Hawaii, like every state, has its own civil commitment laws that establish criteria for determining when court-ordered treatment is appropriate for individuals with severe mental illness who are too ill to seek care voluntarily. The state authorizes both inpatient (hospital) and outpatient (community) treatment, which is known in Hawaii as "involuntary outpatient treatment." It is one of the 27 states whose involuntary treatment standard is based on a person’s “need for treatment” rather than only the person’s likelihood of being dangerous to self or others.

For inpatient treatment, a person must meet the following criteria:

• be in need of treatment AND
  • either be an imminent danger to self/others, including that of substantial emotional injuries to others; OR
  • be unable to provide for basic personal needs for food, clothing, or shelter, unable to make or communicate rational decisions concerning personal welfare, and lacking the capacity to understand that this is so; OR
  • demonstrate behavior and previous history that indicate a disabling mental illness and unable to make rational decisions concerning treatment.

For outpatient treatment, a person must meet the following criteria:

• have either previous inpatient hospital treatment for a severe mental disorder or substance abuse; OR
• previously been imminently dangerous to self/others; OR
• meet the previous criterion and be capable of surviving safely in the community with available supervision; OR
• based on the treatment history and current behavior, need treatment to prevent deterioration predictably resulting in imminent danger to self/others;
• be unable to make a rational decisions concerning treatment; AND
  • be likely to benefit from outpatient commitment.

State standards for emergency hospitalization for evaluation and state-by-state information on initiating emergency hospitalization and assisted inpatient or outpatient treatment can be found from our Civil Commitment Laws and Standards page. 

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