ACCESSING
VOLUNTARY
TREATMENT
Who
provides mental health services?
Private therapists, community mental health agencies,
private and public hospitals, and state-operated mental health centers offer
mental health services.
If
a person is willing to seek mental health services, how does he/she go
about it?
Outpatient mental health services from a private
therapist or community mental health agency are usually scheduled in advance.
Call the therapist or agency for an appointment. Your local NAMI chapter can
provide you with names and phone numbers for mental health service providers.
In the Chicago area, Call NAMI of Greater Chicago at (312) 563-0445.
When your friend or family member is being treated by
a doctor or at a community mental health agency program, and you believe that
the person’s condition is deteriorating, contact the doctor or therapists to
discuss your concerns. If necessary, the treating therapists should assist you
in initiating the process to have the person evaluated for inpatient
admission.
If
the person needs hospitalization and is willing?
Inpatient mental health services are available at
private hospitals and at state-operated mental health centers. A visit to the
Emergency Room of a private hospital, or the Central Intake of a state operated
mental health center will result in an evaluation by a staff physician who can
approve an admission. Whenever possible, call ahead to determine that the
hospital has a psychiatric unit, or in the case of state operated mental health
center that it is the correct facility serving the person’s home address.
After an evaluation at a hospital
or state operated psychiatric facility, and a doctor’s determination that the
person needs inpatient admission, if the person is willing to sign in as a
voluntary patient, the person is admitted. (This is the most common and usual
procedure).
If a
person is not willing to seek mental health services – continue to read
the next section…
For
additional information – Call (312) 563-0445
The Alliance for the Mentally Ill
NAMI of Greater Chicago
1536 West Chicago Avenue, Chicago, IL 60622
ACCESSING
INVOLUNTARY TREATMENT
IN
A SERIOUS EMERGENCY - Call 911.
If there is an immediate threat of harm either
to the person in need of mental health services or to anyone else - call 911 to
summon emergency police assistance, ask for CIT (Crisis Intervention Team)
trained officers to be sent. Whenever possible, warn the responding police
that the person in need of assistance is in need of medical attention for a
mental illness and that police assistance is needed to transport the
individual to a mental health treatment hospital or facility. When the police
are summoned via a 911 call, they will use their discretion to decide whether
the individual needs to go a hospital, or to jail, and they have the option to
do nothing. Ideally, family members or friends will be able to influence the
decision in the direction of seeking medical treatment rather than
incarceration, but sadly, this is not always possible.
IN
A POTENTIALLY SERIOUS SITUATION -
File
a Petition at a States Attorney’s Office
To file a Petition, contact your local States Attorney’s
office (in Cook County call 312-603-8600). Anyone over the age of eighteen (family
member, friend, neighbor, etc.) can complete a petition asserting another
person needs mental health services.
Public Act
95‑602, Section 1‑119 which became effective June 1, 2008 states
that a "person subject to
involuntary admission" is:
(1) A person with mental
illness and who because of his or her illness is reasonably expected to engage
in dangerous conduct which may include threatening behavior or conduct that
places that person or another individual in reasonable expectation of being
harmed;
(2) A person with mental
illness and who because of his or her illness is unable to provide for his
or her basic physical needs so as to guard himself or herself from serious harm
without the assistance of family or outside help; or
(3) A person with mental illness
who, because of the nature of his or her illness, is unable to understand his
or her need for treatment and who, if not treated, is reasonably expected to
suffer or continue to suffer mental deterioration or emotional deterioration,
or both, to the point that the person is reasonably expected to engage in
dangerous conduct.
In determining whether a
person meets the criteria specified in paragraph (1), (2), or (3), the court
may consider evidence of the person's repeated past pattern of specific behavior
and actions related to the person's illness.
Continued →
The
petition should list descriptions of behavior including
time
and place, the name address and phone number of any
witness(es)
to these acts, the relationship of the person to the person being considered
for treatment, and names and addresses of spouse, parent, guardian, close
relative, or any known friend of the person being considered for treatment.
After the States Attorney accepts a petition, they
issue a WRIT for PSYCHIATRIC EVALUATION. This Writ for Psychiatric Evaluation
orders the police to pick up the person in need of treatment and to transport
them immediately to a hospital for a psychiatric evaluation. (This method eliminates
the possibility that the police could decide either to do nothing and/or to
take the person to jail).
** If the States Attorney is
unwilling to file the petition, you can hire a private attorney to do so.
At the hospital,
the person will be evaluated by a physician, and if the physician recommends
hospitalization, the person may be given the option to sign into the hospital
as a voluntary patient, or the doctor will complete a FIRST CERTIFICATE, which
will hold the person in the hospital for up to 24 hours, stating that the
person is subject to an involuntary admission. Within these 24 hours, the
individual must be examined by another physician, and if this physician agrees
that this person needs to be held in the hospital whether or not the person
agrees, a SECOND CERTIFICATE will be completed and the process of Court Review
by a Judge will be initiated.
What
happens at a Court Hearing for Involuntary Admission?
The court hearing takes place about five days after
the petition and both certificates are filed with the court in the person’s
county. At the court hearing, the patient will be represented by an attorney
(either a private attorney or a court-appointed attorney), and the petitioner
is represented by the States Attorney. Each attorney presents his case to the
judge, calling witnesses to testify to the facts in the matter. The States
Attorney will be attempting to persuade the court that the person is mentally
ill, is in need of treatment for this mental illness because his/her condition
is deteriorating and either has already, or is likely to result in harm to the
person or to others, and/or that the person cannot provide for their basic
physical needs to guard against serious harm. The court-appointed lawyer’s
task is to protect the rights of the person being subjected to an involuntary
admission, to guard against the possibility that persons could be wrongfully
deprived of their liberty.
If the court rules that the person is subject to an
involuntary admission, the person is then committed to a treatment program.
COURT
ORDERED TREATMENT
Court ordered treatment is called COMMITMENT. The
person is then said to be “committed” to treatment. In reality, the court
order holds both the committed person, and the treating professionals
responsible for following through with the order for treatment and for
accounting to the court for their actions during the period of the commitment.
How
long does the commitment last?
The court order for commitment is effective for a
maximum of 90 days, but the court may specify a shorter time. The court order
may be extended for an additional 90 days at the request of the facility or
program director who must give the court clear indications of the need to
extend the commitment.
If the facility or program director determines that a
person no longer needs to be committed, they may release them before the
expiration of the court order.
Does
the person have to be committed to a hospital?
No, a person can be committed to a community mental
health program as an outpatient, or even into another person’s care instead.
The court will require proof that the community program will accept
responsibility for the person and may require detailed plans for treatment.
Does
commitment mean that a person will be forced to take medication?
No, people who have been committed retain their right
to refuse treatment.
Under
what circumstances can someone be medicated against their will?
In an emergency to prevent a person from causing
serious and imminent harm to her/himself or others, a person may be medicated
without a court hearing.
Following a court hearing, a person (whether
in-patient or outpatient) can be medicated if s/he meets all of the following
criteria: (a) the person has a serious mental illness; (b) the person’s ability
to function is deteriorating or s/he is suffering or exhibiting threatening
behavior; (c) the benefits of treatment outweigh the harm; (d) the person lacks
the capacity to make a reasoned decision about the treatment; and (e) less
restrictive service have been found inappropriate.
For
persons who are hospitalized, this bill amends the conditions under which
involuntary medication or other treatment can be authorized to include
“current” deterioration “as compared to the recipient’s ability to function
prior to the current onset of symptoms of the mental illness or disability for
which treatment is presently sought.”
If
someone can be committed so they can’t harm anyone in the near future, why can’t
they be forced to take medication for the same reason?
The difference is the immediacy of the danger. The
commitment standard requires a reasonable expectation that harm will occur in
the near future. The standard for overriding an objection to medication is to
prevent harm from occurring now.
Does
someone have to be hurt before a person can be committed or forced to take
medication?
No, the court is not required to wait until the person
injures himself or someone else before ordering commitment, or ordering the
person to take medication over their objection. ☼
