Trumbull County Probate Court

1. Trumbull County Probate Court • Mental Illness Proceedings

2. Legal Definition “Mental Illness” means a substantial disorder of thought, mood, perception, orientation, or memory that grossly impairs judgment, behavior, capacity to recognize reality, or ability to meet the ordinary demands of life.

3. “Mentally ill person subject to hospitalization by court order” means a mentally ill person who, because of the person’s illness: • Represents a substantial risk of physical harm to self as manifested by evidence of threats of, or attempts at, suicide or serious self- inflicted bodily harm; • Represents a substantial risk of physical harm to others as manifested by evidence of recent homicidal or other violent behavior, evidence of recent threats that place another in reasonable fear of violent behavior and serious physical harm, or other evidence of present dangerousness;

4. Represents a substantial and immediate risk of serious physical impairment or injury to self as manifested by evidence that the person is unable to provide for and is not providing for the person’s basic physical needs because of the person’s mental illness and that appropriate provision for those needs cannot be made immediately available in the community; or • Would benefit from treatment in a hospital for the person’s mental illness and is in need of such treatment as manifested by evidence of behavior that creates a grave and imminent risk to substantial rights of others or the person.

5. Mental Illness Proceedings • Initiated by the filing of an Affidavit of Mental Illness • Alleging Individual is: Mentally ill, and A danger to self and/or others

6. Prehearing • Board or Agency designated by board • Completes Report and refers matter to Probate Court

7. If the court finds probable cause, the following are issued: • Order to Convey • Temporary Order of Detention OR • the matter may be set for hearing

8. Initial Hearing • Held within 5 court days or 10 calendar days • Clear and convincing evidence • Commitment can be ordered for up to 90 days • order continues upon respondent’s discharge into the community • Court must consider the following factors in making commitment: • diagnosis • prognosis • preferences of respondent • projected treatment plan • least restrictive alternative consistent with treatment goals

9. In Re Burton (1984), 11 Ohio St. 3d 147.Totality of the circumstances • is there a current risk of physical harm to self or others; • testimony as to present mental and physical condition; • whether individual has insight into mental illness and will continue treatment; • grounds that are basis for commitment; • past history that is relevant to establishing individuals conformity to laws, rules, regulations, and values of society; and • if mental illness is in remission, the court shall consider the cause and degree of remission and probability that individual will continue treatment.

10. Continued Commitment • at least 10 days prior to the end of 90 day period, an application for continued commitment shall be filed • mandatory hearing • court may issue an order of commitment for up to 2 years, and every 2 years thereafter

11. Forced Medication • Application for forced medication • individual does not pose an imminent risk • individual does not have the capacity to give or withhold informed consent • it is the individual’s best interest: the benefits outweigh the risks • no less intrusive treatment will be effective in treating mental illness Steele v. Hamilton Community Mental Health Board (2000), 90 Ohio St. 3d 176 Emergency medication is a medical decision Nonemergency medication is a judicial decision