Free PUB-6 Mental Health Commitments (11-07).indd - Alaska


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Mental Health Commitments
(Civil Commitments)
This pamphlet is designed to answer some common questions about civil commitments in Alaska. The information it contains is not a substitute for the Alaska Statutes, and the statements herein are not intended to be and should not be construed as legal advice.

Published by The Alaska Court System PUB-6 (11/07)(blue)

What is civil commitment?
A civil commitment is a procedure by which a mentally ill person is placed in a hospital or other type of health care center for treatment of his or her mental illness. Chapter 47 of the Alaska Statute governs civil commitments in Alaska.

What if a mentally ill person doesn't want treatment?
There are two types of civil commitments: voluntary and involuntary. A mentally ill person may be voluntarily admitted to a treatment facility by signing papers agreeing to be admitted. A person admitted voluntarily can request to be released at any time. The person must be released or involuntary proceedings must be started within 48 hours after receipt of the patient's request. At this point in time, Alaska Psychiatric Institute in Anchorage, Fairbanks Memorial Hospital, and Mt. Edgecumbe Hospital in Sitka are the only treatment facilities in Alaska designated by the Department of Health and Social Services to receive persons seeking to formally commit themselves on a voluntary commitment. However, a number of other hospitals will also admit persons who seek to enter the hospitals because they are mentally ill. If a mentally ill person does not want to get treatment, or is so ill that it is impossible to determine what the person wants, the superior court can commit him or her for treatment against the person's will under certain social circumstances which are described in the Alaska Statutes. A person who has been involuntarily committed can convert to voluntary status at any time if the doctor agrees that the person is an appropriate patient for voluntary hospitalization and is acting in good faith.

Gravely disabled means that the person cannot take care of basic needs, like food and shelter, and this inability puts the person in danger of serious harm. A person is also considered gravely disabled if he or she will suffer severe and abnormal mental, emotional or physical distress if not treated, and this distress is associated with significant impairment of judgment, reason or behavior causing the person to be able to function much less independently. Under this law, a person presents a likelihood of causing serious harm if the person: (1) poses a substantial risk of physically harming self as shown by behavior causing, attempting or threatening harm to self, or (2) poses a substantial risk of harm to others shown by recent behavior and is likely in the near future to physically hurt someone else or cause substantial property damage, or (3) shows a current intent to carry out plans of serious harm to self.

Who makes the decision about whether or not someone should be involuntarily committed?
A superior court judge will decide whether or not a mentally ill person will be involuntarily committed after the judge hears the facts of the case and the opinions of mental health professionals (for example, psychiatrists) who have examined the mentally ill person.

How does the involuntary commitment procedure start?
The procedure usually starts in one of two ways. 1. Any adult can file a petition with the superior court (not a district court judge or magistrate). A petition is a legal document which states: a. that the petitioner (the person who makes out the petition) believes that the mentally ill person (called the respondent) is likely to seriously harm self or others or is gravely disabled as a result of mental illness; b. the facts which support the petitioner's belief, and c. the names and addresses of all persons known to the petitioner who have knowledge of the facts through personal observation.
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How sick does the mentally ill person have to be before being involuntarily committed?
Alaska law is clear on this point. The person must be mentally ill and, as a result of mental illness, must be gravely disabled or present a likelihood of serious harm to self or others.

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Upon receiving a petition, a superior court judge immediately takes steps to either direct a mental health professional to do a screening investigation or a 72-hour ex parte evaluation of the mentally ill person. Depending on the results of that investigation, either the mentally ill person will be hospitalized and a court hearing will then be scheduled, or no further action will be taken. 2. A peace officer (for example, a state trooper or a police officer) who has a good reason to believe that a person is gravely disabled or is suffering from mental illness and is likely to cause serious harm to self or others of such an immediate nature that considerations of safety do not allow for a petition to be filed and screened as described above, can take immediate action. The peace officer can take the mentally ill person into custody and deliver him or her to the nearest hospital or other appropriate facility, which can evaluate the person. (Government health officers and public health nurses are considered peace officers under this law, also.) When the peace officer delivers the person to the evaluation facility, the peace officer fills out a request that the person be examined by a mental health professional. The person is admitted to the facility and held while an investigation is conducted. The investigation must take place within 24 hours after the person's arrival. Depending on the results of that investigation, the mentally ill person may be hospitalized and a court hearing will then be scheduled.

If the situation is not an emergency, you or any other adult can write up and sign a petition about the mentally ill person and give it to a superior court. The contents of the petition were described above. There is no filing fee or other charge for doing this. Each superior court in the state has petition forms you can fill out and sign. The addresses of all superior courts are listed at the end of this pamphlet. This petition can only be acted upon by a superior court. However, you may contact your local court for assistance. A person who files a petition in good faith upon either actual knowledge or reliable information cannot be found civilly or criminally liable as a result of filing the petition. However, a person who willfully begins an involuntary commitment procedure by filing a petition with the superior court without good cause to believe the other person is suffering from a mental illness and, as a result, is gravely disabled or likely to cause serious harm to self or others is guilty of a felony

Where does a person who is committed go?
At this point in time, Alaska Psychiatric Institute in Anchorage, Fairbanks Memorial Hospital, and Mt. Edgecumbe in Sitka are the only treatment facilities in Alaska at which committed persons are placed for treatment on an inpatient basis.

What can I do if I know someone I think is mentally ill and needs help? Whom should I contact?
You can get information about how you can help a mentally ill person by contacting your community mental health center or your regional Behavioral Health (DBH) regional coordinator. (See page 7.) If the situation is an emergency (for example, if you think the person is going to hurt self or others if some immediate action isn't taken), contact a peace officer. As described above, a peace officer can take immediate custody of the mentally ill person.
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What are the committed persons's rights and who makes sure that the person is treated fairly?
From the time any action is taken against a mentally ill person, that person is entitled to legal protection and help. The person has definite legal rights which will be protected. The person has the right to be notified, orally and in writing, of the commitment proceedings and his or her rights. These explanations must be given in a language the person understands. The person has the right to communicate with a guardian or another adult of his or her choice.
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The person will be represented by a lawyer, and is entitled to a free lawyer if the person and the family cannot pay to hire a lawyer. The person will be able to attend court hearings about the case, and the person can present evidence and crossexamine witnesses. The person has a right to have a court hearing within 72 hours (excluding weekends and holidays) after arriving at a treatment facility for evaluation, and has the right to have further hearings 30 days later, 90 days later, and then 180 days later if the commitment continues. The person has specific rights to receive treatment and to refuse specific types of treatment which are listed in the Alaska Statutes. The treatment facility may administer medication to a person without the patient's consent only if there is a crisis situation requiring immediate use of medication to preserve the life of, or prevent significant physical harm to, the patient or another person and if the medication is ordered by a licensed physician. The treatment facility may also administer psychotropic medications against the person's will in non-emergencies if it follows the procedures set out in Alaska Statutes. The person's freedom can only be restricted to the extent necessary for treatment. The person has a right to be treated at an appropriate facility as close to his or her home as possible. The person must be released at any time if his or her condition improves to the point that he or she is no longer committable. The person retains his or her civil rights, and the care and treatment received are kept confidential. The person has the right to a nutritional evaluation and the right to receive a medically appropriate diet while in the treatment facility. The person has the right to be free of corporal punishment, the right to exercise and recreation and the right to be in contact with a lawyer. After release, the person can request that all records of the commitment proceedings be expunged (erased). There is a non-profit advocacy agency, which responds to complaints of abuse, neglect and other rights violations from individuals in mental health facilities such as API (Alaska Psychiatric Institute). Information about how to contact the Disability Law Center is listed at the end of this pamphlet.
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How long does a civil commitment last?
That depends. A committed person must always be released as soon as the person's condition improves to the point that he or she could no longer be committed under the standards of the law. If the person was taken to a treatment facility by a peace officer, the first court hearing must be held within 72 hours (excluding weekends and holidays) of when the mentally ill person arrived at a treatment center for evaluation. If the superior court judge finds that the person should be involuntarily committed, a 30-day commitment order is made. At the end of 30 days, if the person's condition has not improved, another hearing is held and the person may be committed for up to 90 days more. Likewise, at the end of 90 days, another hearing may be held and a commitment order of up to 180 more days may be made. After that, hearings are held and orders are made every 180 days. The patient has the right to a jury trial concerning any extended commitment petition. A voluntary commitment can last as long as the person continues to be mentally ill and continues to consent to a voluntary commitment.

Can a child be civilly committed?
Yes, but the procedures are slightly different. The child's parents or guardians are involved in the procedures.

Can a person appeal from a judge's decision ordering a civil commitment of that person?
Yes, the person can appeal from any court order of involuntary commitment, and the judge must tell the person about the right to appeal.

Who pays for all of this?
To the extent that they can, a person who is committed, or a legal guardian, or a spouse, or parents if the person is under 18 years of age, must pay for the care, transportation and treatment of the person. If no one else can pay the expenses, the State of Alaska will pay. When the commitment process is started, the Department of Health and Social Services is required to arrange and pay for the transportation
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of the person to a treatment facility. The department also pays for appropriate persons to go with the mentally ill person, and for return transportation for these people. When advisable, one or more relatives or friends shall be permitted to go with the mentally ill person. The department may pay necessary travel, housing and meal expenses for one relative or friend to go with the person, if the department finds that the person's best interests require travel with the relative, or friend and the relative or friend doesn't have enough money to pay these expenses. For more information about this possibility, contact your community mental health center or your Behavioral Health (DBH) regional coordinator.

Office of Public Advocacy Anchorage: 900 W. 5th Ave., Suite 525 Anchorage, AK 99501 269-3500 460 Ridgecrest Dr., Ste 219 PO Box 2129 Bethel, Alaska 99559 543-1234 100 Cushman, Suite 525 Fairbanks, AK 99701 451-5933 Assembly Building, Room 103 P.O. Box 110225 Juneau, AK 99811 465-4718 808 S. Bailey Street #103 Palmer, AK 99645 746-0594 Disability Law Center of Alaska 3330 Artic Boulevard, Suite 103 Anchorage, AK 99503 1-800-478-1234 [email protected] District Court Location That Will Accept Civil Commitment Petitions Homer: 3670 Lake Street Homer, AK 99603 235-8171

Bethel:

Fairbanks:

Behavioral Health Regional Offices
Juneau: Central Region P.O. Box 110620 Juneau, AK 99811-0620 Phone: 465-3370 Fax: 465-2668 1-800-465-4828 Anchorage Region 3601 C Street, Suite 878 Anchorage, AK 99503 Phone: 269-3600 Fax: 269-3623 1-800-770-3930 Northern Region 751 Old Richardson Highway, Ste. 100A Fairbanks, AK 99701 Phone: 451-5045 Fax: 451-5046 1-800-770-1672

Palmer:

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Superior Court Locations Anchorage: 303 K Street Probate Anchorage, AK 99501 Box 270 Barrow, AK 99723 Box 130 Bethel, AK 99559 Box 909 Dillingham, AK 99576 101 Lacey Street Probate Fairbanks, AK 99701 Box 114100 Juneau, AK 99811 125 Trading Bay Dr., Ste. 100 Kenai, AK 99611 415 Main Street, Room 400 Ketchikan, AK 99901 204 Mission Road, Room 124 Kodiak, AK 99615 Box 317 Kotzebue, AK 99752 Box 1110 Nome, AK 99762 435 South Denali Palmer, AK 99645 304 Lake Street Sitka, AK 99835 264-0433

Barrow: Bethel: Dillingham: Fairbanks:

852-4800 543-2298 842-5215 452-9257

Juneau: Kenai: Ketchikan: Kodiak: Kotzebue: Nome: Palmer: Sitka:

463-4707 283-8501 225-3195 486-1600 442-3208 443-5216 746-8127 747-3291
For more information about this publication, please call the Alaska Court System Administrative Office at (907) 264-8240 820 West Fourth Avenue Anchorage, Alaska 99501