The Mental Health Commitment Process (Minnesota)
Many Americans, like others citizens of the world suffer from various mental illnesses. This causes a situation in which such people become a danger to themselves or to other members of their communities. For example, mentally ill people may injure themselves and others: this largely imperils health and lives of people. In addition, people suffering from numerous forms of mental illnesses may engage in destruction of property. In some instances, mental illnesses cause a large extent of disability which makes the affected people to neglect themselves to an extent of not being able to acquire basics of life. The American society including the legal and the medical systems give priority to protection of lives and the wellbeing of the mentally ill and other members of their communities (Minnesota, 2013). Therefore, legal provisions for involuntary commitment of the mentally ill have been enacted in over 45 states in the US. This has been done since most mentally ill people may not be aware of their condition and the danger they pose to selves and other members of the society. The treatment is seen as ‘involuntary’ because it is authorized by the court through the state law. This paper will discuss the process of involuntary commitment for people with mental illness in the state of Minnesota.
In Minnesota, people showing signs of being a threat to their own selves or others can be committed for involuntary treatment. Actions like attempting suicide or being violent warrants commitment where the mentally ill person is evaluated by a therapist, a mental health specialist, a physician among others. Health specialists can commit a person when he or she judges the mentally ill person as requiring immediate intervention through immediate treatment. This can be warranted by the affected person attempting to commit suicide or threatening lives of others. In such a case, the health specialist provided evaluates the individual, fills the required legal forms. In addition, the specialist is required to swear in front of a judge confirming that the information provided is accurate. The authorities immediately pass the case to officers who escort the person committed to a state health facility. After emergency treatment is done, the patient can be called to a hearing to determine if the commitment should proceed. This is done within 72 hours (Minnesota, 2013).
Minnesota laws recognize that there are some instances in which immediate commitment of the mentally ill person is not warranted. A family member may file an application with the county or the city courthouse to have a relative or patient committed. If the applicant does not have enough grounds to have the patient committed immediately, the court schedules a hearing in which a judge is supposed to listen to the case and provide a verdict. A judge may also appoint a referee to determine the case. The applicant may be called to testify while the mentally ill person is supposed to defend him/herself: advocates defend such people to ensure that the process is legal. Dependent on the case at hand and/or the parties involved, advocates may be involved on both sides. When the cases is not concluded in one session, the applicant maybe advised to file for a restraining order to avoid injury from the respondent. When a judge decides that the respondent should be committed, the authorities provide local police officers to escort the respondent to a state mental facility where he is maintained under close supervision of mental health specialist until they certify that he/she is no longer a danger to self and others (Kemp, 2011).
By the end of the year 2014, an estimated 4500 adults out of the adult population of 4.1 million in the state of Minnesota suffered from schizophrenia while approximately 90000 of the same population had severe bipolar disorder. For one to be committed for inpatient treatment in Minnesota, one has to have passed the following criteria. Should pose or likely to pose danger to self or others; this is concluded after one exhibits one or all of the fallowing characteristics. First, when one is unable to obtain necessities of life (clothing, shelter, food or medical care) as a result of Impairment. Secondly, when a person has a serious psychiatric condition making him/her likely to suffer extensive harm or when one is seriously ill or debilitated. Thirdly, a person who has recently attempted to injure him/herself or others or violate rules leading to significant destruction to chattels qualifies to be committed.
A person who qualifies for outpatient commitment must manifest reduced ability to care for self, must have over two court-authorized commitments in the past 3 years (Engdahl, 2010). Additionally, the person must exhibit symptoms or behaviors noticeably similar to those that lead to hospitalization and/or the symptoms must rationally be projected to worsen to inpatient standards if timely intervention is not done. There are generally two types of holds. The first one is the emergency hold in which a mentally ill person is held in custody to prevent him from harming himself or others. The length of this hold is 72 hours.
After the expiry of this period, the fate of the patient is already decided through extensive medical examination or through a court hearing. The patient can either be released, revert to voluntary treatment or pursue a lengthier involuntary commitment. Involuntary commitment is preceded by an official court hearing conducted in the court of law or sometimes in a hospital. This hearing is presided over by a judge where the both parties can be represented by an advocates or attorneys. A judge can also appoint a referee to offer a verdict. In most cases in Minnesota, the judge rules in favor of an involuntary commitment if a psychiatrist or other mental health specialist provides a sworn statement explaining how the respondent’s life and others are likely to be endangered if the accused is released (Kemp, 2011). This form of hold lasts for three months. The requirements and the paperwork required to commit a person for three months include a judge’s ruling to have a patient committed which is supported by a sworn statement from health specialist confirming that the patient needs commitment. Sometimes, a sworn statement from a witness, a relative or local law enforcement officer is also required.
In Minnesota, it is almost impossible for one to contest a psychiatrist’s or physician’s decisions to have one held for compulsory treatment. The physician’s decision after examination holds. However, during a court hearing, the respondent can him/herself or through a lawyer challenge his or her commitment. Most respondents try to prove that they don’t meet the criteria described in the ‘Mental Health Act of 1983’. Such patients try to prove that they are not a danger to themselves and other people. If such patients can provide enough proof, the judge may not be in favor of commitment. An emerging trend in the state of Minnesota and other state is where advocates argue that the process of commitment is an infringement to the patient civil liberties enshrined in the US constitution. The US constitution in the Fifth Amendment bars any individual from being deprived of liberty, life and property without duly following the law. The fourteenth amendment bars states from doing the same. Questions are also raised on how mentally ill people can effectively participate in this court hearing. However, such people are in most cases adequately represented by various advocates (Stride, Wall & Catley, 2007).
For a temporary commitment for any patient, a routine check-up examination is carried out on a regular basis and mostly after a period of three months. If the conditions that led to involuntary commitment no longer hold, the patient is released and the judge or the referee is formally notified. At any time during the time of the hold, the patient can file an application to be moved to voluntary treatment for mental health conditions. This is widely encouraged in Minnesota. The application is evaluated and if granted, the committed person is shifted to voluntary treatment, where a patient can be released as soon as he/ she has recovered and does not pose a danger to self and others (Kemp, 2011). Medical and psychiatric examination is carried out to ensure that the patient is in a position to always come back for treatment if need arises, failure to which he/ she might not be released.
The commitment laws in Minnesota provide a platform on which mental health patients can get the help they need (Wexler & David, 2012). Additionally, these laws help to rid communities of the damages that could arise if such people are not treated. The general public in Minnesota may show stigma against people who have been committed to institutions for mental health problems. This is one of the reasons as to why many people would not like to be committed to such facilities. The process of commitment has been made smooth and humane through passing laws that requires the process to be respectful. Additionally, committed people are guaranteed of their rights. The law requires that officers handle the mentally ill persons with respect, explain that it is not an arrest, and reveal the facility of commitment among other details. Additionally, the institution, the courthouses and the communities ensure that fair hearings are held in which mentally ill people can be represented by attorneys or advocates. This makes the whole process fair. Even if the civil freedoms of the patient seem to be infringed on, the whole process saves lives especially to people who cannot make a voluntary choice to be treated due to their mental health statuses. This reinstates their self-esteem when they are wholly recovered.
Minnesota., & Minnesota. (2013). The Role of Physician Assistants in Outpatient Mental Health Care: A Report to the Minnesota Legislature.
Engdahl, S. (2010). Mental health. Farmington Hills, MI: Greenhaven Press/Gale Cengage Learning.
Wexler, David B. (2012). Mental Health Law: Major Issues. Springer Verlag.
Stride, C., Wall, T. D., & Catley, N. (2007). Measures of job satisfaction, organizational commitment, mental health, and job-related well-being: A bench-marking manual. Chichester, West Sussex: John Wiley & Sons.
Kemp, D. R. (2011). Mental health in America: A reference handbook. Santa Barbara, Calif: ABC-CLIO.