Unfortunately, within the last several years, we as Pittsburghers have had many tragic events which involve individuals with a mental health background committing acts of violence within our community.
This begs the question: What are the procedures in place for dealing with someone who presents with a mental health concern and how does starting the process affect the individual’s life?
Pennsylvania has 2 major types of mental health examination and treatment: voluntary and involuntary.
Voluntary Examination and Treatment (201)
Pennsylvania law says that anyone who is 14 and older, who believes that he/she is in need of treatment and substantially understands the nature of voluntary treatment, can submit him/herself to examination and treatment as long as his/her decision is made voluntarily.
Before someone is accepted for a voluntary commitment, he/she must receive:
- An explanation of the treatment including the types of treatment;
- An explanation of any restraints or restrictions, and
- A statement of the individual’s rights under the mental health laws
In addition, he/she must sign a written consent which states that the individual:
- Understands that his/her treatment will be inpatient;
- Is willing to be admitted to the facility for evaluation and treatment;
- Consents to the admission voluntarily and without duress, and
- If applicable, that he/she agrees to remain in the facility no longer than 72 hours after giving notice of his/her desire to withdraw (this is for individuals who were involuntarily committed, but that commitment has changed to a voluntary one)
Any person who has voluntarily committed his/herself can withdraw from the facility by notifying the facility in writing.
Involuntary Examination and Treatment (302)
Under Pennsylvania law, whenever someone is severely mentally ill and is in need of immediate treatment, he/she may be subject to involuntary commitment.
The definition of “severely mentally ill” is that the person, as a result of mental illness, has a diminished capacity to exercise self-control, judgment and discretion in the conduct of his/her own affairs and social relations, or his/her care of his/her own personal needs is so lessened that he/she poses a clear and present danger of harm to him/herself or others.
Clear Danger to Others:
Within the past 30 days, the person has inflicted or attempted to inflict serious bodily harm on another and there is a reasonable probability that the conduct will be repeated.
Clear Danger to Self:
Within the past 30 days, has acted in a manner to show that he/she is unable to satisfy the need for nourishment, shelter, safety, personal, or medical care, etc., and that there is a reasonable probability that death, disability, or serious injury would occur, OR
The person has attempted suicide and that there is a reasonable probability of suicide (the person will have not only made threats, but committed some act in furtherance of the threat), or the person has attempted to or has substantially mutilated him/herself.
Who can petition for the commitment?
A physician, police officer, someone authorized by the county administrator to make such a determination, or the person themselves.
What rights does the patient have upon being committed involuntarily?
The patient has the right to:
- Be examined by a physician within 2 hours of arrival to determine if he/she is severely mentally disabled
- Communicate with others (including reasonable use of the telephone)
- Provide the names and contact information of the people he/she wants to notify of the custody
- Have the facility contact those people on the patients list and inform them as to how they may contact/visit him/her and receive information about him/her while he/she is in treatment
- Have reasonable steps taken to ensure that his/her personal property and where he/she stays is secure
- Have a reasonable assurance that the health and safety needs of any of his/her dependents have been met
How long can a patient stay in the facility in an involuntary commitment?
Unless the patient consents to a voluntary commitment, or the physician petitions to have the stay extended, the patient should be discharged whenever it is felt he/she is no longer in need of treatment. That being said, it is common for a physician to recommend either an extended stay or additional treatment as an outpatient. The patient has a right to appeal at each stage of the involuntary commitment process. A public defender will be provided to the patient regardless of income. That being said, a patient can also retain his/her own attorney as well.
For a voluntary commitment, there is no time limit. A patient may stay as long as he/she and his/her doctor feel there is a continued need for in-patient treatment.
How does having a mental health record impact a patient’s future?
The Mental Health Procedures Act requires all counties to submit to the Pennsylvania State Police the names of people who have been involuntarily committed. The Act also prohibits anyone who has been involuntarily committed to possess, use, manufacture, control or sell firearms. You do have the right to petition the court (in Allegheny County it’s Orphans’ Court) to expunge the record, but that can at times be a lengthy process with not only the admitting physician, but also the state police opposing the expungement.
Anytime a criminal background check is requested this will likely come up as well.
If someone is having a mental health crisis, how do I get help?
Telephone and mobile crisis services are available from the county 24 hours a day, seven days a week by calling 1-888-796-8226.
For more information or for a referral to an attorney practicing in the field of mental health law, contact the Allegheny County Bar Association Lawyer Referral Service at 412-261-5555.