Civil Commitment

1. Civil Commitment

2. “Mentally Ill” "Mentally ill" means having a disorder of thought or mood which significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life. O.C.G.A. § 37-3-1  (2007)

3. 13- ”very withdrawn’”-counseling 14- comments about Columbine; evaluation and antidepressant meds 16- therapy for “shyness” 20- violence in writing; referral to counseling; he refuses 21- “annoying” contact with coed referral to Police 21- “disturbing” emails and IM contact-in disguise--with coed Was Cho Commitable?

4. Cho • 21- fails to keep appointment at counseling center • 21- disappointment in “love” order to stay away from coed; “I might as well kill myself now”; police take to CSB; “imminent danger to self”; overnight for TDO at psych hospital • 21- Discharge from hospital “not a danger” Judge orders outpatient tx; notes describe: “no indication of psychosis, delusions, suicidal or homicidal ideation—insight and judgment normal.”

5. Cases Lake v. Cameron (1966)   Mayock v. Martin (1968)   Lessard v. Schmidt (1972) O’Connor v. Donaldson (1975) Addington v. Texas (1979) Zinermon v. Burch (1990) Norwood v. Hardy (1855) In re Holly (1988) Ruff v. Central State (1989) Ga Mental Health v Brady (1993)

6. 100 % 99.44% Standards of Proof “Beyond a Reasonable Doubt” 85 % “Clear and Convincing” 65 % “Preponderance of the Evidence” 50 % “Probable Cause” “Reasonably Articulable Suspicion” 1 %

7. ADMISSION OF VOLUNTARY PATIENTS • The chief medical officer of any facility may receive for observation and diagnosis any patient who is:  • 12 years of age or older making application for admission, • or • under 18 years of age and for whom an application for admission is being made by his parent or guardian, • or • any patient who has been declared legallyincompetent and for whom an application for admission is being made by a guardian • 37-3-20

8. Treatment  If found to show evidence of mental illness and to be suitable for treatment, a voluntary patient may be given care and treatment at the receiving facility.  The parents or guardian of a minor child must give written consent to such treatment 37-3-20

9. Right of Voluntary Patient to Discharge on Application A voluntary patient, other than a minor child, or any voluntary patient's personal representative may request such patient's discharge in writing at any time after his admission.  The patient may submit his written request to the chief medical officer.  If a voluntary patient submits an oral request for discharge, a staff member must assist him Once a written request has been delivered to the chief medical officer, the voluntary patient must be discharged within 72 hours, excluding Sundays and legal holidays.  If …patient would be unsafe for the patient or others:  and proceedings for involuntary treatment must be initiated 37-3-22

10. Notice of rights to release  At the time of his admission and each six months thereafter, any voluntary patient admitted to a facility or transferred to voluntary status shall be notified in writing of his right to discharge upon application and of all other rights granted to patients.  Transfer to voluntary status 37-3-24 An involuntary patient may submit an applicationfor a transfer to voluntary status of hospitalization at any time if:  he is able to understand and exercise the rights and powers of a voluntary patient, and the chief medical officer finds that this would be in the best interests of the patient. 37-3-23

11. Notice of Transfer  • 37-3-24 • In the event that a patient is transferred from involuntary to voluntary status, or thereafter discharged, notice of transfer or discharge shall be given to:  • to the patient and his representatives; • if the patient's hospitalization was ordered by the court, to the court which entered such order; • if the patient was admitted to a facility by a physician’s certificate, to the physician or psychologist executing the certificate; and • if the patient was under criminal charges, to the law enforcement agency originally having custody of the patient.

12. Admission to an Emergency Receiving Facility • The court of the county in which a person may be found may issue an order for involuntary hospitalization  • based upon a sworn petition from a community mental health center, or • an unexpired certificate issued by any physician within the state, or • based upon the affidavits of at least two persons, • that a person is believed to be  • mentally ill, • and • in need of involuntary treatment. 37-3-41

13. Judicial Order The order will require that the person be  taken into custody, and delivered forthwith for examination by a physician.  The court order will expire seven days after it is executed.  The evaluation of the patient will be conducted by someone who is:  a psychologist, clinical social worker, or clinical nurse specialist in psychiatric/mental health and authorized to practice under state law.

14. Admission to an Emergency Receiving Facility; Police Officer • A law enforcement officer may take a person into custody and transport him to an emergency receiving facility for evaluation without judicial authorization if:  • the person is committing a penal offense, and • the peace officer has probable cause for believing that the person is: • mentally ill • and • in need of involuntary treatment 37-3-42

15. Time Limits: Evaluation and Custody • A patient shall be examined by a physician as soon thereafter as possible.  • The patient must be examined within 48 hours.  • The patient must be discharged within 48 hours of his arrival unless:  • An examining physician or psychologist executes a certificate stating that there is reason to believe that the person may be: • mentally ill and • in need of involuntary treatment,or • the patient is under criminal charges, notice of which has been given in writing to the facility. • Within 24 hours of the execution of the certificate the patient shall be transported to an evaluating facility

16. Evaluation; Power to Discharge • A patient who has been admitted to an evaluating facility may be detained for a period not to exceed five days, Saturdays, Sundays, and holidays excluded.  • At the expiration of the five day period, the patient must be discharged unless   • Within that period: • The patient is admitted as a voluntary patient • or • The patient is admitted for involuntary inpatient treatment. • or • the patient is under criminal charges, notice of which has been given in writing to the facility.

17. Involuntary Commitment Procedure  • Any person may file a sworn application with the community mental health center for a court ordered evaluation of a person believed to be  mentally ill and in need of involuntary treatment. •  The community health center will then conduct an evaluation of the person, and if the person is found to be as alleged, the center will file a petition with the Court.  37-3-61

18. Any person may file a sworn petition with the court alleging that a person is believed to be  mentally ill and In need of involuntary treatment. The petition must be accompanied by a physician’s certificate which states  the physician has examined the person within the preceding 5 days, the person may be mentally ill and in need of involuntary treatment, and a full evaluation of the patient is necessary. 37-3-61

19. Notice of Hearing • Any petition for a court ordered evaluation will be reviewed by the court, and if it finds reasonable cause to believe that the person is mentally ill and in need of involuntary treatment  • the court shall hold a full and fair hearing on the petition between 10 and 15 days after the filing of the petition;and • the court shall serve notice of the hearing upon • the patient and his representatives • and • the petitioner.

20. Notice of the hearing shall include:  time and place of the hearing; notice of the patient’s right to counsel; that the patient may request court appointed counsel if he cannot afford his own counsel; that the court will appoint counsel unless the patient waives his right to counsel in writing; and notice that the patient may waive his rights to a hearing. After a full and fair hearing or, if the hearing is waived, after a full review of the evidence, if the court is satisfied that immediate evaluation is necessary, the court shall issue an order to admit the person to a designated facility for evaluation. 37-3-62

21. Notice of Other Rights If an evaluating facility has petitioned for a court hearing and in doing so has detained a patient past the five days allotted for evaluation, then five days prior to the hearing the patient must receive:  a copy of the individualized service plan developed by the facility; notice that the patient has a right to be examined by a physician or psychologist of his own choice at his own expense and to have that physician or psychologist submit a suggested service plan for the patient; And all other rights required by notice of the court hearing.

22. Immediately upon arrival at an emergency receiving facility, the facility shall give the patient written notice of:  his right to petition for a writ of habeas corpus; his right to petition for a protective order; his right to legal counsel; and that, if the patient is unable to afford counsel, the court will appoint counsel for him. 37-3-62

23. Matters to be Determined at Hearing • 37-3-81.1 • At the hearing , the court shall determine whether the patient is:  • mentally ill • and • in need of involuntary treatment •  and, if so, whether the patient is: • an inpatient • or • an outpatient • and, • the type of involuntary treatment the patient should be ordered to obtain.

24. At such hearing, if the court determines:  37-3-81.1 That the patient is not a mentally ill person requiring involuntary treatment, the court shall order that the patient be immediately discharged; That the patient is an outpatient, the court shall further determine if outpatient care is acceptable and available for the particular patient; If the requirements are met, the court shall order the patient to obtain that treatment and shall discharge the patient subject to such order

25. If the requirements are not met, and The patient has been admitted to a facility and has received an evaluation within 45 days prior to the date of the hearing, the court shall order that the patient be discharged; Or The patient has not been admitted to a facility and received an evaluation within 45 days prior to the date of the hearing, the court shall order that the patient be admitted to an evaluating facility. That the patient is an inpatient, the court shall order that the patient shall be transported to a treatment facility where the patient shall be admitted for care and treatment. 37-3-81.1

26. Duration of Hospitalization  If the court determines that involuntary hospitalization is necessary, the judge must issue a written order to place the patient in an evaluating facility for any period not longer than six months.

27. Hearing Examiners • Appointed by the Supreme Court • Must be member of the Bar • Powers: • Administer Oaths • Issue Subpoenas • Make evidentiary rulings • Regulate the hearings, generally 37-3-84

28. Transportation • The county of the patient’s residence must provide transportation

29. Rights Retained • “Patients shall retain all rights and privileges granted to other persons or citizens” • Including: civil, political, personal or property rights • “Not to be considered legally incompetent for any purpose” 37-3-140