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 other members of their communities. For example, mentally ill individuals may injure themselves and others, which 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 disability which makes the affected people neglect themselves to an extent of not being able to acquire basics of life. The American society including the legal and medical systems gives priority to the protection of lives and 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 themselves 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 the people with mental illness in the state of Minnesota.
In Minnesota, people showing signs of being a threat to themselves or others can be committed for involuntary treatment. Actions like attempting suicide or being violent warrants commitment where a mentally ill person is examined by a therapist, a mental health specialist, and a physician among others. Health specialists can commit a person when he or she judges the mentally ill individual as requiring immediate intervention through 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 examines the individual and fills in 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 provided, 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 a 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 assist in 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. Depending on the case at hand and/or the parties, 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 kept under a close supervision of a mental health specialist until they certify that he/she is no longer a danger to himself 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 a person to be committed for inpatient treatment in Minnesota, one has to meet the following criteria. Whether a person poses or is likely to pose danger to him/herself or others is concluded after he/she exhibits one or all of the fallowing characteristics. First, one is unable to obtain necessities of life (clothing, shelter, food or medical care) as a result of impairment. Secondly, a person has a serious psychiatric condition making him/her likely to suffer extensive harm or is seriously ill or debilitated. Thirdly, a person 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 the reduced ability to care for him/herself and have more than 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 provided. Generally, there are 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 the extensive medical examination or a court hearing. The patient can 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 a hospital. This hearing is presided over by a judge where both parties can be represented by 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 that provides a sworn statement explaining how the respondent’s and others' lives 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 is very important. However, during a court hearing, the respondent can him/herself or through a lawyer contest his or her commitment. Most respondents try to prove that they do not 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 they 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 that 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 ensures that no individual is 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, a routine check-up examination is carried out on a regular basis every 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 period 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 he/she can be released as soon as he/ she has recovered and does not pose a danger to him/herself 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 such a need arises; otherwise, 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 save communities from 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 due to their mental health problems. This is one of the reasons 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 require the procedure to be respectful. Additionally, committed people are guaranteed 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, courthouses, and 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 of the people who cannot make a voluntary choice to be treated due to their mental health conditions. This reinstates their self-esteem when they are wholly recovered.