Transcript 5150 and Emergency Placements - United Advocates for Children

Sierra Vista Hospital
Department of Psychological Services
Understanding 5150 Laws
Presented by
Scott Christian Selinsky MA
Sierra Vista Hospital
Court Liaison
Learning Objectives
 Participants will understand the 5150 Process.
 Participants will become familiar with legal language used in
involuntary detentions.
 Participants will understand how to interact effectively with the
involuntary detention process to achieve more favorable outcomes
for themselves and family.
Overview of Topics
 Important Terms
 Lanterman, Petris, Short Act
 Criteria for an Involuntary Hold
 Voluntary vs. Involuntary
 What Happens After a 5150 Expires
 Patients’ Rights
 Due Process Right
 The Parent’s Role When the Detainee is a Minor
 Glossary
 Where to Find More Information
Important Terms
Involuntary
Voluntary
LPS
Criteria
Probable Cause
WHY?
Lanterman-Petris-Short Act of 1968
 Rising public awareness and concern for abuses related to
involuntary commitment, as well as to threats to the welfare of the
community prompted legislatures to frame legal codes that attempt
to balance the needs of individuals for freedom with their need for
treatment.
WHY?
LPS Legislative Intent
 To end the inappropriate, indefinite, and involuntary commitment
of mentally disordered and developmentally disabled persons, and
those impaired with chronic alcoholism.
 To require treatment and rehabilitation be the least restrictive
alternative to a total curtailment of freedom and the personal
liberty of the individual.
 To provide prompt evaluation and treatment for these persons.
 To guarantee and protect the public interest.
 To safeguard individual rights through judicial review.
WHY?
Who Can Write Holds?
Mental Health Director
Certified 5150 Designees
Authorized staff at a designated 5150 psychiatric facility
Law Enforcement-Peace Officers
WHO?
Criteria for an Involuntary Hold
Danger to Self and/or
Danger to Others and/or
Gravely Disabled Adult/Minor
WHO?
Danger to Self
Deliberate plan to inflict serious and severe harm to the self, possibly
life-threatening, with the means and intention to use the means other
life-threatening behaviors where impending severe injury or death is
imminent.
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Some Factors Being Considered May Be:
Words or actions showing intent to commit suicide or serious bodily harm
Words or actions indicating gross disregard for personal safety
Words or actions indicating a specific plan for suicide
Means available to carry out suicide plan
WHO?
Danger to Others
Danger to Others is based on criteria including behaviors and
verbalizations indicating the person in question either intends to
cause severe harm to a particular individual, or intends to engage
in acts potentially life-threatening against others, or intends to
engage in acts with gross disregard for the health and safety of
others.
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Some Factors Being Considered May Be:
Nature of the threats against society, others in general, or a particular
individual(s)
Current and prior threats or attempts to harm others or a particular
individual(s)
Means available to carry out threats (i.e., firearms, weapons, poisons);
Expressed intention or attempts to engage in life threatening activities.
WHO?
Gravely Disabled Minor
"Gravely disabled minor" means a minor who, as a result of a mental
disorder, is unable to use the elements of life which are essential to
health, safety, and development, including food, clothing, and
shelter, even though provided to the minor by others. (W & I Code
5585.25)
Involuntary Hospitalization
The LPS Act permits involuntary hospitalization only of those mentally
disabled persons for whom such confinement, with its accompanying
severe deprivation of liberty, is necessary and appropriate.
The LPS Act authorized involuntary evaluation and treatment only for
individuals who are dangerous to themselves and others, and/or
gravely disabled.
Involuntary hospitalization is a temporary suspension of an individuals
rights and freedoms.
Voluntary Hospitalization
5150 application NOT always required
When, as a result of a mental disorder, someone is a
danger to self, danger to others and/or gravely disabled
and they are willing and capable of voluntarily selfadmitting into a 5150 psychiatric facility then the criteria
for admission can be
voluntary.
It is important to have safeguards and supports in place
whether voluntary or involuntary.
Legal Status Can Change
A patient who is admitted to the an inpatient psychiatric facility on a
voluntary basis but later becomes unwilling or unable to accept
voluntary treatment, and is deemed to be a danger to self, others, or
gravely disabled due to a mental disorder, can be placed on an
involuntary hold.
On the other hand, a patient admitted involuntarily to an inpatient
psychiatric facility may be signed in voluntarily for additional
inpatient treatment by themselves (adults only), or by a parent/legal
guardian (minors).
What Happens After the 72 Hours?
 5250 14-Day Certification
 Certification Review Hearing for contesting a 5250 Hold
 Writ of Habeas Corpus by Judicial Review
 5260 Re-Certification as Suicidal 14 more Days
 Certification Review Hearing for contesting a 5260 Hold
 Writ of Habeas Corpus by Judicial Review
 5270 Additional 30 Days Intensive Treatment (GD Only)
 Certification Review Hearing for contesting a 5270 Hold
 Writ of Habeas Corpus by Judicial Review
Other Matters:
 5300 Post-Certification (Dangerous Persons) 180 Days
 5352 Temporary Conservatorship (Gravely Disabled)
 5350 Conservatorship for Grave Disability
Patients Rights While Detained
 Rights that can be denied with good cause.
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Clothing
Money
Visitors
Storage Space
Personal Possessions
Telephone
Mail
Writing Materials
 Rights that CANNOT be denied.
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Humane Care
Social Activities and Recreation
Education
Religious Freedom and Practice
Freedom from Discrimination
Due Process Rights
 Any person placed on an involuntary hold is entitled to due process.
This means that within four days of the hold being written, he they
are guaranteed an opportunity to speak to a Superior Court Judge
or Hearing Officer about their hold status, within 4 days of the hold
being written.
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Certification Review Hearings
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Writ of Habeas Corpus Hearings
The Parent’s Role
 As best you can, understand what the LPS law says before you child is ever placed on
a hold.
 Your child can be placed on an involuntary hold without you present, so be as readily
available to offer information to the person evaluating your child for 5150 criteria.
 Know that the designee writing the hold can detain your child for assessment—
without your consent. LPS law gives them this authority.
 If your child is hospitalized, immediately after admit, request to speak to the treating
physician. If not available, ask when you can call back. Do not hesitate to ask the
hospital’s administration to assist you in securing contact with the doctor.
 If you disagree with the detainment, inform the doctor and let the doctor know why.
 Be emotionally prepared for the doctor to detain your child for the duration of the
5150 anyway. Most doctors treat children with great caution.
 Be ready to discuss medications, and be sure to ask lots of questions, so as to make
an informed decision. Try to be flexible. Conflict is typically counterproductive to
your child’s hospital experience.
 Even if you and the doctor do not reach consensus, recognize that in the vast majority
of cases, the doctor is trying to help, using the tools they have been extensively
trained to apply to these types of circumstances.
 INCLUDE YOUR CHILD IN THIS DIALOGUE.
Brief Glossary
5250—14 day hold for DTS and/or DTO and/or GD
5260—14 day hold that can be written after a 5250 expires; it is for DTS only
5270—30 day hold that can be written after a 5250 expires; it is for GS only
5300—180 day hold that can be written after a 5250 or 5270; it is for DTO only
Cert Hearing—shorthand for Certification Review Hearing, granted to any patient placed on 5250 or 5270. These matters are presided over by
a Hearing Officer, and the patient receives the assistance of a Patients’ Rights Advocate to present their case at the hearing.
Confidential—the obligation during the course of a professional relationship, not to disclose information about a patient or client without the
explicit permission of the individual
DTO—shorthand for Danger To Others
DTS—shorthand for Danger To Self
GD—shorthand for Grave Disability
Good Cause—refers to the criteria for denying a specific patients right; good cause exists only when allowing the right would cause injury to
that person or others, serious infringement on the rights of others, or serious damage to the facility
ICR—shorthand for Independent Clinical Review. It is the right of all minor patients to seek to get out of the hospital after their parent or legal
guardian has signed them in voluntarily for more inpatient treatment. The minor can ask the hospital to arrange for a such a review of their
case, and if the reviewer agrees with the minor, the minor must be discharged, even if it against the wishes of the parent/guardian and/or the
treating physician.
Involuntary—the circumstance where an individual is placed on a legal hold and detained against their will (or perhaps against the will of their
parent/guardian) for the purpose of evaluation and treatment
LPS—shorthand for the Lanterman, Petris, Short Act
Privacy—refers to the basic constitutional right of all citizens of the United States to decide how much personal information can be shared with
others
Brief Glossary cont’d
Probable Cause—the standard of evidence applied to Certification Review Hearings. Specifically it is commonly understood to mean a
reasonable amount of suspicion, supported by circumstances sufficiently strong to justify a prudent and cautious person’s belief that certain
facts are probably true
Risk Assessment—this is commonly the most significant aspect of assessing whether or not an individual meets criteria to be placed on an
involuntary legal hold. Most professionals that write legal holds utilize the standard of “reasonable and cautious” in assessing risk.
Voluntary—the circumstance where an individual makes an informed decision to accept treatment in an inpatient setting. The individual is
being detained, for treatment, and significant freedoms are curtailed, but this is NOT being done against their will.
Writ Hearing—If an individual does not prevail at their Cert hearing, they are allowed one opportunity to have their matter heard before the
court. The individual is represented by an attorney (typically a Public Defender) at these hearings, and the matter is presided over by a judge
from the Superior Court.
Where To Find More Information
Disability Rights California: Primary Source for MH Advocacy in CA
http://www.disabilityrightsca.org/
CA State Codes for Mental Health: Full Text of the LPS Act
http://leginfo.legislature.ca.gov/faces/codesTOCSelected.xhtml
Kathi’s Mental Health Review: Site with great information on advocacy
http://www.toddlertime.com/advocacy/5150/rights/
NAMI: National Alliance on Mental Illness: Education and support for
individuals and families effected by mental illness
http://www.namicalifornia.org/
Your Presenter: Scott “Christian” Selinsky
(916)288-0321 my office
[email protected] my email