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Summary of State Assisted
Treatment Standards:
50 States and DC
Last updated June 2007
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ADDITIONAL INFORMATION
state-by-state chart
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Note that eight
states currently do not have assisted outpatient treatment laws:
Connecticut, Maine, Maryland, Massachusetts, Nevada, New Jersey, New Mexico, and
Tennessee.
Florida’s new law was effective January 1, 2005.
For inpatient:
ALA. CODE § 22-52-10.4
(a). A respondent may be committed to
inpatient treatment if the probate court finds, based upon clear and convincing evidence
that:
(i) the respondent is mentally
ill;
(ii) as a result of the mental illness
the respondent poses a real and present threat of substantial harm to self and/or
others;
(iii) the respondent will, if not
treated, continue to suffer mental distress and will continue to experience deterioration
of the ability to function independently; and
(iv) the respondent is unable to make
a rational and informed decision as to whether or not treatment for mental illness would
be desirable.
(b) If the probate judge finds that no
treatment is presently available for the respondent's mental illness, but that confinement
is necessary to prevent the respondent from causing substantial harm to himself or to
others, the order committing the respondent shall provide that, should treatment for the
respondent's mental illness become available at any time during the period of the
respondent's confinement, such treatment shall be made available to him immediately.
For outpatient:
ALA. CODE § 22-52-10.2. A respondent
may be committed to outpatient treatment if the probate court finds, based upon clear and
convincing evidence that:
(i) the respondent is mentally
ill;
(ii) as a result of the mental illness
the respondent will, if not treated, continue to suffer mental distress and will continue
to experience deterioration of the ability to function independently; and
(iii) the respondent is unable to make
a rational and informed decision as to whether or not treatment for mental illness would
be desirable.
For inpatient:
ALASKA STAT. § 47.30.755(a).
"[M]entally ill and as a result is likely to cause harm to self or others, or is
gravely disabled."
For outpatient:
ALASKA STAT. § 47.30.795. Involuntary
outpatient care for committed persons.
(a) A respondent who was originally
committed to involuntary inpatient care under AS 47.30.700 - 47.30.915 may be released
before the expiration of the commitment period if a provider of outpatient care accepts
the respondent for specified outpatient treatment for a period of time not to exceed the
duration of the commitment, and if the professional person in charge, or that person's
professional designee, finds that:
(1) it is not necessary to treat the
respondent as an inpatient to prevent the respondent from harming self or others;
and
(2) there is reason to believe that
the respondent's mental condition would improve as a result of the outpatient treatment.
ALASKA STAT. § 47.30.915(10).
"likely to cause serious harm" means a person who
(A) poses a substantial risk of bodily
harm to that person's self, as manifested by recent behavior causing, attempting, or
threatening that harm;
(B) poses a substantial risk of harm
to others as manifested by recent behavior causing, attempting, or threatening harm, and
is likely in the near future to cause physical injury, physical abuse, or substantial
property damage to another person; or
(C) manifests a current intent to
carry out plans of serious harm to that person's self or another
ALASKA STAT. § 47.30.915(7).
"gravely disabled" means a condition in which a person as a result of mental
illness
(A) is in danger of physical harm
arising from such complete neglect of basic needs for food, clothing, shelter, or personal
safety as to render serious accident, illness, or death highly probable if care by another
is not taken; or
(B) will, if not treated, suffer or
continue to suffer severe and abnormal mental, emotional, or physical distress, and this
distress is associated with significant impairment of judgment, reason, or behavior
causing a substantial deterioration of the person's previous ability to function
independently.
For both inpatient and outpatient:
ARIZ. REV. STAT. § 36-540 (A).
"If the court finds by clear and convincing evidence that the proposed patient, as a
result of mental disorder, is a danger to self, is a danger to others, is persistently or
acutely disabled or is gravely disabled and in need of treatment, and is either unwilling
or unable to accept voluntary treatment . . . ."
ARIZ. REV. STAT. § 36-501(5).
"Danger to others" means that the judgment of a person who has a mental disorder
is so impaired that he is unable to understand his need for treatment and as a result of
his mental disorder his continued behavior can reasonably be expected, on the basis of
competent medical opinion, to result in serious physical harm.
ARIZ. REV. STAT. § 36-501(6).
"Danger to self" means:
(a) Behavior which, as a result of a
mental disorder, constitutes a danger of inflicting serious physical harm upon oneself,
including attempted suicide or the serious threat thereof, if the threat is such that,
when considered in the light of its context and in light of the individual's previous
acts, it is substantially supportive of an expectation that the threat will be carried
out.
(b) Behavior which, as a result of a
mental disorder, will, without hospitalization, result in serious physical harm or serious
illness to the person, except that this definition shall not include behavior which
establishes only the condition of gravely disabled.
ARIZ. REV. STAT. § 36-501(16).
"Gravely disabled" means a condition evidenced by behavior in which a person, as
a result of a mental disorder, is likely to come to serious physical harm or serious
illness because he is unable to provide for his basic physical needs.
ARIZ. REV. STAT. § 36-501(33).
"Persistently or acutely disabled" means a severe mental disorder that meets all
the following criteria:
(a) If not treated has a substantial
probability of causing the person to suffer or continue to suffer severe and abnormal
mental, emotional or physical harm that significantly impairs judgment, reason, behavior
or capacity to recognize reality.
(b) Substantially impairs the person's
capacity to make an informed decision regarding treatment and this impairment causes the
person to be incapable of understanding and expressing an understanding of the advantages
and disadvantages of accepting treatment and understanding and expressing an understanding
of the alternatives to the particular treatment offered after the advantages,
disadvantages and alternatives are explained to that person.
(c) Has a reasonable prospect of being
treatable by outpatient, inpatient or combined inpatient and outpatient treatment.
For both inpatient and outpatient:
ARK. CODE ANN. § 20-47-207(c). A
person shall be eligible for involuntary admission if he or she is in such mental
condition as a result of mental illness, disease, or disorder that he or she poses a clear
and present danger to himself or herself or others;
(1) As used in this subsection,
"a clear and present danger to himself or herself" is established by
demonstrating that:
(A) The person has inflicted serious
bodily injury on himself or herself or has attempted suicide or serious self-injury, and
there is a reasonable probability that such conduct will be repeated if admission is not
ordered; or
(B) The person has threatened to
inflict serious bodily injury on himself or herself and there is a reasonable probability
that such conduct will occur if admission is not ordered; or
(C) The person's recent behavior or
behavior history demonstrates that he or she so lacks the capacity to care for his or her
own welfare that there is a reasonable probability of death, serious bodily injury, or
serious physical or mental debilitation if admission is not ordered; and
(2) As used in this subsection,
"a clear and present danger to others" is established by demonstrating that the
person has inflicted, attempted to inflict, or threatened to inflict serious bodily harm
on another, and there is a reasonable probability that such conduct will occur if
admission is not ordered.
For both inpatient and outpatient:
CALIF. WELF. & INST. CODE § 5250.
If a person is detained for 72 hours under the provisions of Article 1 (commencing with
Section 5150), or under court order for evaluation pursuant to Article 2 (commencing with
Section 5200) or Article 3 (commencing with Section 5225) and has received an evaluation,
he or she may be certified for not more than 14 days of intensive treatment related to the
mental disorder or impairment by chronic alcoholism, under the following conditions:
(a) The professional staff of the
agency or facility providing evaluation services has analyzed the person's condition and
has found the person is, as a result of mental disorder or impairment by chronic
alcoholism, a danger to others, or to himself or herself, or gravely disabled.
(b) The facility providing intensive
treatment is designated by the county to provide intensive treatment, and agrees to admit
the person. No facility shall be designated to provide intensive treatment unless it
complies with the certification review hearing required by this article. The procedures
shall be described in the county Short-Doyle plan as required by Section 5651.3.
(c) The person has been advised of the
need for, but has not been willing or able to accept, treatment on a voluntary basis.
(d)
(1) Notwithstanding paragraph (1) of
subdivision (h) of Section 5008, a person is not "gravely disabled" if that
person can survive safely without involuntary detention with the help of responsible
family, friends, or others who are both willing and able to help provide for the person's
basic personal needs for food, clothing, or shelter.
(2) However, unless they specifically
indicate in writing their willingness and ability to help, family, friends, or others
shall not be considered willing or able to provide this help.
(3) The purpose of this subdivision is
to avoid the necessity for, and the harmful effects of, requiring family, friends, and
others to publicly state, and requiring the certification review officer to publicly find,
that no one is willing or able to assist the mentally disordered person in providing for
the person's basic needs for food, clothing, or shelter."
CALIF. WELF. & INST. CODE §
5008(h)(1) "gravely disabled" means either of the following:
(A) A condition in which a person, as
a result of a mental disorder, is unable to provide for his or her basic personal needs
for food, clothing, or shelter.
(B) A condition in which a person, has
been found mentally incompetent under Section 1370 of the Penal Code and all of the
following facts exist:
(i) The indictment or information
pending against the defendant at the time of commitment charges a felony involving death,
great bodily harm, or a serious threat to the physical well-being of another person.
(ii) The indictment or information has
not been dismissed.
(iii) As a result of mental disorder,
the person is unable to understand the nature and purpose of the proceedings taken against
him or her and to assist counsel in the conduct of his or her defense in a rational
manner.
For outpatient via assisted outpatient
treatment*
5346. (a) In any county in which services are available as provided in Section 5348, a court may order a person who is the subject
of a petition filed pursuant to this section to obtain assisted outpatient treatment if the court finds, by clear and convincing evidence,
that the facts stated in the verified petition filed in accordance with this section are true and establish that all of the requisite criteria
set forth in this section are met, including, but not limited to, each of the following:
(1) The person is 18 years of age or older.
(2) The person is suffering from a mental illness as defined in paragraphs (2) and (3) of subdivision (b) of Section 5600.3.
(3) There has been a clinical determination that the person is unlikely to survive safely in the community without supervision.
(4) The person has a history of lack of compliance with treatment for his or her mental illness, in that at least one of the following
is true:
(A) The person's mental illness has, at least twice within the last 36 months, been a substantial factor in necessitating
hospitalization, or receipt of services in a forensic or other mental health unit of a state correctional facility or local correctional
facility, not including any period during which the person was hospitalized or incarcerated immediately preceding the filing of
the petition.
(B) The person's mental illness has resulted in one or more acts of serious and violent behavior toward himself or herself or another,
or threats, or attempts to cause serious physical harm to himself or herself or another within the last 48 months, not including
any period in which the person was hospitalized or incarcerated immediately preceding the filing of the petition.
(5) The person has been offered an opportunity to participate in a treatment plan by the director of the local mental health
department, or his or her designee, provided the treatment plan includes all of the services described in Section 5348, and the
person continues to fail to engage in treatment.
(6) The person's condition is substantially deteriorating.
(7) Participation in the assisted outpatient treatment program would be the least restrictive placement necessary to ensure the
person's recovery and stability.
(8) In view of the person's treatment history and current behavior, the person is in need of assisted outpatient treatment in order to
prevent a relapse or deterioration that would be likely to result in grave disability or serious harm to himself or herself, or to
others, as defined in Section 5150.
(9) It is likely that the person will benefit from assisted outpatient treatment.
* Standard
only applies in counties that have adopted provisions established by Assembly Bill 1421
(2002) (a.k.a. Laura’s Law); otherwise mandated outpatient treatment only permitted
via conservatorship process.]
For both inpatient and outpatient:
COLO. REV. STAT. § 27-10-111(1).
"The court or jury shall determine that the respondent is in need of care and
treatment only if the court or jury finds such person mentally ill and, as a result of
such mental illness, a danger to others or to himself or gravely disabled . . . ."
COLO. REV. STAT. § 27-10-102(5)
(a) "Gravely disabled" means
a condition in which a person, as a result of mental illness:
(I) Is in danger of serious physical
harm due to his inability or failure to provide himself the essential human needs of food,
clothing, shelter, and medical care; or
(II) Lacks judgment in the management
of his resources and in the conduct of his social relations to the extent that his health
or safety is significantly endangered and lacks the capacity to understand that this is
so.
(b) A person who, because of care
provided by a family member or by an individual with a similar relationship to the person,
is not in danger of serious physical harm or is not significantly endangered in accordance
with paragraph (a) of this subsection (5) may be deemed "gravely disabled" if
there is notice given that the support given by the family member or other individual who
has a similar relationship to the person is to be terminated and the individual with mental illness:
(I) Is diagnosed by a professional person as suffering from: Schizophrenia; a major affective disorder; a delusional disorder; or another mental disorder with psychotic features; and
(II) Has been certified, pursuant to
this article, for treatment of such disorder or has been admitted as an inpatient to a
treatment facility for treatment of such disorder at least twice during the last
thirty-six months with a period of at least thirty days between certifications or
admissions; and
(III) Is exhibiting a deteriorating
course leading toward danger to self or others or toward the conditions described in
paragraph (a) of this subsection (5) with symptoms and behavior which are substantially
similar to those which preceded and were associated with his hospital admissions or
certifications for treatment; and
(IV) Is not receiving treatment which
is essential for his health or safety.
For inpatient*:
CONN. GEN. STAT. ANN. § 17a-498(c).
If, on such hearing, the court finds by clear and convincing evidence that the person
complained of has psychiatric disabilities and is dangerous to himself or herself or
others or gravely disabled, it shall make an order for his or her commitment, considering
whether or not a less restrictive placement is available, to a hospital for psychiatric
disabilities to be named in such order, there to be confined for the period of the
duration of such psychiatric disabilities or until he or she is discharged or converted to
voluntary status pursuant to section 17a-506 in due course of law.
CONN. GEN. STAT. ANN. § Sec.
17a-495(a). "dangerous to himself or herself or others" means there is a
substantial risk that physical harm will be inflicted by an individual upon his or her own
person or upon another person, and "gravely disabled" means that a person, as a
result of mental or emotional impairment, is in danger of serious harm as a result of an
inability or failure to provide for his or her own basic human needs such as essential
food, clothing, shelter or safety and that hospital treatment is necessary and available
and that such person is mentally incapable of determining whether or not to accept such
treatment because his judgment is impaired by his psychiatric disabilities.
* Connecticut does not have an
assisted outpatient treatment law.
For both inpatient and outpatient:
DEL. CODE ANN. tit. 16, § 5010. As a
result of the hearing to determine mental illness, the court shall make specific findings:
. . . (2) That based upon clear and convincing evidence, the involuntary patient is a
mentally ill person in which case the court shall enter an order of disposition, which
disposition shall be effective for a period not to exceed 3 months. In determining the
disposition of the involuntary patient the court shall consider all available
alternatives, including inpatient confinement at the hospital, and shall order such
disposition as imposes the least restraint upon the involuntary patient's liberty and
dignity consistent both with affording mental health treatment and care with protecting
the safety of the involuntary patient and the public.
DEL. CODE ANN. tit. 16, § 5001(6).
"Mentally ill person" means a person suffering from a mental disease or
condition which requires such person to be observed and treated at a mental hospital for
the person's own welfare and which both
(i) renders such person unable to make
responsible decisions with respect to the person's hospitalization, and
(ii) poses a real and present threat,
based upon manifest indications, that such person is likely to commit or suffer serious
harm to that person's own self or others or to property if not given immediate hospital
care and treatment.
For both inpatient and outpatient:
D.C. CODE ANN. § 21-545(b). If the
court or jury finds that the person is mentally ill and, because of that illness, is
likely to injure himself or other persons if allowed to remain at liberty, the court may
order his hospitalization for an indeterminate period, or order any other alternative
course of treatment which the court believes will be in the best interests of the person
or of the public.
For inpatient*:
FLA. STAT. ANN. § 394.467(1). Criteria - A person may be placed in involuntarily inpatient placement for treatment upon a finding of the court by clear and convincing evidence that:
(a) He or she is mentally ill and
because of his or her mental illness:
1.
a. He or she has refused voluntary
placement for treatment after sufficient and conscientious explanation and disclosure of
the purpose of placement for treatment; or
b. He or she is unable to determine
for himself or herself whether placement is necessary; AND
2.
a. He or she is manifestly incapable
of surviving alone or with the help of willing and responsible family or friends,
including available alternative services, and, without treatment, is likely to suffer from
neglect of refuse to care for himself or herself, and such neglect or refusal poses a real
and present threat of substantial harm to his or her well-being; or
b. There is substantial likelihood
that in the near future he or she will inflict serious bodily harm on himself or herself
or another person, as evidenced by recent behavior causing, attempting, or threatening
such harm; and
(b) All available less restrictive
treatment alternatives which would offer an opportunity for improvement of his or her
condition have been judged to be inappropriate.
For outpatient:
FLA. STAT. ANN. §
394.4655(1) A person may be ordered to involuntary outpatient placement upon a finding of
the court that by clear and convincing evidence:
(a) The person is 18
years of age or older;
(b) The person has a mental illness;
(c) The person is unlikely to survive safely in the community without supervision, based
on a clinical determination;
(d) The person has a history of lack of compliance with treatment for mental illness;
(e) The person has:
1. At least twice within the immediately
preceding 36 months been involuntarily admitted to a receiving facility or treatment
facility as defined in s. 394.455, or has received mental health services in a forensic or
correctional facility. The 36-month period does not include any period during which the
person was admitted or incarcerated; or
2. Engaged in one or more acts of serious violent behavior toward self or others, or
attempts at serious bodily harm to himself or herself or others, within the preceding 36
months;
(f) The person is, as a
result of his or her mental illness, unlikely to voluntarily participate in the
recommended treatment plan and either he or she has refused voluntary placement for
treatment after sufficient and conscientious explanation and disclosure of the purpose of
placement for treatment or he or she is unable to determine for himself or herself whether
placement is necessary;
(g) In view of the person’s treatment history and current behavior, the person is in
need of involuntary outpatient placement in order to prevent a relapse or
deterioration that would be likely to result in serious bodily harm to himself or herself
or others, or a substantial harm to his or her well-being as set forth in s. 394.463(1);
(h) It is likely that the person will benefit from involuntary outpatient placement; and
(i) All available less restrictive alternatives that would offer an opportunity for
improvement of his or her condition have been judged to be inappropriate or unavailable.
Florida reformed its Baker Act in June, 2004
to allow for assisted outpatient treatment. The
revised law is effective on January 1, 2005.
For inpatient:
GA. CODE ANN. § 37-3-1(9.1).
"Inpatient" means a person who is mentally ill and:
(A)
(i) Who presents a substantial risk of
imminent harm to that person or others, as manifested by either recent overt acts or
recent expressed threats of violence which present a probability of physical injury to
that person or other persons; or
(ii) Who is so unable to care for that
person's own physical health and safety as to create an imminently life-endangering
crisis; and
(B) Who is in need of involuntary
inpatient treatment.
For outpatient:
GA. CODE ANN. § 37-3-1(12.1).
"Outpatient" means a person who is mentally ill and:
(A) Who is not an inpatient but who,
based on the person's treatment history or current mental status, will require outpatient
treatment in order to avoid predictably and imminently becoming an inpatient;
(B) Who because of the person's
current mental status, mental history, or nature of the person's mental illness is unable
voluntarily to seek or comply with outpatient treatment; and
(C) Who is in need of involuntary
treatment.
For inpatient:
HAW. REV. STAT. § 334-60.2. A person
may be committed to a psychiatric facility for involuntary hospitalization, if the court
finds:
(1) That the person is mentally ill or
suffering from substance abuse.
(2) That the person is imminently
dangerous to self or others, is gravely disabled or is obviously ill; and
(3) That the person is in need of care
or treatment, or both, and there is no suitable alternative available through existing
facilities and programs which would be less restrictive than hospitalization.
For outpatient:
HAW. REV. STAT. § 334-121. A person
may be ordered to obtain involuntary outpatient treatment if the family court finds
that:
(1) The person is suffering from a
severe mental disorder or from substance abuse; and
(2) The person is capable of surviving
safely in the community with available supervision from family, friends, or others;
and
(3) The person, at some time in the
past:
(A) has received inpatient hospital
treatment for a severe mental disorder or substance abuse, or
(B) has been imminently dangerous to
self or others, or is gravely disabled, as a result of a severe mental disorder or
substance abuse; and
(4) The person, based on the person's
treatment history and current behavior, is now in need of treatment in order to prevent a
relapse or deterioration which would predictably result in the person becoming imminently
dangerous to self or others, and
(5) The person's current mental status
or the nature of the person's disorder limits or negates the person's ability to make an
informed decision to voluntarily seek or comply with recommended treatment; and
(6) There is a reasonable prospect
that the outpatient treatment ordered will be beneficial to the person.
HAW. REV. STAT. § 334-1.
"Dangerous to others" means likely to do substantial physical or emotional
injury on another, as evidenced by a recent act, attempt or threat.
"Dangerous to property"
means inflicting, attempting or threatening imminently to inflict damage to any property
in a manner which constitutes a crime, as evidenced by a recent act, attempt or threat.
"Dangerous to self" means
the person recently has threatened or attempted suicide or serious bodily harm; or the
person recently has behaved in such a manner as to indicate that the person is unable,
without supervision and the assistance of others, to satisfy the need for nourishment,
essential medical care, shelter or self-protection, so that it is probable that death,
substantial bodily injury, or serious physical debilitation or disease will result unless
adequate treatment is afforded.
"Gravely disabled" means a
condition in which a person, as a result of a mental disorder,
(1) is unable to provide for that
individual's basic personal needs for food, clothing, or shelter;
(2) is unable to make or communicate
rational or responsible decisions concerning the individual's personal welfare; and
(3) lacks the capacity to understand
that this is so.
"Obviously ill" means a
condition in which a person's current behavior and previous history of mental illness, if
known, indicate a disabling mental illness, and the person is incapable of understanding
that there are serious and highly probable risks to health and safety involved in refusing
treatment, the advantages of accepting treatment, or of understanding the advantages of
accepting treatment and the alternatives to the particular treatment offered, after the
advantages, risks, and alternatives have been explained to the person.
For inpatient:
IDAHO CODE § 66-329(k). If, upon completion of the hearing and consideration of the record, the court finds by clear and convincing evidence that the proposed patient:
(1) is mentally ill; and
(2) is, because of such condition, likely to injure himself or others, or is gravely disabled due to mental illness;
the court shall order the proposed patient committed to the custody of the department director for an indeterminate period of time not to exceed one (1) year.
For outpatient:
IDAHO CODE § 66-339A. A person may be committed to outpatient treatment for a period of up to one (1) year if, after a court hearing conducted substantially similar to the one outlined in section 66-329, Idaho Code, the court determines, on the basis of clear and convincing evidence that:
(1) The person is diagnosed as having a mental illness; and
(2) The person, without the requested treatment:
(a) Is likely to cause harm to himself or to suffer substantial mental or emotional deterioration, or become gravely disabled, or
(b) Is likely to cause harm to others; and
(3) The person lacks capacity to make an informed decision concerning his need for treatment; and
(4) The person has previously been hospitalized for treatment of mental illness and has by history substantially failed to comply on
one (1) or more occasions with the prescribed course of treatment outside the hospital; and
(5) A treatment plan has been prepared which includes specific conditions with which the patient is expected to comply, together with a detailed plan for reviewing the patient's medical status and for monitoring his or her compliance with the required conditions of treatment; and
(6) There is a reasonable prospect that the patient's disorder will respond to the treatment proposed in the treatment plan without having to be involuntarily committed to an inpatient facility if the patient complies with the treatment requirements specified in the court's order; and
(7) The physician or treatment facility which is to be responsible for the patient's treatment under the commitment order has agreed to accept the patient.
IDAHO CODE § 66-317. Definitions.
(11) "Likely to injure himself or others" means either:
(a) A substantial risk that physical harm will be inflicted by the proposed patient upon his own person, as evidenced by threats or attempts to commit suicide or inflict physical harm on himself; or
(b) A substantial risk that physical harm will be inflicted by the proposed patient upon another as evidenced by behavior which has caused such harm or which places another person or persons in reasonable fear of sustaining such harm.
(12) "Mentally ill" means a person, who as a result of a substantial disorder of thought, mood, perception, orientation, or memory, which grossly impairs judgment, behavior, capacity to recognize and adapt to reality, requires care and treatment at a facility.
(13) "Gravely disabled" means a person who, as the result of mental illness, is in danger of serious physical harm due to the person's inability to provide for any of his basic needs for nourishment, or essential medical care, or shelter or safety.
For both inpatient and outpatient:
405 ILL. COMP. STAT. 5/1-119. Person
subject to involuntary admission; subject to involuntary admission § 1-119.
"Person subject to involuntary
admission" or "subject to involuntary admission" means:
(1) A person with mental illness and
who because of his or her illness is reasonably expected to inflict serious physical harm
upon himself or herself or another in the near future
which may include
threatening behavior or conduct that places another individual in reasonable expectation
of being harmed; or;
(2) A person with mental illness and
who because of his or her illness is unable to provide for his basic physical needs so as
to guard himself or herself from serious harm without the
assistance of family or outside help.
In determining whether a person
meets the criteria specified in paragraph (1) or (2), the court may consider evidence of
the person's repeated past pattern of specific behavior and actions related to the
person's illness.
For both inpatient and outpatient (see below for additional outpatient criteria):
IND. CODE ANN. § 12-26-6-8(a) [temporary commitment, up to 90 days] and IND. CODE ANN. § 12-26-7-5(a) [regular commitment, beyond 90 days]. "If at the completion of the hearing . . . an individual is found to be mentally ill and either dangerous or gravely disabled . . . ."
For outpatient:
IND. CODE ANN. § 12-26-14-1. If a hearing has been held under IC 12-26-6 or IC 12-26-7 and the court finds that the individual is:
(1) Mentally ill and either dangerous or gravely disabled;
(2)Llikely to benefit from an outpatient therapy program that is designed to decrease the individual's dangerousness or disability;
(3) Not likely to be either dangerous or gravely disabled if the individual complies with the therapy program; and
(4) Recommended for an outpatient therapy program by the individual's examining physician;
the court may order the individual to enter a therapy program as an outpatient.
IND. CODE ANN. § 12-7-2-53. "Dangerous", for purposes of IC 12-26, means a condition in which an individual as a result of mental illness, presents a substantial risk that the individual will harm the individual or others.
IND. CODE ANN. § 12-7-2-96. "Gravely disabled", for purposes of IC 12-26, means a condition in which an individual, as a result of mental illness, is in danger of coming to harm because the individual:
(1) is unable to provide for that individual's food, clothing, shelter, or other essential human needs; or
(2) has a substantial impairment or an obvious deterioration of that individual's judgment, reasoning, or behavior that results in the individual's inability to function independently.
For both inpatient and outpatient:
IOWA CODE § 229.1(15).
"Seriously mentally impaired" or "serious mental impairment" describes
the condition of a person with mental illness and because of that illness lacks sufficient
judgment to make responsible decisions with respect to the person's hospitalization or
treatment, and who because of that illness meets any of the following criteria:
a. Is likely to physically injure the
person's self or others if allowed to remain at liberty without treatment.
b. Is likely to inflict serious
emotional injury on members of the person's family or others who lack reasonable
opportunity to avoid contact with the person with mental illness if the person with mental
illness is allowed to remain at liberty without treatment.
c. Is unable to satisfy the person's
needs for nourishment, clothing, essential medical care, or shelter so that it is likely
that the person will suffer physical injury, physical debilitation, or death.
IOWA CODE § 229.1 (14). "Serious
emotional injury" is an injury which does not necessarily exhibit any physical
characteristics, but which can be recognized and diagnosed by a licensed physician or
other qualified mental health professional and which can be causally connected with the
act or omission of a person who is, or is alleged to be, mentally ill.
For both inpatient and outpatient (see below for additional outpatient criteria):
KAN. STAT. ANN. § 59-2946(f)
(1) "Mentally ill person subject
to involuntary commitment for care and treatment" means a mentally ill person, as
defined in subsection (e), who also lacks capacity to make an informed decision concerning
treatment, is likely to cause harm to self or others, and whose diagnosis is not solely
one of the following mental disorders: Alcohol or chemical substance abuse; antisocial
personality disorder; mental retardation; organic personality syndrome; or an organic
mental disorder.
(2) "Lacks capacity to make an
informed decision concerning treatment" means that the person, by reason of the
person's mental disorder, is unable, despite conscientious efforts at explanation, to
understand basically the nature and effects of hospitalization or treatment or is unable
to engage in a rational decision-making process regarding hospitalization or treatment, as
evidenced by an inability to weigh the possible risks and benefits.
(3) "Likely to cause harm to self
or others" means that the person, by reason of the person's mental disorder:
(a) Is likely, in the reasonably
foreseeable future, to cause substantial physical injury or physical abuse to self or
others or substantial damage to another's property, as evidenced by behavior threatening,
attempting or causing such injury, abuse or damage; except that if the harm threatened,
attempted or caused is only harm to the property of another, the harm must be of such a
value and extent that the state's interest in protecting the property from such harm
outweighs the person's interest in personal liberty; or
(b) is substantially unable, except
for reason of indigency, to provide for any of the person's basic needs, such as food,
clothing, shelter, health or safety, causing a substantial deterioration of the person's
ability to function on the person's own.
Additional criteria for
outpatient:
KAN. STAT. ANN. § 59-2967(a). An
order for outpatient treatment may be entered by the court at any time in lieu of any type
of order which would have required inpatient care and treatment if the court finds that
the patient is likely to comply with an outpatient treatment order and that the patient
will not likely be a danger to the community or be likely to cause harm to self or others
while subject to an outpatient treatment order.
For both inpatient and outpatient:
KY. REV. STAT. ANN. § 202A.026. No
person shall be involuntarily hospitalized unless such person is a mentally ill
person:
(1) Who presents a danger or threat of
danger to self, family or others as a result of the mental illness;
(2) Who can reasonably benefit from
treatment; and
(3) For whom hospitalization is the
least restrictive alternative mode of treatment presently available.
KY. REV. STAT. ANN. § 202A.011(2).
"Danger" or "threat of danger to self, family or others" means
substantial physical harm or threat of substantial physical harm upon self, family, or
others, including actions which deprive self, family, or others of the basic means of
survival including provision for reasonable shelter, food or clothing;
For both inpatient and outpatient:
LA. REV. STAT. ANN. § 28:55(E)(1). If
the court finds by clear and convincing evidence that the respondent is dangerous to self
or others or is gravely disabled, as a result of substance abuse or mental illness, it
shall render a judgment for his commitment.
LA. REV. STAT. ANN. § 28:2(3).
"Dangerous to others" means the condition of a person whose behavior or
significant threats support a reasonable expectation that there is a substantial risk that
he will inflict physical harm upon another person in the near future.
LA. REV. STAT. ANN. § 28:2(4).
"Dangerous to self" means the condition of a person whose behavior, significant
threats or inaction supports a reasonable expectation that there is a substantial risk
that he will inflict physical or severe emotional harm upon his own person.
LA. REV. STAT. ANN. § 28:2(10).
"Gravely disabled" means the condition of a person who is unable to provide for
his own basic physical needs, such as essential food, clothing, medical care, and shelter,
as a result of serious mental illness or substance abuse and is unable to survive safely
in freedom or protect himself from serious harm; the term also includes incapacitation by
alcohol, which means the condition of a person who, as a result of the use of alcohol, is
unconscious or whose judgment is otherwise so impaired that he is incapable of realizing
and making a rational decision with respect to his need for treatment.
For inpatient*:
ME. REV. STAT. ANN. tit. 34-B, §
3864(6)(A). The District Court shall so state in the record, if it finds upon completion
of the hearing and consideration of the record:
(1) Clear and convincing evidence that
the person is mentally ill and that the person's recent actions and behavior demonstrate
that the person's illness poses a likelihood of serious harm;
(2) That inpatient hospitalization is
the best available means for treatment of the patient; and
(3) That it is satisfied with the
individual treatment plan offered by the hospital to which the applicant seeks the
patient's involuntary commitment.
ME. REV. STAT. ANN. tit. 34B, §
3801(4). "Likelihood of serious harm" means:
A. A substantial risk of physical harm
to the person himself as manifested by evidence of recent threats of, or attempts at,
suicide or serious bodily harm to himself and, after consideration of less restrictive
treatment settings and modalities, a determination that community resources for his care
and treatment are unavailable;
B. A substantial risk of physical harm
to other persons as manifested by recent evidence of homicidal or other violent behavior
or recent evidence that others are placed in reasonable fear of violent behavior and
serious physical harm to them and, after consideration of less restrictive treatment
settings and modalities, a determination that community resources for his care and
treatment are unavailable; or
C. A reasonable certainty that severe
physical or mental impairment or injury will result to the person alleged to be mentally
ill as manifested by recent evidence of his actions or behavior which demonstrate his
inability to avoid or protect himself from such impairment or injury, and, after
consideration of less restrictive treatment settings and modalities, a determination that
suitable community resources for his care are unavailable.
* Maine does not have an assisted
outpatient treatment law.
For inpatient*:
MD. CODE ANN., HEALTH-GEN. §
10-632(e)(2).
(i) The individual has a mental
disorder;
(ii) The individual needs in-patient
care or treatment;
(iii) The individual presents a danger
to the life or safety of the individual or of others;
(iv) The individual is unable or
unwilling to be voluntarily admitted to the facility;
(v) There is no available less
restrictive form of intervention that is consistent with the welfare and safety of the
individual; and
(vi) If the individual is 65 years old
or older and is to be admitted to a State facility, the individual has been evaluated by a
geriatric evaluation team and no less restrictive form of care or treatment was determined
by the team to be appropriate.
*Maryland does not have an assisted
outpatient treatment law.
For inpatient*:
MASS. GEN. LAWS ANN. ch. 123, § 8(a).
After a hearing, unless such hearing is waived in writing, the district court or the
division of the juvenile court department shall not order the commitment of a person at a
facility or shall not renew such order unless it finds after a hearing that
(1) such person is mentally ill,
and
(2) the discharge of such person from
a facility would create a likelihood of serious harm.
MASS. GEN. LAWS ANN. ch. 123, § 1.
"Likelihood of serious harm",
(1) a substantial risk of physical
harm to the person himself as manifested by evidence of, threats of, or attempts at,
suicide or serious bodily harm;
(2) a substantial risk of physical
harm to other persons as manifested by evidence of homicidal or other violent behavior or
evidence that others are placed in reasonable fear of violent behavior and serious
physical harm to them; or
(3) a very substantial risk of
physical impairment or injury to the person himself as manifested by evidence that such
person's judgment is so affected that he is unable to protect himself in the community and
that reasonable provision for his protection is not available in the community.
* Massachusetts does not have an
assisted outpatient treatment law.
For both inpatient and outpatient (except that if the court relies exclusively on criteria in (1)(d), only outpatient may be ordered):
MICH. COMP. LAWS ANN. § 330.1401. (1) As used in this chapter, "person requiring treatment" means (a), (b),(c), or (d):
(a) An individual who has mental illness, and who as a result of that mental illness can reasonably be expected within the near future to intentionally or unintentionally seriously physically injure himself, herself, or another individual, and who has engaged in an act or acts or made significant threats that are substantially supportive of the expectation.
(b) An individual who has mental illness, and who as a result of that mental illness is unable to attend to those of his or her basic physical needs such as food, clothing, or shelter that must be attended to in order for the individual to avoid serious harm in the near future, and who has demonstrated that inability by failing to attend to those basic physical needs.
(c) An individual who has mental illness, whose judgment is so impaired that he or she is unable to understand his or her need for treatment and whose continued behavior as the result of this mental illness can reasonably be expected, on the basis of competent clinical opinion, to result in significant physical harm to himself, herself, or others. This individual shall receive involuntary mental health treatment initially only under the provisions of sections 434 through 438.
(d) An individual who has mental illness, whose understanding of the need for treatment is impaired to the point that he or she is unlikely to participate in treatment voluntarily, who is currently noncompliant with treatment that has been recommended by a mental health professional and that has been determined to be necessary to prevent a relapse or harmful deterioration of his or her condition, and whose noncompliance with treatment has been a factor in the individual's placement in a psychiatric hospital, prison, or jail at least 2 times within the last 48 months or whose noncompliance with treatment has been a factor in the individual's committing 1 or more acts, attempts, or threats of serious violent behavior within the last 48 months. An individual under this subdivision is only eligible to receive assisted outpatient treatment under section 433 or 469a.
For inpatient:
MINN. STAT. ANN. § 253B.09(1)
"If the court finds by clear and convincing evidence that the proposed patient is a
person who is mentally ill, developmentally disabled, or chemically dependent and after careful
consideration of reasonable alternative dispositions . . . it finds that there is no
suitable alternative to judicial commitment, the court shall commit the patient to the
least restrictive treatment program or alternative programs which can meet the patient's
treatment needs . . . ."
For outpatient:
MINN. STAT. ANN. § 253B.065(5)
(a) A court shall order early
intervention treatment of a proposed patient who meets the criteria under paragraph (b).
The early intervention treatment must be less intrusive than long-term inpatient
commitment and must be the least restrictive treatment program available that can meet the
patient's treatment needs.
(b) The court shall order early
intervention treatment if the court finds all of the elements of the following factors by
clear and convincing evidence:
(1) the proposed patient is mentally
ill;
(2) the proposed patient refuses to
accept appropriate mental health treatment; and
(3) the proposed patient's mental
illness is manifested by instances of grossly disturbed behavior or faulty perceptions and
either:
(i) the grossly disturbed behavior or
faulty perceptions significantly interfere with the proposed patient's ability to care for
self and the proposed patient, when competent, would have chosen substantially similar
treatment under the same circumstances; or
(ii) due to the mental illness, the
proposed patient received court-ordered inpatient treatment under section 253B.09 at least
two times in the previous three years; the patient is exhibiting symptoms or behavior
substantially similar to those that precipitated one or more of the court-ordered
treatments; and the patient is reasonably expected to physically or mentally deteriorate
to the point of meeting the criteria for commitment under section 253B.09 unless treated.
MINN. STAT. ANN. § 253B.02(13)(a). A
“person who is mentally ill” means any person who has an organic disorder of the
brain or a substantial psychiatric disorder of thought, mood, perception, orientation, or
memory which grossly impairs judgment, behavior, capacity to recognize reality, or to
reason or understand, which is manifested by instances of grossly disturbed behavior or
faulty perceptions and poses a substantial likelihood of physical harm to self or others
as demonstrated by:
(1) a failure to obtain necessary food, clothing,
shelter, or medical care as a result of the impairment; or
(2)
an inability for reasons other than indigence to
obtain necessary food, clothing, shelter, or medical care as a result of the impairment
and it is more probable than not that the person will suffer substantial harm, significant
psychiatric deterioration or debilitation, or serious illness, unless appropriate
treatment and services are provided;
(3) a
recent attempt or threat to physically harm self or others.
(4) recent
and volitional conduct involving significant damage to substantial property.
MINN. STAT. ANN. § 253B.02(17). A
"person mentally ill and dangerous to the public" is a person
(a) who is mentally ill; and
(b) who as a result of that mental
illness presents a clear danger to the safety of others as demonstrated by the facts
that
(i) the person has engaged in an overt
act causing or attempting to cause serious physical harm to another and
(ii) there is a substantial likelihood
that the person will engage in acts capable of inflicting serious physical harm on
another. A person committed as a sexual psychopathic personality or sexually dangerous
person as defined in subdivisions 18a and 18b is subject to the provisions of this chapter
that apply to persons mentally ill and dangerous to the public.
Note: The distinction made between
a person committed as a "mentally ill person" and a "person mentally ill
and dangerous to the public" is that the latter is not permitted to transfer to
voluntary status per 253B.10(5). Both satisfy conditions for assisted treatment.
For both inpatient and outpatient:
MISS. CODE ANN. § 41-21-73(4).
"If the court finds by clear and convincing evidence that the proposed patient is a
mentally ill . . . person and, if after careful consideration of reasonable alternative
dispositions . . . the court finds that there is no suitable alternative to judicial
commitment. . . . A nonresident of the state
may be committed for treatment or confinement in the county where such person was found.
Alternatives to commitment to inpatient care may include, but shall not be limited to:
voluntary or court-ordered outpatient commitment for treatment with specific reference to
a treatment regimen, day treatment in a hospital, night treatment in a hospital, placement
in the custody of a friend or relative or the provision of home health services.
For persons committed as mentally ill… the initial commitment shall not exceed three
(3) months.”
MISS. CODE ANN. § 41-21-61(e).
"Mentally ill person" means any person who has a substantial psychiatric
disorder of thought, mood, perception, orientation, or memory which grossly impairs
judgment, behavior, capacity to recognize reality, or to reason or understand, which
(i) is manifested by instances of
grossly disturbed behavior or faulty perceptions; and
(ii) poses a substantial likelihood of
physical harm to himself or others as demonstrated by
(A) a recent attempt or threat to
physically harm himself or others, or
(B) a failure to provide necessary
food, clothing, shelter or medical care for himself, as a result of the impairment.
"Mentally ill person"
includes a person who, based on treatment history and other applicable psychiatric
indicia, is in need of treatment in order to prevent further disability or deterioration
which would predictably result in dangerousness to himself or others when his current
mental illness limits or negates his ability to make an informed decision to seek or
comply with recommended treatment.
For both inpatient and outpatient:
MO. ANN. STAT. 632.350(5) " At
the conclusion of the hearing, if the court or jury finds that the respondent, as the
result of mental illness, presents a likelihood of serious harm to himself or to others,
and the court finds that a program appropriate to handle the respondent's condition has
agreed to accept him, the court shall order the respondent to be detained for involuntary
treatment in the least restrictive environment for a period not to exceed ninety days or
for outpatient detention and treatment under the supervision of a mental health program in
the least restrictive environment for a period not to exceed one hundred eighty
days.”
MO. ANN. STAT. § 632.005(9).
"Likelihood of serious harm" means any one or more of the following but does not
require actual physical injury to have occurred:
(a) A substantial risk that serious
physical harm will be inflicted by a person upon his own person, as evidenced by recent
threats, including verbal threats, or attempts to commit suicide or inflict physical harm
on himself. Evidence of substantial risk may also include information about patterns of
behavior that historically have resulted in serious harm previously being inflicted by a
person upon himself;
(b) A substantial risk that
serious physical harm to a person will result or is occurring because of an impairment in
his capacity to make decisions with respect to his hospitalization and need for treatment
as evidenced by his current mental disorder or mental illness which results in an
inability to provide for his own basic necessities of food, clothing, shelter, safety or
medical care or his inability to provide for his own mental health care which may result
in a substantial risk of serious physical harm. Evidence of that substantial risk may also
include information about patterns of behavior that historically have resulted in serious
harm to the person previously taking place because of a mental disorder or mental illness
which resulted in his inability to provide for his basic necessities of food, clothing,
shelter, safety or medical or mental health care; or
(c) A substantial risk that serious physical harm will be inflicted by a person upon
another as evidenced by recent overt acts, behavior or threats, including verbal threats,
which have caused such harm or which would place a reasonable person in reasonable fear of
sustaining such harm. Evidence of that substantial risk may also include information about
patterns of behavior that historically have resulted in physical harm previously being
inflicted by a person upon another person;
For both inpatient and outpatient (except that if the court relies exclusively on criteria in (1)(d), only outpatient may be ordered):
MONT. CODE ANN. § 53-21-126(1). If
the court determines that the respondent is suffering from a mental disorder, the court
shall then determine whether the respondent requires commitment. In determining whether
the respondent requires commitment, the court shall consider the following:
(a) whether the respondent, because of
a mental disorder, is substantially unable to provide for the respondent's own basic needs
of food, clothing, shelter, health, or safety;
(b) whether the respondent has
recently, because of a mental disorder and through an act or an omission, caused
self-injury or injury to others;
(c) whether, because of a mental
disorder, there is an imminent threat of injury to the respondent or to others because of
the respondent's acts or omissions; and
(d) whether the respondent's mental
disorder, as demonstrated by the respondent's recent acts or omissions, will, if
untreated, predictably result in deterioration of the respondent's mental condition to the
point at which the respondent will become a danger to self or to others or will be unable
to provide for the respondent's own basic needs of food, clothing, shelter, health, or
safety. Predictability may be established by the respondent's relevant medical
history.
MONT. CODE ANN. § 53-21-127 (7) Satisfaction of any one of the criteria listed in
53-21-126(1) justifies commitment pursuant to this chapter. However, if the court relies
solely upon the criterion provided in 53-21-126(1)(d), the court may require commitment
only to a community facility and may not require commitment at the state hospital.
MONT. CODE ANN. § 53-21-102(9)(a).
"Mental disorder" means any organic, mental, or emotional impairment that has
substantial adverse effects on an individual's cognitive or volitional functions.
For both inpatient and outpatient:
NEB. REV. STAT. § 71-925(1). The
state has the burden to prove by clear and convincing evidence that (a) the subject is
mentally ill and dangerous and (b) neither voluntary hospitalization nor other treatment
alternatives less restrictive of the subject's liberty than inpatient or outpatient
treatment ordered by the mental health board are available or would suffice to prevent the
harm described in section 71-908.
(4) If the subject admits the
allegations of the petition or the mental health board finds that the subject is mentally
ill and dangerous and that neither voluntary hospitalization nor other treatment
alternatives less restrictive of the subject's liberty than inpatient or outpatient
treatment ordered by the board are available or would suffice to prevent the harm
described in section 71-908, the board shall, within forty-eight hours, (a) order the
subject to receive outpatient treatment or (b) order the subject to receive inpatient
treatment.
NEB. REV. STAT. § 71-908. Mentally
ill and dangerous person means a person who is mentally ill. . . and because of such
mental illness… presents:
(1) A substantial risk of serious harm
to another person or persons within the near future as manifested by evidence of recent
violent acts or threats of violence or by placing others in reasonable fear of such harm;
or
(2) A substantial risk of serious harm
to himself or herself within the near future as manifested by evidence of recent attempts
at, or threats of, suicide or serious bodily harm or evidence of inability to provide for
his or her basic human needs, including food, clothing, shelter, essential medical care,
or personal safety.
For inpatient*:
NEV. REV. STAT. § 433A.310(1).
"If the district court finds, after proceedings for the involuntary court-ordered
admission of a person to a . . . mental health facility: . . . (b) That there is clear and
convincing evidence that the person . . . is mentally ill and, because of that illness, is
likely to harm himself or others if allowed his liberty, the court may order the involuntary
admission of the person for the most appropriate course of treatment."
NEV. REV. STAT. § 433A.115
"Mentally ill person" defined.
1. As used . . . unless the context
otherwise requires, "mentally ill person" means any person whose capacity to
exercise self-control, judgment and discretion in the conduct of his affairs and social
relations or to care for his personal needs is diminished, as a result of a mental
illness, to the extent that he presents a clear and present danger of harm to himself or
others, but does not include any person in whom that capacity is diminished by epilepsy,
mental retardation, Alzheimer's disease, brief periods of intoxication caused by alcohol
or drugs, or dependence upon or addiction to alcohol or drugs, unless a mental illness
that can be diagnosed is also present which contributes to the diminished capacity of the
person.
2. A person presents a clear and
present danger of harm to himself if, within the next preceding 30 days, he has, as a
result of a mental illness:
(a) Acted in a manner from which it
may reasonably be inferred that, without the care, supervision or continued assistance of
others, he will be unable to satisfy his need for nourishment, personal or medical care,
shelter, self-protection or safety, and if there exists a reasonable probability that his
death, serious bodily injury or physical debilitation will occur within the next following
30 days unless he is admitted to a mental health facility . . . and adequate treatment is
provided to him;
(b) Attempted or threatened to commit
suicide or committed acts in furtherance of a threat to commit suicide, and if there
exists a reasonable probability that he will commit suicide unless he is admitted to a
mental health facility . . . and adequate treatment is provided to him; or
(c) Mutilated himself, attempted or
threatened to mutilate himself or committed acts in furtherance of a threat to mutilate
himself, and if there exists a reasonable probability that he will mutilate himself unless
he is admitted to a mental health facility . . . and adequate treatment is provided to
him.
3. A person presents a clear and
present danger of harm to others if, within the next preceding 30 days, he has, as a
result of a mental illness, inflicted or attempted to inflict serious bodily harm on any
other person, or made threats to inflict harm and committed acts in furtherance of those
threats, and if there exists a reasonable probability that he will do so again unless he
is admitted to a mental health facility . . . and adequate treatment is provided to him.
* Nevada does not have an assisted
outpatient treatment law.
For inpatient and outpatient:
N.H. REV. STAT. ANN. § 135-C:34.
Involuntary Treatment Standard. - The standard to be used by a court, physician, or
psychiatrist in determining whether a person should be admitted to a receiving facility
for treatment on an involuntary basis shall be whether the person is in such mental
condition as a result of mental illness as to create a potentially serious likelihood of
danger to himself or to others.
N.H. REV. STAT. ANN. §
135-C:27.
I. As used in this section
"danger to himself" is established by demonstrating that:
(a) Within 40 days of the completion
of the petition, the person has inflicted serious bodily injury on himself or has
attempted suicide or serious self-injury and there is a likelihood the act or attempted
act will recur if admission is not ordered;
(b) Within 40 days of the completion
of the petition, the person has threatened to inflict serious bodily injury on himself and
there is likelihood that an act or attempt of serious self-injury will occur if admission
is not ordered; or
(c) The person's behavior demonstrates
that he so lacks the capacity to care for his own welfare that there is a likelihood of
death, serious bodily injury, or serious debilitation if admission is not ordered.
(d) The person meets all of the
following criteria:
(1) The person has been determined to
be severely mentally disabled in accordance with rules authorized by RSA 135-C:61 for a
period of at least one year;
(2) The person has had at least one
involuntary admission, within the last 2 years, pursuant to RSA 135-C:34-54;
(3) The person has no guardian of the
person appointed pursuant to RSA 464-A;
(4) The person is not subject to a
conditional discharge granted pursuant to RSA 135-C:49, II;
(5) The person has refused the
treatment determined necessary by a mental health program approved by the department;
and
(6) A psychiatrist at a mental health
program approved by the department has determined, based upon the person's clinical
history, that there is a substantial probability that the person's refusal to accept
necessary treatment will lead to death, serious bodily injury, or serious debilitation if
admission is not ordered.
II. As used in this section
"danger to others" is established by demonstrating that within 40 days of the
completion of the petition, the person has inflicted, attempted to inflict, or threatened
to inflict serious bodily harm on another.
For inpatient*:
N.J. STAT. ANN. § 30:4-27.2(m).
"In need of involuntary commitment": means that an adult who is mentally ill,
whose mental illness causes the person to be dangerous to self or dangerous to others or
property and who is unwilling to be admitted to a facility voluntarily for care, and who
needs care at a short-term care, psychiatric facility or special psychiatric hospital
because other services are not appropriate or available to meet the person's mental health
care needs.
N.J. STAT. ANN. § 30:4-27.2(r).
"Mental illness" means a current, substantial disturbance of thought, mood,
perception or orientation which significantly impairs judgment, capacity to control
behavior or capacity to recognize reality, but does not include simple alcohol
intoxication, transitory reaction to drug ingestion, organic brain syndrome or
developmental disability unless it results in the severity of impairment described herein.
The term mental illness is not limited to "psychosis" or "active
psychosis," but shall include all conditions that result in the severity of
impairment described herein.
N.J. STAT. ANN. § 30:4-27.2(h).
"Dangerous to self" means that by reason of mental illness the person has
threatened or attempted suicide or serious bodily harm, or has behaved in such a manner as
to indicate that the person is unable to satisfy his need for nourishment, essential
medical care or shelter, so that it is probable that substantial bodily injury, serious
physical debilitation or death will result within the reasonably foreseeable future;
however, no person shall be deemed to be unable to satisfy his need for nourishment,
essential medical care or shelter if he is able to satisfy such needs with the supervision
and assistance of others who are willing and available.
N.J. STAT. ANN. § 30:4-27.2(i)
"Dangerous to others or property" means that by reason of mental illness there
is a substantial likelihood that the person will inflict serious bodily harm upon another
person or cause serious property damage within the reasonably foreseeable future. This
determination shall take into account a person's history, recent behavior and any recent
act or threat.
* New Jersey does not have an
assisted outpatient treatment law.
For inpatient*:
N.M. STAT. ANN. § 43-1-11(C). Upon
completion of the hearing, the court may order a commitment for evaluation and treatment
not to exceed thirty days if the court finds by clear and convincing evidence that:
(1) as a result of a mental disorder,
the client presents a likelihood of serious harm to himself or others;
(2) the client needs and is likely to
benefit from the proposed treatment; and
(3) the proposed commitment is
consistent with the treatment needs of the client and with the least drastic means
principle.
N.M. STAT. ANN. § 43-1-3(M).
"likelihood of serious harm to oneself" means that it is more likely than not
that in the near future the person will attempt to commit suicide or will cause serious
bodily harm to himself by violent or other self-destructive means, including but not
limited to grave passive neglect;
N.M. STAT. ANN. § 43-1-3(N).
"likelihood of serious harm to others" means that it is more likely than not
that in the near future the person will inflict serious, unjustified bodily harm on
another person or commit a criminal sexual offense, as evidenced by behavior causing,
attempting or threatening such harm, which behavior gives rise to a reasonable fear of
such harm from the person;
* New Mexico does not have an
assisted outpatient treatment law.
For inpatient:
60-day involuntary treatment based on
medical certification:
N.Y. MENTAL HYG. LAW § 9.05(b) A
certificate, as required by this article, must show that the person is mentally ill . . .
[and] the condition of the person examined is such that he needs involuntary care and
treatment in a hospital . . . .
N.Y. MENTAL HYG. LAW § 9.37(a) The
director of a hospital, upon application by a director of community services or an
examining physician duly designated by him or her, may receive and care for in such
hospital as a patient any person who, in the opinion of the director of community services
or the director's designee, has a mental illness for which immediate inpatient care and
treatment in a hospital is appropriate and which is likely to result in serious harm to
himself or herself or others.
If a hearing on the patient's need for
treatment during the 60-day involuntary treatment:
N.Y. MENTAL HYG. LAW § 9.31(c). If it
be determined [by the court] that the patient is in need of retention, the court shall
deny the application for the patient's release. If it be determined that the patient is
not mentally ill or not in need of retention, the court shall order the release of the
patient.
N.Y. MENTAL HYG. LAW § 9.01. As used
in this article: "in need of care and treatment" means that a person has a
mental illness for which in-patient care and treatment in a hospital is appropriate.
"in need of involuntary care and treatment" means that a person has a mental
illness for which care and treatment as a patient in a hospital is essential to such
person's welfare and whose judgment is so impaired that he is unable to understand the
need for such care and treatment.
N.Y. MENTAL HYG. LAW § 9.01.
"need for retention" means that a person who has been admitted to a hospital
pursuant to this article is in need of involuntary care and treatment in a hospital for a
further period.
N.Y. MENTAL HYG. LAW § 9.01.
"likelihood to result in serious harm" or "likely to result in serious
harm" means
(1) a substantial risk of physical
harm to the person as manifested by threats of or attempts at suicide or serious bodily
harm or other conduct demonstrating that the person is dangerous to himself or herself,
or
(2) a substantial risk of physical
harm to other persons as manifested by homicidal or other violent behavior by which others
are placed in reasonable fear of serious physical harm.
Case Law. Although not explicitly in
the state’s code, a strong majority of the New York courts addressing the issue have
held that in order to retain a patient for involuntary psychiatric care under New York law
a hospital must establish that the patient is (1) mentally ill; (2) in need of continued,
supervised care and treatment; and (3) that the patient poses a substantial threat of physical harm to
himself and/or others. E.g., Anonymous v. Carmichael, 727 N.Y.S.2d (N.Y. App. Div. 2001)
For outpatient:
N.Y. MENTAL HYG. LAW § 9.60(C).
Criteria for Assisted Outpatient Treatment. A patient may be ordered to obtain assisted
outpatient treatment if the court finds that:
(1) The patient is eighteen years of
age or older; and
(2) The patient is suffering from a
mental illness; and
(3) The patient is unlikely to survive
safely in the community without supervision, based on a clinical determination; and
(4) The patient has a history of lack
of compliance with treatment for mental illness that has:
(I) At least twice within the last
thirty-six months been a significant factor in necessitating hospitalization in a
hospital, or receipt of services in a forensic or other mental health unit of a
correctional facility, not including any period during which the person was hospitalized
or incarcerated immediately preceding the filing of the petition or;
(II) Resulted in one or more acts of
serious violent behavior toward self or others or threats of, or attempts at, serious
physical harm to self or others within the last forty-eight months, not including any
period in which the person was hospitalized or incarcerated immediately preceding the
filing of the petition; and
(5) The patient is, as a result of his
or her mental illness, unlikely to voluntarily participate in the recommended treatment
pursuant to the treatment plan; and
(6) In view of the patient's treatment
history and current behavior, the patient is in need of assisted outpatient treatment in
order to prevent a relapse or deterioration which would be likely to result in serious
harm to the patient or others as defined in section 9.01 of this article; and
(7) It is likely that the patient will
benefit from assisted outpatient treatment; and
(8) If the patient has executed a
health care proxy as defined in article 29-C of the Public Health Law, that any directions
included in such proxy shall be taken into account by the court in determining the written
treatment plan.
For inpatient:
N.C. GEN. STAT. § 122C-268(j). To
support an inpatient commitment order, the court shall find by clear, cogent, and
convincing evidence that the respondent is mentally ill and dangerous to self, as defined
in G.S. 122C-3(11)a., or dangerous to others, as defined in G.S. 122C-3(11)b. The court
shall record the facts that support its findings.
N.C. GEN. STAT. § 122C-3(11).
"Dangerous to himself or others" means:
a. "Dangerous to himself"
means that within the relevant past:
1. The individual has acted in such a
way as to show:
I. That he would be unable,
without care, supervision, and the continued assistance of others not otherwise available,
to exercise self-control, judgment, and discretion in the conduct of his daily
responsibilities and social relations, or to satisfy his need for nourishment, personal or
medical care, shelter, or self-protection and safety; and
II. That there is a reasonable probability of his suffering serious physical
debilitation within the near future unless adequate treatment is given pursuant to this
Chapter. A showing of behavior that is grossly irrational, of actions that the individual
is unable to control, of behavior that is grossly inappropriate to the situation, or of
other evidence of severely impaired insight and judgment shall create a prima facie
inference that the individual is unable to care for himself; or
2. The individual has attempted suicide or threatened suicide and that there is a
reasonable probability of suicide unless adequate treatment is given pursuant to this
Chapter; or
3. The individual has mutilated himself or attempted to mutilate himself and that
there is a reasonable probability of serious self-mutilation unless adequate treatment is
given pursuant to this Chapter.
Previous episodes of dangerousness to self, when applicable, may be considered when
determining reasonable probability of physical debilitation, suicide, or self-mutilation.
b. "Dangerous to
others" means that within the relevant past, the individual has inflicted or
attempted to inflict or threatened to inflict serious bodily harm on another, or has acted
in such a way as to create a substantial risk of serious bodily harm to another, or has
engaged in extreme destruction of property; and that there is a reasonable probability
that this conduct will be repeated. Previous episodes of dangerousness to others, when
applicable, may be considered when determining reasonable probability of future dangerous
conduct. Clear, cogent, and convincing evidence that an individual has committed a
homicide in the relevant past is prima facie evidence of dangerousness to others.
For outpatient: