing and stability.

In the mental health community, involuntary commitment is considered a “last resort” option and is mainly issued when an individual is unable to care for him or herself and have demonstrated behaviors indicating they are a danger to themselves or others.

II. Possible Mental Illness Warning Signs:
• Change in thinking, mood or behavior
• Confusion, poor concentration, indecision
• Depression, apathy, sleeping pattern changes
• Anxiety, fear, withdrawal
• Inappropriate emotion responses to people or events
• Feelings of losing control
• Addiction to chemicals, people or events
• Thinking or talking about suicide
• Delusions, hallucinations
• Violence
• Illegal substance abuse and alcoholism

If someone you know suffers from mental illness and is displaying these warning signs, you may consider applying for a mental health warrant to begin the involuntary commitment process. It is important to note that even though a “warrant” will be issued, the involuntary commitment process is civil in nature and not criminal.

III. Beginning the Involuntary Commitment Process
In order to begin the Involuntary Commitment process, a Mental Health Warrant must be issued. This warrant serves as a Magistrate’s Order for Emergency Apprehension and Detention. The “Magistrate” is the Judge who will issue the warrant. Keep in mind that this warrant does not guarantee admission, but rather guarantees evaluation for the need of treatment in the least restrictive environment.

A. Applying for a Mental Health Warrant

Step 1: Contact your local county clerk’s office or Justice of the Peace Office. Most counties have a specific office where an application for a warrant may be filed. E.g., Wichita County – Mental Health Coordinator, located at 900 7th Street, Room 350, Wichita County Courthouse, Wichita Falls, TX 76301 940-766-8103.

Step 2: In order to approve the application, the magistrate must find that there is reasonable cause to believe that the person you are trying to commit evidences mental illness or evidences a substantial risk of serious harm to himself or others. Intervention by the Court is necessary because the risk of harm will be imminent unless the person is immediately restrained, and the
necessary restraint cannot be accomplished without emergency detention. If the application for a warrant is approved, then a warrant is issued and the local sheriff or constable’s office will locate and detain the individual. The sheriff or constable will then transport the individual to a local mental health facility.

Step 3: Once the patient is at the mental health facility, a physician has to provide a medical
certificate within 24 hours of the patient’s admission. This certificate enables the court to establish whether or not it is necessary to issue an order of protective custody (OPC). The OPC is an order issued by a Probate Court after an Application for Court Ordered Mental Health Services has been filed. At least one Physician’s Certificate must be on file with the Court if an OPC is to be issued. The Physician’s Certificate must demonstrate sufficient facts for the Court to believe that the proposed patient is mentally ill and, as a result of the mental illness, is substantially likely to cause serious harm to self or others.

Step 4: If an OPC is issued, a probable cause hearing must be held within 72 hours. At this hearing the judge decides whether the patient will be held at a mental health facility or released on his own, while he awaits the mental health hearing.

Step 5: The Mental Health hearing must take place within two weeks of the patient’s detention. At this hearing, the court may listen to testimony from the applicant for the warrant, medical experts, and the patient themselves. The court may decide to dismiss the case, issue a court order for outpatient treatment, or order inpatient hospitalization. Prior to this hearing, two Physician Certificates are required to be on file; one of these must be by a psychiatrist. The hearings are generally held at the hospital at which the patient is detained if they were not released following the OPC.

B. What Sorts of Questions Are in the Application?
In order to obtain a mental health warrant, an applicant must provide information about the individual in need of treatment. That information includes, but is not limited to, contact information, medical history, prior alcohol and substance abuse, as well as current information about the individual’s mental health status. The following excerpt is taken from the Texas Mental Heath Code:

…(b) The application for detention must contain:
(1) a statement that the guardian [or applicant] has reason to believe and does believe that the ward evidences mental illness;
(2) a statement that the guardian [or applicant] has reason to believe and does believe that the ward evidences a substantial risk of serious harm to the ward or others;
(3) a specific description of the risk of harm;
(4) a statement that the guardian [or applicant] has reason to believe and does believe that the risk of harm is imminent unless the ward is immediately restrained;
(5) a statement that the guardian’s [or applicant’s] beliefs are derived from specific recent behavior, overt acts, attempts, or threats that were observed by the guardian [or applicant]; and
(6) a detailed description of the specific behavior, acts, attempts, or threats.

It is important that you are truthful in the Application and provide all facts necessary to support your belief that the person you are trying to help is mentally ill and, as a result of the mental illness, is substantially likely to cause serious harm to themselves or others.

IV. Involuntary Commitment in an Emergency Situation
If you find yourself in an emergency situation, and require immediate assistance, call 911 or your local police department. When the police arrive to the emergency scene, they will ask themselves whether the person is over 18, and whether they pose a substantial risk of imminent harm to themselves or others?

If the answer is “YES,” peace officers have the authority to take an individual into custody and
immediately transport them to a mental health facility for observation. This can occur even if the
individual does not want to go voluntarily. Once the officer transports the individual to a mental health facility the involuntary commitment process discussed above begins.

V. Difference in Guardianship and Involuntary Commitment
There is a difference between guardianship and involuntary commitment. As explained above, involuntary commitment is the use of legal means to commit a person to a mental hospital or psychiatric ward against their will or over their protests. Guardianship is the use of legal means to grant another person or entity full or limited authority over an incapacitated person (ward) to promote and protect the well-being of the ward. In guardianships, the guardian is NOT allowed to commit the ward to a mental hospital, insane asylum or psychiatric ward. In guardianships, the guardian’s role is to step into the shoes of the ward because they are incapacitated and unable to perform the functions necessary to manage themselves or their estate. Involuntary commitments are used only to assist the mentally ill with getting necessary medical treatment for their mental illness. The person you are trying to help may not be incapacitated; they simply need medical attention to help them with their problem.

Contact us at 940-692-7800 to discuss your involuntary mental health commitment questions.