MENTAL HEALTH PROCEEDINGS



Voluntary and Involuntary Hospitalization:

Voluntary Hospitalization:
It is always preferable for someone to be hospitalized voluntarily, if possible. Anticipating crisis situations and developing a plan ahead of time may facilitate voluntary hospitalization. Even after an application or petition for involuntary hospitalization has been initiated, formal commitment can be avoided if the person agrees to cooperate with the treatment plan proposed at the deferral meeting held soon after admission to the hospital.

Involuntary Hospitalization:
In order for a person to be involuntarily hospitalized, they must meet the Michigan Mental Health Code definition of a "person requiring treatment." A person may be seriously mentally ill and still not fit that definition. The Probate Court, based on statements made by the person initiating the proceedings and by either two physicians or one physician and one clinical psychologist, makes the determination as to whether the individual is a person requiring treatment.
A recent amendment to the Mental Health Code ("Kevin's Law, 2004) allows involuntary outpatient treatment for a person who "as a result of mental illness, is unlikely to voluntarily participate in treatment" and in addition specifies that, "For a judge to order treatment, an individual must have been hospitalized, jailed, imprisoned, or have acted violently within the previous two years."

The Michigan Mental Health Code defines mental illness as "a substantial disorder of thought or mood that significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life." Mental illness alone, however, is not sufficient to justify involuntary hospitalization. The Mental Health Code defines "person requiring treatment" as follows:

330.1401 "Person requiring treatment" defined; exception. Sec. 1401.
(1) As used in this chapter, "person requiring treatment" means (a), (b), or (c):
a. An individual who has mental illness and who as a result of that mental illness can reasonably be expected within the near future to intentionally or unintentionally seriously physically injure himself or another individual, and who has engaged in an act or acts or made significant threats that are substantially supportive of the expectation.
b. An individual who has mental illness, and who as a result of that mental illness is unable to attend to those of his or her basic physical needs such as food, clothing or shelter that must be attended to in order for the individual to avoid serious harm in the near future, and who has demonstrated that inability by failing to attend to those basic physical needs.
c. An individual who has mental illness, whose judgment is so impaired that he or she is unable to understand his/her need for treatment and whose continued behavior as the result of this mental illness can reasonably be expected, on the basis of competent medical opinion, to result in significant physical harm to himself or herself or others. This individual shall receive involuntary mental health treatment initially only under the provisions of section 434 through 438 of this act.
(2) An individual whose mental processes have been weakened or impaired by a dementia, an individual with a primary diagnosis of epilepsy, or an individual with alcoholism or other drug dependence is not a person requiring treatment under this chapter unless the individual also meets the criteria specified in subsection (1). An individual described in this subsection may be hospitalized under the informal or formal voluntary hospitalization provisions of this chapter if the hospital director considers him or her clinically suitable for hospitalization.

Any person 18 years or older may file a petition/application which asserts that an individual is a person requiring treatment. This may be a family member, friend, mental health worker, police officer, or any adult who has direct knowledge on which to base their assertion that the person requires treatment.

Admission by Application
A relative, mental health worker, police officer or other person may take a person who appears to be mentally ill to a physician, or nearest emergency room for assessment. A Petition/Application for Hospitalization referred to as (Application) for this method of admission must be completed.

The form requires examples of recent behaviors which have been directly observed by the person filling out the form, and why the individual needs to be hospitalized. (See Section 401 criteria.) The form must also include the names and addresses of witnesses and the name and address of the persons nearest relative, guardian or friend. The form may be obtained through Probate Court, or  the Charlevoix Community Mental Health agency at 6250 M-66 North, Charlevoix, MI 49720, (231) 547-5885.
A physician or clinical psychologist will examine the individual. If the doctor finds that the individual meets the criteria for admission, he/she will fill out a Clinical Certificate stating that the person examined required treatment. The individual will then be admitted to a hospital and a psychiatrist will complete a second assessment and Clinical Certificate.
If the mental health professional that conducts the preadmission screening denies hospitalization, the relative or other involved person may request a second opinion and an additional evaluation will be performed as soon as possible.
Within 72 hours of admission, excluding Sundays and holidays, the individual will have a deferral meeting in the hospital and be assigned representation by a lawyer. The patient may also designate a friend or relative to attend. At this meeting, a representative from CMH and one from the hospital will present a proposed treatment plan. If the person agrees to cooperate with this plan, he/she is accepted as a voluntary patient. However, if at any time during the course of treatment the person refuses to accept the agreed-on treatment, the hospital may notify the Probate Court and a court hearing will be held on the original application.
The hearing will be held within 7 days of the date that all necessary forms are received by the Probate Court. It will be necessary for the individual who signed the application to be in court in order to testify about the person's behavior.

Admission by Petition
A Petition/Application for Hospitalization referred to as (Petition) for this method of admission, must be completed. (See section on Admission by Application for further details.)
The main difference between the Application procedure and by filing by Petition, the Petition/Application for Hospitalization is filed directly with the Probate Court. However, in Charlevoix, all admissions by Petition must be screened prior to the filing with the Court by North Country Community Mental Health. A Clinical Certificate should accompany the Petition/Application for Hospitalization, but if it is not possible to obtain one, the Probate Court can order (by police transport if necessary) the person to be examined by a psychiatrist and either another physician or a clinical psychologist. If the person is found to be a person requiring treatment, there will be a deferral meeting. Then, a court hearing will be held within 7 days after the Probate Court receives the necessary forms, if the person does not agree to defer the hearing and accept the treatment plan as outlined in the individual's plan of service.

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