Seniors’ and Families’ Guidelines on Involuntary Commitment
There are certain facts that are unknown to us, until a crisis arrives. And while I try to write with a certain amount of levity, this subject has no light-heartedness about it. The fact is that seniors can be and are “Baker-Acted.” What is the Baker Act? It is the involuntary commitment of a person to a psychiatric facility. How does that happen? An individual demonstrates an inability “to exercise voluntary control over his or her own symptoms” (mental health symptoms.) This can include depression, anxiety, dementia, irritability, aggression, etc. and in the judgment of the evaluator is deemed an imminent danger to him or herself or to others. Such must be documented with the “nature and extent of the danger posed.” The evaluator can be a law enforcement officer, a psychiatrist, a psychiatric nurse, or a psychologist. A person who has been deemed incompetent to consent to treatment will lose that right to consent and will be involuntarily committed.
The second part of involuntary commitment can be involuntary treatment. Involuntary treatment in a psychiatric institution can include psychiatric drugs, electroconvulsive therapy also known as electroshock treatment, and psychosurgery. Interestingly, involuntary treatment for people in a psychiatric facility is now illegal in Germany, the birthplace of psychiatry, but it is still allowed in the U.S.
There are specific things that a person who is involuntarily committed can and cannot do.
- The person does have the right to file a petition for a writ of habeas corpus to formally request why he or she is being detained.
- The person does not have the right to refuse the involuntary commitment but does have the right of informed consent regarding the risks and the alternatives to the proposed treatment. If a person strongly objects to a particular form of treatment, the person’s guardian/guardian advocate or surrogate/proxy should talk with the patient to determine the reasons for the objections. If appropriate, the guardian/guardian advocate or surrogate/proxy may, based on this information, withdraw his or her consent for the proposed treatment and negotiate a revised treatment plan with the physician.
There may be many reasons why a person may decide not to consent to a particular medication or to any medication ordered by a particular physician, or to treatment ordered at a particular facility. The decision as to whether a person is competent to consent is a clinical judgment of his or her capacity to decide, not one based on whether the person does or doesn’t provide such consent.
According to the Baker Act, the psychiatric treatment needs to be given in “the least restrictive manner.”
What is most important here is that you, I, all of us should be well-prepared for this possibility. If we have appointed a guardian/guardian advocate in advance, such a person can act on our behalf in this unfortunate situation. If there is no guardian, the administrator of the psychiatric facility, upon the recommendation of the psychiatrist, can authorize what is considered “emergency medical treatment.”
The guardian should be well aware of your wishes in advance. Suffice it to say that the irreversible effects of psychiatric drugs, shock treatments, and psychosurgeries are well documented. There is no medical test that psychiatry performs, to evidence a “chemical imbalance.” Therefore any claim that a psychiatric drug will balance chemicals in the brain is pure folly. However suicide, physical illness, aggression, and other maladies are FDA listed warnings on the psychiatric drugs, and have been well-documented.
For further information on this subject, log on to cchrflorida.org or call 800-782-2878.
Lee N. Sheldon, DMD