Emergency Admission: Help for Mental Conditions

Posted on December 16, 2017

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By Jennifer Rainville

Mental Health conditions are prevalent. According to the National Alliance on Mental Illness (NAMI), at least 40% of adults experience a mental health issue that substantially interferes with one or more major life activities. However, those suffering from mental illness are not always willing to seek treatment. Indeed, often one of the results of their illness is a distrust of the medical profession. So what do you do when a person you care about won’t get treatment when they need it?

There are two different ways that a court in South Carolina can force a person to get treatment for their mental health conditions: (1) an Emergency Admission, and (2) a Petition for Judicial Commitment. This article will only address the Emergency Admission.

The procedure for the emergency admission varies county to county, so you should check with the Probate Court in the county where the person in crisis is located. However, the criteria is the same statewide. A person who is in need of involuntary commitment must be likely to cause serious harm to themselves or others if not immediately hospitalized. The law defines serious harm as a substantial risk of physical harm or injury to you or to others. The best example of this is a person who is suicidal or homicidal. You must also have first-hand information about the mental state of the person in crisis. This means that you have to witness the behavior with your own eyes or ears.

Depending on the situation, you may need to call local law enforcement to immediately intervene if your family member is likely to cause serious harm to themselves or others. Or, more ideally, depending on the threat of harm, you may be able to transport your family member to the emergency room at the local hospital, and explain to the staff that they need to be evaluated for involuntary commitment. If either of those options are not available to you, you should contact the Probate Court in the jurisdiction where the person in crisis is located to find out what that court’s procedures are for Emergency Admission. Some courts require that the individual with first-hand information come down to the court and complete an affidavit with the court staff; other courts require that you go to the local Department of Mental Health (DMH) office and complete the affidavit there.

Once the affidavit is complete, the Probate Court can issue something called a Detention Order. This Order is good for 72 hours, and allows law enforcement to pick up the person in crisis and take them into custody for up to 24 hours for the sole purpose of having them evaluated by a physician. When the person in crisis is picked up will depend on where they are taken to be evaluated. Typically, evaluations are conducted at the local DMH office or the local emergency room.

The person in crisis is evaluated by a physician, and that physician will either certify that the person is in need of involuntary commitment, or not. If the person in crisis is not in need of involuntary commitment, they are discharged and the process is over. (There is still, however, the option to file a Judicial Petition for Admission, which will be explained in a later article.)

If the person in crisis is in need of involuntary commitment, the physician signs a certification that allows that individual to be committed to a mental health facility. This certification is sent to the Probate Court. Sometimes it can take a day, or several days, to find a bed for the person in crisis. This may mean that person remains in the emergency room getting treatment until a bed can be secured.

Within 48 hours of a person’s involuntary admission to a psychiatric hospital, the Affidavit and Certification must be sent to the Probate Court. The Court must review these documents to see if there is probable cause to continue the emergency involuntary hospitalization. Weekends and holidays do not count toward the 48 hours. Probable cause means there is a reasonable likelihood that the information in the Affidavit and the Certification is correct. Basically, the Affidavit and Certification must indicate that there are still good reasons for an emergency commitment.

The court will then set a hearing date and appoint designated examiners to evaluate the person. The court must hold a hearing within 15 days of the initial involuntary commitment if the person has not been discharged. If the person goes to a hearing, the court will appoint an attorney and a Guardian Ad Litem at no charge.

The Court has to provide a five-day notice in advance of the hearing for the involuntarily committed person, who has a right to attend the hearing. Their attorney and Guardian Ad Litem have the ability to question and cross-examine any witnesses. This includes the designated examiners. Based on the testimony and evidence, the court will make a decision as to whether or not continued involuntary commitment is needed or outpatient treatment is needed. Even if the court rules against involuntary confinement, the court can require your family member to continue with outpatient treatment after discharge.

All Probate Court records of involuntary commitment proceedings are completely confidential, with exception to adjudications of mental illness or incapacity, after which the court is required to report these to the State Law Enforcement Division (SLED), as firearm ownership and possession can be restricted. There is a process to have this restriction lifted, and you should contact your local probate court to learn more.

To learn more about mental health statistics and figures check out www.nami.org. To learn more about involuntary commitment in your county, contact your county Probate Court or your county mental health agency. For a complete list of DMH locations visit www.state.sc.us/dmh/countymap.htm

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