From the Guidelines
In Massachusetts, the process for involuntary commitment for mental health reasons primarily occurs through Section 12 proceedings, which allows for emergency hospitalization and evaluation of an individual who presents a danger to themselves or others due to mental illness. This process is crucial in balancing individual civil liberties with public safety and treatment needs, recognizing that involuntary commitment represents a significant restriction of personal freedom and should only be used when absolutely necessary for the individual's safety or the safety of others 1.
The process begins when a qualified mental health professional, physician, police officer, or family member petitions for emergency hospitalization, allowing for a 3-day hospitalization for evaluation. If longer treatment is needed, the facility must petition the court for continued commitment under Section 7 and 8, which can extend hospitalization for up to 6 months. During court hearings, the individual has legal rights including representation by an attorney, the right to present evidence, and to cross-examine witnesses. For commitment to be approved, the court must find clear and convincing evidence that the person has a mental illness, poses a likelihood of serious harm, and that no less restrictive alternative exists.
Key considerations in the evaluation process include assessing the individual's risk of harm to themselves or others, their mental health history, and the presence of any underlying psychiatric conditions. As noted in a study on suicidal adolescents, management depends on the degree of acute risk, and intent is a key issue in determining risk 1. The study highlights the importance of vigorous treatment of underlying psychiatric disorders in decreasing short-term and long-term risk of suicide.
Massachusetts also has provisions for outpatient commitment through Rogers Guardianship for medication administration. This process allows for individuals to receive necessary treatment while maintaining their autonomy and freedom. However, as emphasized in a study on consent for anaesthesia, patients cannot be treated as lacking capacity to consent to or refuse medical procedures unless all practicable steps to support them to do so have been taken without success 1.
In the context of mental health treatment, it is essential to prioritize the individual's autonomy and capacity to make decisions about their care. As noted in the study on consent for anaesthesia, a patient's decision does not have to be sensible, rational, or well-considered, and refusal of treatment by an adult with capacity is legally binding, even if refusal is likely to result in the patient's death 1.
Ultimately, the goal of involuntary commitment is to provide necessary treatment and support to individuals in crisis while respecting their rights and autonomy. By prioritizing the individual's safety and well-being, and ensuring that all alternatives have been explored, the process of involuntary commitment can be a crucial step in providing necessary care and support.
From the Research
Involuntary Commitment for Mental Health Reasons in Massachusetts
- The process for involuntary commitment for mental health reasons in Massachusetts is governed by state laws and regulations.
- To be involuntarily committed, an individual must pose a risk to themselves or others due to a mental illness, as determined by a court or authorized medical professional.
- The following are the general steps involved in the involuntary commitment process in Massachusetts:
- Emergency evaluation: A person may be brought to a hospital or crisis center for an emergency evaluation if they are deemed to be a risk to themselves or others.
- Application for commitment: If the evaluation determines that the person meets the criteria for commitment, an application for commitment may be filed with the court.
- Court hearing: A court hearing is held to determine whether the person should be committed to a mental health facility.
- Commitment order: If the court determines that the person should be committed, a commitment order is issued, which may include outpatient treatment or inpatient hospitalization.
Relevant Studies
- Unfortunately, none of the provided studies directly address the process for involuntary commitment for mental health reasons in Massachusetts 2, 3, 4, 5, 6.
- The studies primarily focus on the treatment and management of mental health conditions, such as bipolar disorder, and the safety and efficacy of various medications.
- Therefore, there is limited relevant information available from these studies to inform the process of involuntary commitment in Massachusetts.