involuntary committments by POLICE!

  1. 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
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    About PGH70

    Joined: Oct '01; Posts: 16
    psych RN


  3. by   donmurray
    Similar police powers exist in England, but removing the person to "A place of safety" is the key phrase. A place of safety can be a hospital, but also a hostel, psych registered nursing home, or a police station. The hospital has no obligation to accept the "request" for admission, and in practice most assessments are done in police cells.
  4. by   delirium
    In my state, the police can bring in patients for psychiatric evaluation on 'emergency petition'. That means either the police think he/she is a danger to him/herself or others or someone else does. If its a layperson, they must file a petition in a court, get a judge to sign it, and then the police carry it out and gather up the person (much like an arrest warrant) and take them to the emergency room.
    The petition does not mean that the person will be confined for 72 hours, however. It means the person must go to the emergency room and be evaluated and the person is not permitted to leave before the evaluation is completed.
    If, however, the psych evaluator and psychiatrist feel the person is stable and not a danger to anyone, they are often released. If not, they are generally hospitalized for a length of time to be determined by the health care team.
    I'm in Maryland, and although I am not yet a nurse, I have seen more than my share of emergency petitions come through the ER. Generally its the same 5 or 6 people.
  5. by   Mary Dover
    In NC ANYONE who has direct knowledge that a person presents a danger to themselves or others, can petition the magistrate to have them picked up by law enforcement. If the magistrate finds that there is enough information to support the request, he completes the affadavit. Once that happens, and they are taken into custody, they are taken before a physician (doesn't necessarily even have to be a psychiatrist) OR a licensed psychologist who does an initial assessment to determine if they meet criteria for involuntary committment. If they do, they are then sent to a psychiatric facility where a 2nd physician assessment must be done within 24 hours. At that point, they are either "committed" or discharged. If they are involuntarily committed - they have the option of signing themselves in, voluntarily (although that may not always be explained to them). At that point, technically, they can sign what's called a 72 hour hold, which means that they can legally be held for up to 72 more hours and if there is no evidence that supports they are still a danger, they must be distcharged - although it may be considered AMA.
  6. by   NZ RN
    well, in NZ the police could hold some one if they were seen to be a danger to them selves or others, but then they would have to be assessed under the mental health act pretty quickly.
  7. by   PGH70
    thanks for your responses. Do you feel sometimes the patient is committed unnecessarily? Our ER physicians never break the committment, our psychiatrists rarely break the committment out of fear of liability.
    I feel this system, although created for the public safety, over runs the health care sytem with needless admissions. Do you think we, as nurses, have any power to change this.????
  8. by   slinkeecat

    The ever wonderful BAKER ACT in Florida ..... 72 hr commitment to determine psych need. Totally abused down there when I was there. My experience was that many times the pt was brought in cuz of a careless judgement. However, here in WV it is worse...You can go and committ a person on basic hearsay in front of the mental hygiene comissioner, who is a lay person and has no psych knowlegde.... all it takes is a couple of witnesses to petition and a quicky eval at an ER where the doc is to afriad to not send them and has no clue about Axis I diagnoses and then you are committed for a 30 day eval & treat period... it is frightening. YEP YEP I know where you are coming from.....
  9. by   slinkeecat
    And usually it is the weekend drinker who gets out of control under the influence and gets committed for being a jackass one night and the person with schizophrenia is walking down the street worsening from being off meds or whatnot and they are not being treated because the beds are filled up with people with behavior problems rather than true psychotic issues...... CAN I GET AN AMEN?????
  10. by   PJRNC2
    AMEN and AMEN
  11. by   nakitamoon
    Living and Working in Fl,,,,,,,,, Yes we do have the baker act,,,,,,,
    I find that in assisted living,,,,,, It is very hard to get patient baker acted,,,,, PCP has to sign psych,,,has to agree to see,,,,,

    Those ppl on the street,,,,, police can deliever them to hosp ER where they will be put in mental health unit for 72 hours,,,,,

    If it is your family member or friend,,,,, police would prefer you handle it,,,,, transport,,,,, etc,,,,,,

    This is good if needed,,,,,,,, Dont' think it should be used,,,, to get rid of problem for night,,,,,

    It's early,,,, worked 18 hours,,yesterday and coffee hasn't kicked in yet,,,,,, hope I made sense,,,,,,, lol ~Moon
  12. by   Nurse Ratched
    In our state, anyone can petition, a doctor (medical or psychiatric) has to agree and sign off on the 72 hour hold (this is actually 3 court day - weekends and holidays don't count.) If the person is still deemed a danger to himself or others after that time, a committment must be applied for within 5 days.

    I can't say I've seen it abused in my experience - the people who get put on 72 holds are dangers to themselves or others, or are gravely disabled at the time of admission.
  13. by   MHN
    where i work the police or a GP MD or mental health Officer can bring someone in for psych assessment on an emergency action they must be seen within 4hrs then can be placed on an emergency detention order and detained for 72hrs and reviewed by the mental health tribunal if they are to be held longer the psychiatrist must then apply for an extension of 7 days then if further treatment a PTO Psychiatric treatment order can be applied for at the mental health tribunal which can mean the person must be compliant with their meds ,reside at a specific facility or they can then be breached collected by the police and brought to the psych unit to comply these breaches can only be granted by the chief psychiatrist of the state.MHN
    Last edit by MHN on Aug 2, '02
  14. by   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.