Involuntary or Civil Commitment

A person experiencing a mental health crisis can be detained by the State if they pose a likelihood of serious harm to others, themselves, or present with a grave disability (unable to provide for basic needs of safety or health).  In an involuntary commitment proceeding, the State serves as the petitioner, or party seeking the commitment. Only the State can petition that an adult be detained.  A Designated Mental Health Professional (DMHP) initiates civil commitment proceedings.  The DMHP is the mental health professional appointed by the county or other authority authorized to perform duties under the civil commitment statute.  Typically a public defender will be appointed to represent the interest of the respondent, the person who is the subject of the detainer.  The commitment may be in an inpatient or outpatient facility.

Who Can Be Detained?

A person suffering from a mental disorder who, as a result of the mental disorder, presents a danger to themselves, others, or property, or is unable to provide for basic needs of their own safety or health (also known as gravely disabled) may be detained.  In some cases, a person suffering from a chemical or alcohol addiction who is gravely disabled as a result of the addiction can be involuntarily committed. The referral for involuntary commitment may occur in the context of a criminal proceeding where an individual has been arrested and displays erratic behavior or where an attorney has concerns that their client is not competent.

How Long will a Person be Detained?

Initially, a person can only be detained for 72 hours.  This may be referred to as a “72-hour hold”.  During the 72 how period (excluding weekends and holidays) the individual will be evaluated by a psychiatrist within 24 hours of detention.  Court evaluators will also complete evaluations in preparation for a court hearing.  A person is not presumed incompetent as a result of being hospitalized.  After the 72 hour period if a determination is made that the person requires mental health treatment they can be held for an additional 14 or 90 days.  The 90 day period may be renewed and the respondent committed for an additional 180 period.  

What if the Person is in Jail?

Many involuntary commitments arise when a person has been contacted by police and law enforcement or jail staff notice unusual behavior.  If a person has a pending criminal investigation and meets the criteria for involuntary commitment at the same time they will be transferred to a hospital for an evaluation.  The Court cannot proceed with a criminal case until the person is deemed competent and able to make decisions on their own behalf. In some cases criminal charges will be dismissed if a person cannot be restored to competency.

Can I speak with or Visit a Person who has been Committed?

Strict confidentiality is maintained in all proceedings.  Family members cannot speak with the person committed unless that person grants permission.  Rules on contacting individuals who are hospitalized vary between facilities but in most cases family members can send mail to the hospital.  The person who is committed will certainly have the option to call out from the facility if they choose.  

What will Happen to the Person if they are Committed?

A civil commitment can be a temporary or long-term event.  The respondent will be assigned an attorney through the office of public defense.  This attorney’s role is to represent the wishes of their client, not the family.  If the individual is unwilling to accept treatment and further treatment is required, the Judge can make a determination at a Probable Cause Hearing that further treatment is necessary.  Further treatment and commitment can be ordered for up to 14 days.  The Judge also has the option to dismiss the case and release the patient.  If it is determined that further treatment is required after the 14 days period, the Judge has the option to grant a petition for 90 days of treatment.  This treatment can either be in an outpatient or inpatient facility.  If the 90 day treatment is inpatient for adults this will occur at Western State Hospital and for juveniles at Fairfax Hospital .Further extensions of treatment are possible upon a showing that they are required under the civil commitment statute.

Who will Pay for Treatment?

The patient and his or her legal guardian or parent are responsible for the cost of hospitalization.  However, if the patient or parent or legal guardian are unable to pay or payment would result in a financial hardship upon the patient or his family then the County of residence will be responsible for the cost.

See more at: King County Crisis and Commitment Services.