Psych Test 1 Review
UNIT 1 – Mental Health, Mental Illness, & Legal Issues
Mental Health and Mental Illness
Review The Focus Sheet on the Florida Mental Health Act
**pasted below**
What is the Baker Act?
The Florida Mental Health Act, commonly referred to as the Baker Act, applies to all those who enter
public or private facilities as voluntary or involuntary mental health clients. All aspects of their care,
including the protection of their rights, are addressed in this act.
How Does Voluntary Admission To A Psychiatric Facility Occur?
Clients who are voluntarily admitted to a psychiatric facility sign a CFMH 30-40 consent form. Voluntary
clients must be able to give informed consent. This means they must be able to understand the purpose of
the treatment to be provided, the common side effects of the treatment, and the alternative treatments that
are available.
What is the "Right to Release" form?
Unlike general medical facilities, voluntary clients at psychiatric facilities cannot simply sign themselves
out against medical advice. This decision is up to the treating psychiatrist. If there is a dispute between the
voluntary client and his/her admitting psychiatrist regarding length of stay, the client must sign a "Right to
Release" form. If the admitting psychiatrist wants to petition the court to hold the client involuntarily, a
CFMH 30-32 petition must be filed within 24 hours.
How Does Involuntary Admission To A Psychiatric Facility Occur?
There are three admission procedures whereby clients are involuntary placed for psychiatric examination.
Exparte: This takes place when one or more people in the community (commonly family members or
friends) believe that an individual needs psychiatric treatment. The three individuals are required to present
their concerns in writing to the judge. An order is signed asking law enforcement to bring the individual to
the nearest Baker Act receiving facility (i.e., a facility that is licensed by the state for the treatment of
mental health clients).
CFMH 30-52a: This takes place when a law enforcement officer observes that an individual clearly is at
risk for harming self or others. The officer transports that person to the nearest Baker Act receiving facility.
CFMH 30-52b: This takes place when a mental health professional initiates the admission. The mental
health professional (physician, psychologist, nurse or social worker) must be specifically licensed for this
purpose.
How Long Can Clients Be Involuntarily Detained For Screening?
1
,For all three types of involuntary admissions, the individual can be held for a period of no longer than 72
hours. Within this 72 hour period, one of three things must happen:
1. The client has signed a CFMH 30-40 form for voluntary admission.
2. The physician has signed a discharge form.
3. The physician has signed a petition for involuntary commitment.
How Does Involuntary Commitment To A Psychiatric Facility Occur?
A petition for an involuntary placement court hearing (CFMH 30-32) is initiated by a psychiatric hospital
administrator and signed by the treating psychiatrist. A second psychiatrist also signs. According to client's
rights for "due process", the court hearing must take place within five working days from the time the
petition is filed. A date is set for the court to hear the petition and to determine the disposition of the case.
What Happens At A Court Hearing For Involuntary Commitment?
The client is present for the hearing and is represented by his/her own attorney or a public defender is
provided. The treating psychiatrist is present with a representative of the state attorney's office. A
representative from the Human Rights Advocacy Committee also attends and any of the client's family
members, guardians or friends who wish to do so. An attorney appointed by the court to oversee the
proceedings, called a hearing master, listens to the evidence on both sides and makes the final
determination of whether the petition is or is not granted.
During the hearing many issues are discussed. It must be established that the client suffers from a mental
illness, what the nature of the illness is, what treatment is required, and whether any less restrictive
treatment alternatives are available or appropriate. "Clear and convincing evidence" must be presented that
the individual meets the criteria for involuntary psychiatric treatment.
What Criteria Determine The Need For Involuntary Commitment?
Any client who is involuntarily held for psychiatric treatment must meet the following criteria:
1. The client must have refused voluntary placement after sufficient and conscientious
explanation of the purpose of the treatment.
2. The client must be unable to determine for him or herself whether placement is necessary,
and
3. The client either:
a. is likely to suffer from neglect or refuse to care for self and such neglect would pose a
real and present threat of substantial harm to the person's well-being and it is not
apparent that such harm could be avoided through the help of willing or responsible
family or friends OR
b. there is a substantial likelihood that, in the near future, client will inflict serious harm on
self or another person as evidenced by recent behavior causing, attempting or
threatening such harm.
What Happens To The Client After All The Evidence Has Been Heard?
2
, If the hearing master denies the petition, the client is discharged immediately. If the petition is granted, an
order is issued (CFMH 30-08) for involuntary placement in a facility which is either private or public
(funded by the state). The client must be screened to determine if any lesser restrictive environment is
appropriate. A guardian advocate may need to be appointed if the client is deemed unable to make his/her
own treatment decisions.
How Is A Guardian Advocate Different From A Legal Guardian?
A guardian advocate is different from a full legal guardian and is appointed for the purpose of giving
consent for psychiatric treatment only. Consent for medical, surgical or ECT procedures cannot be
provided by the guardian advocate. The guardian advocate may be a family member or, if that is not
appropriate, a trained but unpaid volunteer is appointed by the court. Once the psychiatric treatment is
completed, the guardian advocate is dismissed.
Do Clients Who Are Involuntarily Committed Lose Their Civil Rights?
Involuntary committed clients retain all their civil rights. They may make their own decisions about how to
spend their money and may sign binding contracts. Clients lose their civil rights only when they are
declared legally incompetent and a legal guardian is appointed who makes decisions for the client. This is
a separate legal proceeding from a Baker Act hearing.
How Long May An Involuntary Client Be Held For Treatment?
Involuntary orders are good for from seven days to six months. The CFMH 30-08 order often specifies a
time period within that range during which the client's treatment must be accomplished. A client may be
stabilized sooner than the psychiatrist expected and thus may be discharged prior to the end of the specified
period of treatment. However, the client cannot be kept longer than the period specified in the petition.
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UNIT 1 – Mental Health, Mental Illness, & Legal Issues
Mental Health and Mental Illness
Review The Focus Sheet on the Florida Mental Health Act
**pasted below**
What is the Baker Act?
The Florida Mental Health Act, commonly referred to as the Baker Act, applies to all those who enter
public or private facilities as voluntary or involuntary mental health clients. All aspects of their care,
including the protection of their rights, are addressed in this act.
How Does Voluntary Admission To A Psychiatric Facility Occur?
Clients who are voluntarily admitted to a psychiatric facility sign a CFMH 30-40 consent form. Voluntary
clients must be able to give informed consent. This means they must be able to understand the purpose of
the treatment to be provided, the common side effects of the treatment, and the alternative treatments that
are available.
What is the "Right to Release" form?
Unlike general medical facilities, voluntary clients at psychiatric facilities cannot simply sign themselves
out against medical advice. This decision is up to the treating psychiatrist. If there is a dispute between the
voluntary client and his/her admitting psychiatrist regarding length of stay, the client must sign a "Right to
Release" form. If the admitting psychiatrist wants to petition the court to hold the client involuntarily, a
CFMH 30-32 petition must be filed within 24 hours.
How Does Involuntary Admission To A Psychiatric Facility Occur?
There are three admission procedures whereby clients are involuntary placed for psychiatric examination.
Exparte: This takes place when one or more people in the community (commonly family members or
friends) believe that an individual needs psychiatric treatment. The three individuals are required to present
their concerns in writing to the judge. An order is signed asking law enforcement to bring the individual to
the nearest Baker Act receiving facility (i.e., a facility that is licensed by the state for the treatment of
mental health clients).
CFMH 30-52a: This takes place when a law enforcement officer observes that an individual clearly is at
risk for harming self or others. The officer transports that person to the nearest Baker Act receiving facility.
CFMH 30-52b: This takes place when a mental health professional initiates the admission. The mental
health professional (physician, psychologist, nurse or social worker) must be specifically licensed for this
purpose.
How Long Can Clients Be Involuntarily Detained For Screening?
1
,For all three types of involuntary admissions, the individual can be held for a period of no longer than 72
hours. Within this 72 hour period, one of three things must happen:
1. The client has signed a CFMH 30-40 form for voluntary admission.
2. The physician has signed a discharge form.
3. The physician has signed a petition for involuntary commitment.
How Does Involuntary Commitment To A Psychiatric Facility Occur?
A petition for an involuntary placement court hearing (CFMH 30-32) is initiated by a psychiatric hospital
administrator and signed by the treating psychiatrist. A second psychiatrist also signs. According to client's
rights for "due process", the court hearing must take place within five working days from the time the
petition is filed. A date is set for the court to hear the petition and to determine the disposition of the case.
What Happens At A Court Hearing For Involuntary Commitment?
The client is present for the hearing and is represented by his/her own attorney or a public defender is
provided. The treating psychiatrist is present with a representative of the state attorney's office. A
representative from the Human Rights Advocacy Committee also attends and any of the client's family
members, guardians or friends who wish to do so. An attorney appointed by the court to oversee the
proceedings, called a hearing master, listens to the evidence on both sides and makes the final
determination of whether the petition is or is not granted.
During the hearing many issues are discussed. It must be established that the client suffers from a mental
illness, what the nature of the illness is, what treatment is required, and whether any less restrictive
treatment alternatives are available or appropriate. "Clear and convincing evidence" must be presented that
the individual meets the criteria for involuntary psychiatric treatment.
What Criteria Determine The Need For Involuntary Commitment?
Any client who is involuntarily held for psychiatric treatment must meet the following criteria:
1. The client must have refused voluntary placement after sufficient and conscientious
explanation of the purpose of the treatment.
2. The client must be unable to determine for him or herself whether placement is necessary,
and
3. The client either:
a. is likely to suffer from neglect or refuse to care for self and such neglect would pose a
real and present threat of substantial harm to the person's well-being and it is not
apparent that such harm could be avoided through the help of willing or responsible
family or friends OR
b. there is a substantial likelihood that, in the near future, client will inflict serious harm on
self or another person as evidenced by recent behavior causing, attempting or
threatening such harm.
What Happens To The Client After All The Evidence Has Been Heard?
2
, If the hearing master denies the petition, the client is discharged immediately. If the petition is granted, an
order is issued (CFMH 30-08) for involuntary placement in a facility which is either private or public
(funded by the state). The client must be screened to determine if any lesser restrictive environment is
appropriate. A guardian advocate may need to be appointed if the client is deemed unable to make his/her
own treatment decisions.
How Is A Guardian Advocate Different From A Legal Guardian?
A guardian advocate is different from a full legal guardian and is appointed for the purpose of giving
consent for psychiatric treatment only. Consent for medical, surgical or ECT procedures cannot be
provided by the guardian advocate. The guardian advocate may be a family member or, if that is not
appropriate, a trained but unpaid volunteer is appointed by the court. Once the psychiatric treatment is
completed, the guardian advocate is dismissed.
Do Clients Who Are Involuntarily Committed Lose Their Civil Rights?
Involuntary committed clients retain all their civil rights. They may make their own decisions about how to
spend their money and may sign binding contracts. Clients lose their civil rights only when they are
declared legally incompetent and a legal guardian is appointed who makes decisions for the client. This is
a separate legal proceeding from a Baker Act hearing.
How Long May An Involuntary Client Be Held For Treatment?
Involuntary orders are good for from seven days to six months. The CFMH 30-08 order often specifies a
time period within that range during which the client's treatment must be accomplished. A client may be
stabilized sooner than the psychiatrist expected and thus may be discharged prior to the end of the specified
period of treatment. However, the client cannot be kept longer than the period specified in the petition.
3
