Civil Commitment

1
Civil Commitment
2
Mentally Ill

• "Mentally ill" means having a disorder of thought
  or mood which significantly impairs judgment,
  behavior, capacity to recognize reality, or
  ability to cope with the ordinary demands of
  life.
• O.C.G.A. 37-3-1  (2007)

3
Was Cho Commitable?

• 13- very withdrawn-counseling
• 14- comments about Columbine evaluation and
  antidepressant meds
• 16- therapy for shyness
• 20- violence in writing referral to counseling
  he refuses
• 21- annoying contact with coed referral to
  Police
• 21- disturbing emails and IM contact-in
  disguise--with coed

4
Cho

• 21- fails to keep appointment at counseling
  center
• 21- disappointment in love order to stay away
  from coed I might as well kill myself now
  police take to CSB imminent danger to self
  overnight for TDO at psych hospital
• 21- Discharge from hospital not a danger Judge
  orders outpatient tx notes describe no
  indication of psychosis, delusions, suicidal or
  homicidal ideationinsight and judgment normal.

5
Cases

• Lake v. Cameron (1966)  
• Mayock v. Martin (1968)  
• Lessard v. Schmidt (1972)
• OConnor v. Donaldson (1975)
• Addington v. Texas (1979)
• Zinermon v. Burch (1990)
• Norwood v. Hardy (1855)
• In re Holly (1988)
• Ruff v. Central State (1989)
• Ga Mental Health v Brady (1993)

6
Standards of Proof
100
99.44
Beyond a Reasonable Doubt
85
Clear and Convincing
65
Preponderance of the Evidence
50
Probable Cause
Reasonably Articulable Suspicion
1
7

• ADMISSION OF VOLUNTARY PATIENTS 
• The chief medical officer of any facility may
  receive for observation and diagnosis any patient
  who is 
• 12 years of age or older making application for
  admission,
• or
• under 18 years of age and for whom an application
  for admission is being made by his parent or
  guardian,
• or
• any patient who has been declared legally
  incompetent and for whom an application for
  admission is being made by a guardian
•   37-3-20

8
Treatment  If found to show evidence of mental
illness and to be suitable for treatment, a
voluntary patient may be given care and treatment
at the receiving facility.  The parents or
guardian of a minor child must give written
consent to such treatment
37-3-20
9
 Right of Voluntary Patient to Discharge on
Application  A voluntary patient, other than a
minor child, or any voluntary patient's personal
representative may request such patient's
discharge in writing at any time after his
admission.  The patient may submit his written
request to the chief medical officer.  If a
voluntary patient submits an oral request for
discharge, a staff member must assist him Once a
written request has been delivered to the chief
medical officer, the voluntary patient must be
discharged within 72 hours, excluding Sundays and
legal holidays.  If patient would be unsafe for
the patient or others  and proceedings for
involuntary treatment must be initiated
37-3-22
10
Notice of rights to release  At the time of his
admission and each six months thereafter, any
voluntary patient admitted to a facility or
transferred to voluntary status shall be notified
in writing of his right to discharge upon
application and of all other rights granted to
patients.  Transfer to voluntary status 
37-3-24 An involuntary patient may
submit an application for a transfer to voluntary
status of hospitalization at any time if  he is
able to understand and exercise the rights and
powers of a voluntary patient, and the chief
medical officer finds that this would be in the
best interests of the patient.
37-3-23
11

• Notice of Transfer 
• 37-3-24
• In the event that a patient is transferred from
  involuntary to voluntary status, or thereafter
  discharged, notice of transfer or discharge shall
  be given to 
• to the patient and his representatives
• if the patient's hospitalization was ordered by
  the court, to the court which entered such order
• if the patient was admitted to a facility by a
  physicians certificate, to the physician or
  psychologist executing the certificate and
• if the patient was under criminal charges, to the
  law enforcement agency originally having custody
  of the patient.
•  

12
Admission to an Emergency Receiving
Facility   The court of the county in which a
person may be found may issue an order for
involuntary hospitalization  based upon a sworn
petition from a community mental health center,
or an unexpired certificate issued by any
physician within the state, or based upon the
affidavits of at least two persons,   that a
person is believed to be  mentally ill, and in
need of involuntary treatment. 37-3-41  
13
Judicial Order The order will require that the
person be  taken into custody, and delivered
forthwith for examination by a physician.  The
court order will expire seven days after it is
executed. 
The evaluation of the patient will be conducted
by someone who is  a psychologist, clinical
social worker, or clinical nurse specialist in
psychiatric/mental health and authorized to
practice under state law.
14
Admission to an Emergency Receiving Facility
Police Officer   A law enforcement officer may
take a person into custody and transport him to
an emergency receiving facility for evaluation
without judicial authorization if  the person
is committing a penal offense, and the peace
officer has probable cause for believing that the
person is mentally ill and in need of
involuntary treatment
37-3-42
15
Time Limits Evaluation and Custody  A patient
shall be examined by a physician as soon
thereafter as possible.  The patient must be
examined within 48 hours.  The patient must be
discharged within 48 hours of his arrival
unless  An examining physician or psychologist
executes a certificate stating that there is
reason to believe that the person may
be mentally ill and in need of involuntary
treatment,or the patient is under criminal
charges, notice of which has been given in
writing to the facility.   Within 24 hours of the
execution of the certificate the patient shall
be transported to an evaluating facility
16
Evaluation Power to Discharge   A patient who
has been admitted to an evaluating facility may
be detained for a period not to exceed five days,
Saturdays, Sundays, and holidays excluded.  At
the expiration of the five day period, the
patient must be discharged unless   Within that
period The patient is admitted as a voluntary
patient or The patient is admitted for
involuntary inpatient treatment. or the patient
is under criminal charges, notice of which has
been given in writing to the facility.  
17

• Involuntary Commitment Procedure  
• Any person may file a sworn application with the
  community mental health center for a court
  ordered evaluation of a person believed to be 
  mentally ill and in need of involuntary
  treatment.
•  The community health center will then conduct an
  evaluation of the person, and if the person is
  found to be as alleged, the center will file a
  petition with the Court. 

37-3-61
18
Any person may file a sworn petition with the
court alleging that a person is believed to
be  mentally ill and In need of involuntary
treatment. The petition must be accompanied by a
physicians certificate which states  the
physician has examined the person within the
preceding 5 days, the person may be mentally ill
and in need of involuntary treatment, and a full
evaluation of the patient is necessary.  
37-3-61
19
Notice of Hearing  Any petition for a court
ordered evaluation will be reviewed by the court,
and if it finds reasonable cause to believe that
the person is mentally ill and in need of
involuntary treatment  the court shall hold a
full and fair hearing on the petition between 10
and 15 days after the filing of the
petitionand the court shall serve notice of the
hearing upon the patient and his
representatives and the petitioner.  
20
Notice of the hearing shall include  time and
place of the hearing notice of the patients
right to counsel that the patient may request
court appointed counsel if he cannot afford his
own counsel that the court will appoint counsel
unless the patient waives his right to counsel in
writing and notice that the patient may waive
his rights to a hearing.   After a full and fair
hearing or, if the hearing is waived, after a
full review of the evidence, if the court is
satisfied that immediate evaluation is
necessary, the court shall issue an order to
admit the person to a designated facility for
evaluation.
37-3-62
21
Notice of Other Rights  If an evaluating
facility has petitioned for a court hearing and
in doing so has detained a patient past the five
days allotted for evaluation, then five days
prior to the hearing the patient must
receive  a copy of the individualized service
plan developed by the facility notice that the
patient has a right to be examined by a physician
or psychologist of his own choice at his own
expense and to have that physician or
psychologist submit a suggested service plan for
the patient And all other rights required by
notice of the court hearing.
22
 Immediately upon arrival at an emergency
receiving facility, the facility shall give the
patient written notice of  his right to
petition for a writ of habeas corpus his right
to petition for a protective order his right to
legal counsel and that, if the patient is
unable to afford counsel, the court will appoint
counsel for him.
37-3-62
23

• Matters to be Determined at Hearing
•   37-3-81.1
• At the hearing , the court shall determine
  whether the patient is 
• mentally ill
• and
• in need of involuntary treatment
•  and, if so, whether the patient is
• an inpatient
• or
• an outpatient
• and,
• the type of involuntary treatment the patient
  should be ordered to obtain.
•  

24
At such hearing, if the court determines 
37-3-81.1 That the patient is not a mentally ill
person requiring involuntary treatment, the court
shall order that the patient be immediately
discharged That the patient is an outpatient,
the court shall further determine if outpatient
care is acceptable and available for the
particular patient If the requirements are met,
the court shall order the patient to obtain that
treatment and shall discharge the patient subject
to such order
25
If the requirements are not met, and The patient
has been admitted to a facility and has received
an evaluation within 45 days prior to the date of
the hearing, the court shall order that the
patient be discharged Or The patient has not
been admitted to a facility and received an
evaluation within 45 days prior to the date of
the hearing, the court shall order that the
patient be admitted to an evaluating
facility. That the patient is an inpatient, the
court shall order that the patient shall be
transported to a treatment facility where the
patient shall be admitted for care and treatment.
37-3-81.1
26
 Duration of Hospitalization  If the court
determines that involuntary hospitalization is
necessary, the judge must issue a written order
to place the patient in an evaluating facility
for any period not longer than six months.
27
Hearing Examiners

• Appointed by the Supreme Court
• Must be member of the Bar
• Powers
• Administer Oaths
• Issue Subpoenas
• Make evidentiary rulings
• Regulate the hearings, generally

37-3-84
28
Transportation

• The county of the patients residence must
  provide transportation

29
Rights Retained

• Patients shall retain all rights and privileges
  granted to other persons or citizens
• Including civil, political, personal or property
  rights
• Not to be considered legally incompetent for any
  purpose

37-3-140