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Know the Laws in Your State

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Open this link on your smartphone for mobile information about the involuntary treatment laws in your state.

In a mental health crisis, your first priority will be to protect your loved one and others from dangerous or inappropriate behaviors that result from untreated or uncontrolled mental illness. Because your family member may not even realize or acknowledge being ill, recruiting public health or other officials to intervene is frequently necessary.

To effectively advocate for intervention, it is essential to know the civil commitment standards for intervention in your state or the state where the family member lives.

At least two - and, in all but a handful of states, three - forms of court-ordered treatment are authorized by state law. States use different names to describe each form of treatment.

  • Emergency hospitalization for evaluation (sometimes called "psychiatric hold" or "pick-up") in a treatment facility for psychiatric evaluation; typically short intervention of fixed duration (e.g., 72 hours).
  • Civil commitment – inpatient. Also labeled differently in different states, civil commitment is a process whereby a judge orders a person with symptoms of mental illness who meets the state’s legal criteria to be held in a hospital beyond the emergency detention period. Civil commitment exists in all states, but the standards that must be met for it to occur vary from state to state. It is essential to know the standards for civil commitment in your own state.
  • Civil commitment – outpatient. Assisted outpatient treatment (AOT), which also goes by different names in different states (e.g., outpatient commitment or mandated outpatient treatment), is a process whereby a judge orders a qualifying person with symptoms of mental illness to adhere to a mental health treatment plan while living in the community. AOT laws have been passed in 45 states, but the standards for ordering it vary from state to state. It is essential to know the standards for court-ordered outpatient treatment in your own state. For answers to Frequently Asked Questions about assisted outpatient treatment, click here.

State-by-state information about each form of civil commitment laws, standards and procedures may be found as follows:

The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its "Privacy Rule" regulates the disclosure of medical information by medical providers. Generally speaking, when a state law and HIPAA conflict, HIPAA preempts the state law. However, state laws that prohibit or further restrict the disclosure of protected health information will prevail even if HIPAA would permit the disclosure. Many states have their own laws governing confidentiality – several of which are more stringent than federal law. See "HIPAA at a Glance" for an orientation to understanding and navigating HIPAA privacy restrictions.
 
 
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