Mental Commitment, Civil Commitment, Involuntary Commitment Proceedings

The terms “Mental Commitment,” “Civil Commitment,” and “Involuntary Commitment” all refer to legal proceedings in which someone with a mental illness is committed to a mental health facility against their will.  In Texas this process is governed by the Texas Constitution and the Texas Health & Safety Code.  This blog post is designed to walk you through the steps of having someone who is suffering from a severe mental illness committed to ensure the safety of that person and/or others.

4 Steps of Mental Commitment

There are up to 4 steps in the Mental Commitment process:

1. Emergency Detention;
2. Protective Custody;
3. Temporary Commitment (up to 90 days); and
4. Extended Commitment (12 months).

Step 1 in Mental Commitment: Emergency Detention

There are 3 types of Emergency Detention:

1. Emergency Detention without a warrant (Peace Officer initiated);
2. Emergency Detention without a warrant (Guardian initiated); and
3. Emergency Detention with a warrant.

Emergency Detention without a warrant (Peace Officer Initiated)

If a peace officer believes 1) that the person is mentally ill and 2) that there is a substantial risk that the person will harm himself or others if that person is not immediately restrained (i.e., there is not time to go to the judge and get a warrant issued) then the officer may take that person into custody without a warrant and transport the person to the nearest inpatient mental health facility.  Once at the facility, the officer may then file an application with the facility for an emergency detention.

Emergency Detention without a warrant (Guardian initiated)

Guardians of an adult person may not provide consent for inpatient psychiatric commitment.  However, if a guardian believes 1) that the ward is mentally ill and 2) that the ward poses a substantial risk to harm herself or others without immediate restraint, then the Guardian may transport the ward to an inpatient mental health facility and apply for a preliminary examination and emergency detention without a warrant.

Emergency Detention with a Warrant

Typically this is the least common situation because if someone is suffering from severe mental illness that warrants an emergency detention there is not usually time to seek out a warrant.  That said, any adult may file an Application for Emergency Detention.  If the court finds reasonable cause it will issue a warrant for the proposed patient to be apprehended, transported to an inpatient mental health facility, and detained until further proceedings.

Step 2: Protective Custody

1. Presentment (P) to Mental Health Facility
2. Within P + 12 Hours:
   • The Mental Health Facility must complete a Preliminary Physician Exam, and
   • Issue a Medical Certificate
3. Within P + 48 hours:
   • The proposed patient must either be released, or
   • An Application for Court-Ordered Mental Health Services (Application) must be filed which contains allegations that the proposed patient presents a substantial risk of serious harm to self or others which will result in an Order of Protective Custody (OPC) allowing the proposed patient to be detained at the mental health facility for an additional 72 hours.
4. Application + 24 hours
   • Court must appoint an attorney to represent the proposed patient.
5. OPC + 72 hours
   • Probable Cause Hearing must be held to determine if the proposed patient can continue to be detained in the Mental Health Facility pending the final hearing.

Step 3: Temporary Commitment (90 days)

1. Application + 14 days: Final Hearing must be held.
   • Proposed Patient has right to be present.
   • Medical Certificates from 2 doctors required.
   • Hearing is public (unless good cause to close to public is shown).
   • Proposed Patient has a right to a jury trial.
   • Testimony of at least one psychiatrist must be presented.
2. Possible outcomes:
   • Court orders Inpatient Mental Health Services (90 days);
   • Court orders Outpatient Mental Health Services (90 days); or
   • Court releases proposed patient.
3. The deciding factor between whether the court orders Inpatient or Outpatient Mental Health Services is whether it is determined that the proposed patient is likely to cause serious harm to himself or to others.

Step 4: Extended Commitment (12 Months)

If after 90 days it is believed that the patient requires further treatment, then an application for extended treatment can be filed.  To order the patient to undergo extended commitment, the court must find:

1. The patient is mentally ill;
2. That the patient’s condition will last longer than 90 days; and
3. The patient has been admitted to inpatient treatment under court order for at least 60 days in the last 12 months.

Involuntary Commitments & Guardianships

• Guardians may voluntarily admit a ward who is under age 18, but
• Guardians may not voluntarily admit a ward who is over age 18; however,
• A Guardian may transport an adult ward to a mental health facility and apply for a “preliminary examination” and emergency detention without a warrant, and
• A Guardian may consent to involuntary psychoactive medication for an adult ward who is under an Order of Protective Custody.

Chemical Dependency Commitments

The process for a chemical dependency commitment is very similar to a mental health commitment.

The attorneys at Romano & Sumner are experienced in the guardianship process as well as mental health commitments.  To speak to an attorney about guardianship or mental health commitment, contact our office today.