involuntary committments by POLICE!

[PGH70]

In Florida, all of the police, local or staties, have the power to

commit a person, any age, for 72 hours in a mental facility. I am amazed by this. It can be a good thing, because they are in the trenches with the crazies on the street.

I'm from PA, where only MDs or trained crisis workers, county hired, were allowed to commit.

What about other states?

My job is psych assessment in the ER, and I see every psych pt in the ER, on my shift, that is committed or otherwise, screening, voluntary, counseling referral, etc.

All too often the committments are inappropriate, and sometimes quite stupid. Opinions?, thanks, PGH70

[JailRN]

In Calif, ploice officers can 5150 a person without training. However, nurses, doctors, mental health providers must take a 2 day course and be 'certified' to write holds on a patient. The patient must be a danger to self, others, or gravely disabled, with a Psych dx.. Too often, in jail, an inmate will say they are suicidal, a hold is written, they are transported to the local psych ward of the county hospital, where they tell the staff what they need to to convince them they are ok, They are released and get back into the city before the officers have finished their paperwork. Even if the hospital agrees that the pt is in need of 72 hr hold, the pt may be released prior to the 72 hrs, if they know how to work the system

In Los Angeles County, there is the LPS Act, which is very specific about holds, restraints, etc. My son, who is autistic, was at school, when the security gusrd provoked him and ended up with my son in handcuffs, leg shackles and being transported to the local ER for clearance, before going to the psych unit. When I got to the hospital, I found out they didn't even have a hold written. I advised the MD what he was doing was against the law, he refused to listen. My son suffered major psych trauma, which, 3 years later, he is still in counseling over. The school district, MD, and hospital were sued and the hospital settled out of court. He has a developmental disability, not a psychiatric problem, well he has one now.

[CATHYW]

When I worked in FL, the law was that a Police person could INITIATE a Form-52 (aka "Baker Act" & Involuntary commitment) but the form had to be co-signed either by a Physician or a judge who had seen the person in question. Our ER was always busy with those folks coming in to get an officer's Form-52 corroborated. This was to protect someone (i.e., an officer's spouse, for instance, from being railroaded into being committed as a convenience to the officer).

[Orca, ADN, ASN, RN]

In Nevada, law enforcement officials may take anyone into custody who presents a danger to self or others, but they do not have direct authority to commit them to a mental health facility. Generally, the person is taken to a hospital emergency room where they are evaluated. Any physician (not just a psychiatrist) may initiate an emergency commitment order. In practice, this is generally done with the ER physician consulting with the psychiatrist on call. The ER doc completes the commitment order with the understanding that the psychiatrist will accept the patient for admission to the unit.

Commitment in this manner is deemed a Legal 2000 (referring to the year the statute was last amended). The order will hold the patient for 72 hours, after which the patient must either be discharged, allowed to sign in voluntarily, or commitment proceedings must be initiated with the mental health court.

Oklahoma had a similar system, except that the commitment was termed an EOD (Emergency Order of Detention). The same time frames applied.

I can see a huge potential for abuse in the Baker Act scenario. First, law enforcement officials are not qualified to assess a person's psychiatric status. Bizarre behavior can be due to a number of different things, not all of which require mental health treatment. I can also see them using it for people they are simply tired of dealing with (vagrants, chronic alcoholics, etc.), and dumping them on mental health units because they don't have grounds to arrest them. If physician verification is indeed required, it makes much more sense.

[Heidi]

In NZ the police can hold someone for the purpose of an assessment. Mental Health Act section 8A (application for assessment under MHA) can be filled in by anyone who is aged 18 and over and they must have seen the person within the last three days. A sec 8b must be (supporting or not supporting the application for assessment) must be done by a Doctor, either a general practitioner, registrar, medical officer of special scale etc. If the Doctor supports the application a duly authorised officer (usually a registered nurse) serves the proposed patient with sec 9 of the MHA which details that they are required to attend an assessment by a psychiatrist at a specified place, also gives the proposed patient their rights under the MHA. Sec 10 is the assessment of the proposed patient by the psychiatrist. If the psychiatrist from the assessment determines that the proposed patient does not meet the criteria (very fixed) of the MHA, they may offer informal admission or the proposed patient can go on their merry way. If the psychiatrist deems that the person meets the criteria of the MHA it then proceeds to sec 11 compulsary 5 day inpatient treatment and assessment. This can be discontinued at any time. The patient must be assessed regularily and if they are still under sec 11 on day five they are reassessed for sec 13 of the MHA which is a compulsary inpatient order for 14 days. The judge does not get involved untill the application is made for either a sec 30 (six month compulsary inpatient) or sec 29 community treatment order, however the info above needs to be implemented before this. Registered nurses anywhere in the hospital setting can apply sec 111 of the MHA for the patient to be held for up to 6 hours for the purpose of assessment under the MHA, this must be followed by an 8A. So NO police cannot place someone in a psychiatric hospital at their discretion but can request the crisis team to assess and can fill in an 8A. This was a very brief attempt to explain.