Laws regarding involuntary psychiatric hospitalization vary from state to state. In general, one must be a danger to oneself/suicidal, a danger to others/homicidal, or unable to care for oneself due to mental illness, for example malnourished because of thinking food is poisoned.
In Michigan, a family member or a health care provider may “petition” for involuntary treatment. The petitioner must describe, in writing, why they feel that the person in question needs psychiatric treatment. In most cases, this leads to police or EMS bringing the petitioned person to an emergency room for evaluation. If the medical provider there agrees that the petitioned person is in need of further evaluation, that provider completes the First Clinical Certificate for involuntary treatment.
Sometimes, before this takes place, the petitioned person may decide to agree to hospitalization on a voluntary basis. After the first certification is completed, the petitioned person is sent to a psychiatric facility. A psychiatrist must evaluate the patient within 24 hours of hospitalization. At that point, the petitioned person may decide to stay at the hospital on a voluntary basis. If the petitioned person still disagrees regarding their need for treatment, the Second Clinical Certificate is completed.
From there, well, it’s kind of like going to jail—the petitioned person is allowed to make 2 phone calls and offered legal assistance. Within 3 days, the petitioned person has the right to a hearing to determine whether the person still meets criteria for involuntary treatment under the mental health code. In some states, a homicidal person may be held, involuntarily, for up to 180 days. A person who is unable to care for themselves is usually held for treatment until they are either able to care for themselves in the community, in some capacity, or they are sent to a long term residential treatment facility. Homelessness, alone, is not adequate criteria for continued inpatient psychiatric treatment. Having a substance abuse problem that is likely to recur outside of a controlled environment is not adequate legal justification for continued involuntary treatment. And…you’re responsible for the hospital bill.
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