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Involuntary Commitment in Washington State November 1, 2011

Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
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Washington State Mental Health System: Involuntary Commitment

Patient Rights

At all times in the legal process, patients have the right to agree to entry of a court order detaining them in a facility. Involuntary commitment should not be confused with competency to handle financial and legal affairs. Patients have the right to refuse psychiatric medication 24 hours prior to any court hearing. Patients have the right to have: an attorney to represent them (a public defender if unable to afford private counsel), witnesses to testify for them, to cross-examine witnesses against them, and to present documentary evidence. Patients have the right to testify or to remain silent. The Rules of Evidence apply to these hearings. Patients have the right to view and copy all petitions and reports in the court file as well to have adequate time to prepare for the hearing. Hearings are not closed but the patient has the right to object to the presence of others not involved with the case. The court decides if the hearing should be closed.

Basis for Involuntary Commitment

A person can be detained on any of three grounds: likelihood of serious harm to others; likelihood of serious harm to self; or most commonly, grave disability. Grave disability is defined as a condition in which a person, as a result of a mental disorder (a) is in danger of serious physical harm resulting from a failure to provide for his or her essential human needs of health or safety, or (b) manifests severe deterioration in routine functioning evidenced by repeated and escalating loss of cognitive or volitional control over his or her actions and is not receiving such care as is essential for his or her health or safety.

Initial Detention

A person can be detained by a Designated Mental Health Professional for up to 72 hours without a court order. The 72 hours does not include weekends or legal holidays. When being interviewed by the DMHP, the patient has the right to speak to an attorney and the right not to participate in the DMHP’s evaluation. The legal standard for the initial detention is probable cause.

14 Day Hearing

If the patient is not ready for release within the 72 hours, a petition for involuntary treatment is filed seeking detention for up to 14 days (calendar days). If the patient elects to have a contested hearing, then a judicial officer decides the outcome. There is no right to a jury trial. The petitioner cannot request detention for any other period of time (i.e., 9 days or 13 days). Once the court order is entered, the petitioners can release the patient before 14 days is completed if the patient is ready for release. The legal standard is preponderance of the evidence.

90 Day Hearing

If the patient requires treatment beyond 14 days, then a petition seeking detention for up to 90 days (calendar days) is filed. The petitioner cannot file for another 14 days nor for any other number of days. It has to be up to 90 days. The patient has a right to a jury trial (using a jury of 6 or 12 persons) or to have a bench trial as in the 14 day hearing. Jury trials may take up to 20 business days to occur. The patient also has the right to seek a second opinion regarding their mental status as well as the use of a professional such as a social worker to seek less restrictive placement for the patient. There may be a preliminary hearing for the court to formally advise the patient of his/her rights as well as to allow the attorneys and the court to deal with scheduling issues for contested cases. Once the 90 day order is entered, the petitioners can release the patient early if the patient is ready for release. The legal standard is clear, cogent convincing evidence.

180 Day Hearing

If the patient requires treatment beyond 90 days, then a petition for 180 days (calendar days) is filed. The petitioners cannot ask for another 90 days. It has to be 180 days. As with the 90 day hearing, the patient has the right to a jury trial, a second opinion and a preliminary hearing. The legal standard is clear, cogent and convincing evidence. The petitioners can release the patient early if the patient is ready for release.

Less Restrictive Alternatives

At any point the petitioners can ask that the patient be on a Less Restrictive Alternative (LRA), court-ordered treatment outside of the facility. Conditions the patient must comply with include living at a specific address, maintaining compliance with treatment, taking medications as prescribed, refraining from threats or acts of harm to self, others or property, as well as maintaining one’s own health and safety in the community. Possession of firearms is prohibited. Failure to comply with any of the LRA conditions results in being returned to the facility for a revocation hearing. The rights in Step 1 apply to revocation hearings. If the LRA is revoked, the patient is detained at the facility for the remainder of the commitment period (e.g., revoked 30 days into a 90 day LRA = 60 days at the facility). The patient may later be re-released on a new LRA. LRAs can be extended in 180 day increments (they start with 90 or 180 days).

This article was written by Carolyn Annette Elsey.

My Experience…

My experience was very different from the way this article is laid out. The Designated Mental Health Professional that handled my case interviewed me in a local hospital to determine whether I should be put on a 72 hour hold.  I entered the local hospital at around 10:00 a.m., and the DMHP finally interviewed me at around 5:30 p.m. She determined that I should be involuntarily committed, and the search was on to find a mental hospital that would take me. It took until midnight for a bed to open up.  At that point, I was strapped to a board (a four point restraint system) and loaded into an ambulance for my trip to the  mental hospital.

Around 48 hours after I arrived a the mental hospital, the mental hospital  presented me with a public defender who was supposed to represent me before a judge to determine whether I was going to be committed for 14 days.  Unfortunately for me, that representative took ill the day of my hearing, and I was represented by a different public defender who didn’t know my case.  In order to transport five of us to the court, we were loaded onto a van with windows tinted so dark that we couldn’t see out. The interior was outfitted to transport prisoners. We had no idea where we were going, and no one told us anything. When we got there, contrary to what this article says, I was not allowed to say anything to the judge in my defense at my hearing. I sat there in disbelief as the hearing happened right in front of my eyes as if I were a piece of furniture.

As a practical matter, when I was involuntarily committed, I wasn’t  privy to the laws, so I didn’t know that my rights had been violated.  Besides, who would I, a “crazy mental patient”, complain to?

Close to the end of my 14 day hold, the hospital wasn’t ready to release me, so the original public defender (who had fallen ill before my first hearing) again represented me at my second hearing. But she convinced me not to attend the second hearing.  As I hadn’t been involved in the first hearing, I assumed the next hearing would be a duplicate of the first (with no opportunity to speak), so I went along with her recommendation and stayed away.

I was released a week later, which meant I spent 21 days in the mental hospital at a cost of almost $60,000. But it was a conditional release, called Least Restrictive Treatment (LRT) instead of the Less Restrictive Alternative it was called in this article. They pointed out to me that I was still in treatment, and that if I didn’t follow the LRT, I would be re-committed to the mental hospital.



1. Jen Daisybee - November 1, 2011

It is important to know the laws, but as you said, the laws are not always precisely followed. I’m glad we at least have these laws in this country to prevent long-term, involuntary commitments from happening when they’re not necessary. I know in some of my commitments I was at such low points or so psychotic, I didn’t really care if I was kept in a hospital or not. But now, I dread the thought of ever being forced to enter one again. I know how little is actually accomplished in hospitals in the way of actually helping people. They are good for keeping people alive and dispensing medications, but I think tha tis about all they are good at in the U.S.

2. LunaSunshine - November 3, 2011

That is absolutely awful. But, it’s unfortunately common. Just because there is a judicial process, it doesn’t mean that it is just at all.

My husband voluntarily hospitalized himself 7 years ago. He didn’t feel as if he was receiving adequate care, and he didnt feel as if he was a threat to himself anymore. So, he went to sign himself out. When he did, they stopped him at the desk. They threatened him that if he walked out that door, that they’d have a court order to detain him again in a few hours. They had no right, but my husband was being manipulated. So he spend another 7 days being “voluntarily” hospitalized.

Pretty twisted stuff.

3. Hannah - November 10, 2011

Gosh, it’s unbelievable reading the way you were treated, even more so as it was a violation of the law. Just found your blog – think it is fab, can’t wait till I have a bit more time to explore & read more! Thank you x

4. FC - November 15, 2011

I am surprised you were even committed in the first place. I’m the relative of someone with a mental illness and I can’t stand the whole MHP process. I’ve been looking into trying to change the laws by checking out the Treatment Advocacy Center, but nothing’s going to happen while the state keeps cutting.

5. John - February 23, 2012

For voluntary commitment I spent 6 days locked in a room ( strapped in a 2 point harness for the better part of that) before a court order was signed for 14 day commitment. Is that even legal?

6. MentalHealthAdvocate (@MentalHealthCAN) - December 9, 2012

What’s up with the psychiatric medical profession? Are some cherry picking their patients? How do capable citizens defend themselves when medical staff refuse their requested call to lawyer to check the validity of their detention?

Imagine what happens when a capable citizen is forced to defend themselves against fabricated information provided to police by a caller Acting in Bad Faith who are out to discredit that person in order to take control of their affairs money unlawfully.

Who’s Watching the Watchers?

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