How Does Casey Law Work?

How Does Casey Law Work
The Matthew Casey Wethington Act provides a means of intervening with someone who is unable to recognize his or her need for treatment due to their impairment. This law allows parents, relatives and/or friends to petition the court for treatment on behalf of the substance abuse-impaired person.

Does Casey’s Law apply in Indiana?

Casey’s Law allows for involuntary treatment, meaning that someone can have their drug addicted loved one evaluated for and admitted into drug treatment even if that person is an adult and is unwilling to get help. Mathew Casey Wethington’s life and death is the inspiration for this law that allows parents, relatives and/or friends to intervene on the substance use disorder of a loved one, regardless of age and without criminal charges.

Casey’s Story At the tragically young age of 23, Mathew Casey Wethington slipped into a heroin-induced coma and later died on August 19, 2002 of what is considered to be a heroin overdose. His family wanted more than anything to give him the right to live a life in recovery. Because he was over the age of 18 and unwilling to seek help voluntarily, his family’s hands were tied – they could not force him to go into treatment,

History of the Act Casey’s Law is the broader name for The Matthew Casey Wethington Act for Substance Abuse Intervention and became a law on April 9, 2004 and went into effect in the state of Kentucky on July 13, 2004. It is now a means of intervention in Indiana and Ohio, as well.

Premise for Casey’s Law Early drug use can basically arrest someone’s emotional development at the age of first use. Because Casey began using drugs around 14 or 15 years old, he had the emotionality and rationality of a 14 year old even as he became a young adult. The premise for allowing the intervention of loved ones on the behalf of someone who is addicted to drugs lies within this understanding: someone reacting emotionally as an adolescent (when most addicts’ drug use begins) and who is suffering from an ultimately fatal disease cannot respond in a normal, healthy way and choose to get treatment.

Before Casey’s Law, parental intervention was denied by law and even discouraged, at times. The act provides a means of intervening with someone who is unable to recognize their own need for treatment due to their impairment from drugs. This law will allow parents, relatives and/or friends to petition the court for treatment on behalf of the substance abuse-impaired person.

Get a copy of the petition from the District Court clerk’s office or access it online. You, as the loved one of the drug addicted person, will fill out the petition on their behalf and file it with the District Court clerk. The court will review your claims made in the petition and will question you under oath. The court will determine if there is probable cause to require treatment for your loved one. If there is probable cause, a judge will appoint an attorney to represent your loved one, require your loved one to be evaluated, and schedule a hearing within 14 days. Your loved one will be notified of the date and purpose of the hearing. Your loved one is evaluated by two qualified health professionals, one being a physician, to determine if your loved one could benefit from treatment.

If the judge finds that your loved one needs addiction treatment, the court will order treatment for anywhere between 60 days and 360 days, and can range from detoxification to intensive treatment through recovery. Depending upon your request in the petition and the result of the evaluation, treatment options will vary.

How Casey’s Law is Helping Every year from 2004 through 2008, there were fewer than 10 petitions filed in the Kentucky counties of Boone, Campbell, and Kenton. According to the Kentucky Administrative Office of the Courts, these three counties had an increase in cases of a total of 20 in 2009 and in 2010.

The number of petitions shot up to 66 in 2011 and 71 in 2012. There has also been a coinciding heroin epidemic to account for the upshot in petitions filed. For more information on how to use Casey’s Law to help your addicted loved one, please give us a call at 800-951-6135.

Does California have Casey’s Law?

Casey’s Law, The California Youth Prevention and Recovery Act of 2003: Supporting Youth Alcohol Prevention and Recovery Programs in California – Casey’s Law (CA Assembly Bill 216) is named after Casey Godwin, a 20-year old student who was killed by an underage drunk driver. Casey was an active member of Friday Night Live and had devoted her life to preventing youth alcohol problems. Casey’s Law addresses the growing problem of alcohol abuse by minors.

It establishes centers across the state to support youth alcohol prevention and recovery programs.
Casey’s Law pays for the establishment of these centers by requiring alcohol producers to pay a fee based on the revenue they earn from the illegal sale of alcohol to minors.
Children Under the Influence: Alcohol Advertising and Reducing Underage Alcohol Use” was the title for two important public hearings convened by the Select Committee on California Childrens School Readiness and Health.

The hearings were convened by California Assembly Majority Leader Wilma Chan, the author of Caseys Law (AB 216), and were held on October 28th in Oakland, and October 30th in Los Angeles. Nearly 200 people attended the hearings, including a large contingent of 7th and 8th grade students in Los Angeles.

Expert testimony documented that alcohol continues to be the number one substance abuse problem among Californias youth, costing the cash-strapped state more than $6 billion a year. Dr.
David Jernigan of the Center on Alcohol Marketing and Youth (CAMY) presented dramatic testimony about youth overexposure to beer and distilled spirits advertising.

Dr. Deidra Brown-Taylor spoke at the Los Angeles hearing about her research on marketing targeted at underage African American males. Young people presented powerful testimony at both hearings about youth alcohol problems in their communities and called on California lawmakers to pass Caseys Law so that the state can get the resources it needs for prevention and recovery programs focused on youth.

Nationwide, the number of adolescents aged 12 to 17 admitted to addiction treatment during the period between 1994 and 1999, increased. (SAMSHA 1994-1999 Treatment Episode Data Set (TEDS) http://wwwdasis.samhsa.gov/teds99/highlights_1.htm ) Alcohol use is quite widespread among today’s teenagers. Nearly 4 out of every 5 students (78%) have consumed alcohol by the end of high school; and nearly half (47%) have done so by 8th grade. (Johnston, LD et al. Monitoring the Future national results on adolescent drug use: Overview of key findings, 2002. (NIH Pub # 03-5374). National Institute on Drug Abuse. http://monitoringthefuture.org/pubs/monographs/overview2002.pdf) In California, 26% of 11th graders reported consuming five drinks in a row in the past two weeks (a standard indicator of heavy drinking).

The solution: Alcohol recovery and prevention centers for youth. CA AB 216 addresses the growing problem of alcohol use and abuse by youth, by creating at least 68 centers to support youth alcohol recovery and prevention in the state of California. AB 216 would create at least one center in each county in California, and at least ten additional centers in counties with populations of more than 2 million residents.

The centers would be administered by local counties and would provide a variety of services, education and activities related to treating and preventing youth alcohol abuse. Alcohol fees pay for centers, counteract aggressive marketing tactics by alcohol producers. AB 216 pays for these recovery and prevention centers by levying fees on alcohol producers.

The amount of the fee is based on the revenues that alcohol producers collect from selling to underage drinkers, as estimated by the Department of Alcoholic Beverage Control.

Underage drinkers consume about 12% of all the alcohol purchased in the Unites States, or 3.6 billion drinks annually, with the vast majority of it consumed in a risky fashion. ( OJJDP. ” Drinking in America: Myths, Realities, and Prevention Policy http://www.udetc.org/documents/Drinking_in_America.pdf ) Furthermore, our nation’s youth report that it is not hard to get access to alcohol. Nearly twenty five percent of 6th graders report that it is “fairly easy” to “very easy” to get beer, while 26.5% of 12th graders report that their access to beer is “fairly easy” with 52.4% reporting “very easy.” ( PRIDE Questionnaire Report: 2001-02 National Summary, Grades 6 through 12. Parents Resource Institute for Drug Education. http://www.pridesurveys.com/main/supportfiles/natsum01.pdf )

More Information:

Casey Goodwin’s Website

What are the three criteria that can allow someone to be admitted to the hospital involuntarily?

Table 1 – Legislations, criteria, and procedures in Europe.


Country	Legislation	Diagnosis	Other criteria	Proposal	Validation	Duration	Ability to appeal
England and Wales	Mental Health Act 1983, amended in 2007; The Welsh Mental health code of practice	Any disorder and disability of mind	The mental disorder requires detention for assessment; detention in the interest of health and safety of patient and others; available appropriate medical treatment	Relatives or professionals; police (emergency)	Two registered medical practitioners with written recommendations (non-emergency); a mental health professional and a doctor (emergency)	Admission for assessment: 28 days; for treatment: 6 months renewable once for another 6 months	Yes; mental health review tribunal
Northern Ireland	Mental Health Order 1986, amended in 2018	Mental disorder as “mental illness, mental handicap or any other disorder or disability of mind”	The mental disorder requires detention for assessment; failure to detain would create serious physical harm to patient and others	The nearest parent or an approved social worker; application for assessment shall be accompanied by medical recommendation	Responsible medical officer for assessment	Assessment: 2 days; detention for medical treatment: 6 months renewable of 6 months; then further periods of 1 year	Yes; mental health review tribunal
Scotland	Mental health Act 2015 amended the MHA (care and treatment) 2003	Mental disorder	Medical treatment available; significant risk for the health and safety of patient and others; impaired ability to make decisions; requires treatment	Two medical practitioners; mental health officer	Tribunal hearing persons who have opportunity to make representations, of leading and producing evidence	6 months renewable for 6 months twice; subsequent further reviews: 12 months	Yes; patient’s responsible medical officer
Italy	Law 180 incorporated in Law 833 of 1978	Mental condition requiring urgent treatment	The person does not accept the treatments; it is not possible to take appropriate extra hospital measures	Two physicians	The mayor and authorized by the tutelary judge who is entrusted with the jurisdictional safeguard of such treatment	7 days; renewable several times at the request of the psychiatrist to the mayor	Yes; competent court
Spain	Ley de Enjuiciamiento Civil of 8 January 2000, Book IV, Title I. Chapter 2 art.763	Psychological disturbance, which causes inability to take decision and care for oneself	–	Psychiatrist	Judge	–	Yes
Portugal	Law 36/98 and decree 35/99, which regulates the law	Person with severe psychic anomaly	Danger to themselves or others, and refuses to submit to necessary medical treatment	Legal representative; public health authorities; the Public Prosecution Service; doctors; the clinical director of an institution (if in the course of a voluntary admission)	Judge	Least restrictive possible	Yes
Greece	(Law 2071/1992 (hospitalization.123/A/1992): Modernization and health system organization. Articles 94–100: involuntary hospitalization and treatment The enforcement of Law 2071/92 for Involuntary Hospitalization of Psychiatric Patients.504: Interpretative Circular of the Supreme Court of Appeal (1996)	Diagnosis of a severe mental disorder, takes into account the patient’s need for treatment and their dangerousness	Inability to judge one’s own health interest; if the nonadmission could lead to ineffective treatment or aggravation of the disease Dangerousness criteria are sufficient	Two individual assessments by psychiatrists; the closest relative brings the report to judges authorized to police escort Public Prosecutor	Two qualified psychiatrists in 24 h then Public Prosecutor orders the patient’s admission	–	Yes
Belgium	Loi modifiant la loi du 26 june 1990 relayive à la protection de la personne des malades mentaux 2017	Mental disorder	Danger for the health and safety of the person and others	Any interested person	Justice of the Peace	Observation period of maximum 40 days; the duration of maintenance cannot exceed 2 years (renewable)	Yes; Justice of the peace
The Netherlands	Rules may provide for compulsory care to a person with a mental disorder (Obligatory mental health) 2009; Compulsory admission Act 1992	Severe mental disorders that constitute a danger to themselves or others, including severe negligence or severe social inadequacy	Imminent danger for oneself and others	Doctor; judge	Judge	3 weeks (emergency procedure) 6 months (regular procedure)	Yes
France	Law n ° 2013–869 (27–9–2013)	Admission at a request of a third party: mental disorder	The mental disorder makes consent impossible and requires immediate care and medical supervision	Family member, guardian, or curator of the patient	The director of the establishment on the basis of two medical certificates	After the first period of observation (72 h) a month, renewable	Yes; college of experts, departmental commission
		Admission on the decision of the representative of the state: mental disorder	People whose mental disorder require care and jeopardize the safety of people or public order	Warden Home representative	Representative of the State
Germany	Different regulations and procedures for involuntary placements or treatments among Germany’s 16 federal states	Some federal states specify “psychosis”	Mental disorder and severe conditions “equivalent to psychosis” + danger (dangerous or self–destructive behavior)	“Physician” in some Federal States; “psychiatrist” or “physician experienced in psychiatry” in others	A specialist must be involved in assessment of psychiatric condition Maximum period of time between psychiatric assessment and compulsory admission different for each Federal State: ranging from 24 h to 14 days	Preliminary detention: 6 weeks regular placement 1 year, in obvious cases 2 years Reapproval of decision is 6 months (defined by Federal State of Saarland only)	Patients have the right to appeal to courts at any stage of the procedure Patients’ advocates are approved during all stages
Switzerland	Swiss civil code (Part three; third section; third paragraph: Forced hospitalization. Reviewed 2013)	Mental disorders or mental disability	The required treatment cannot be provided otherwise; to protect family members and third parties	–	Adult protection authority and doctors designated by the cantons	The period may not exceed 6 weeks	Yes; adult protection authority
Sweden	Compulsory Psychiatric Treatment Act 1991 Revised in 2000	Severe mental disorder	Need for care, unwilling/unable to decide, risk of harm to self/others due to m. disorder	Doctor in public service or Chief physician	Chief physician in 24 h	4 weeks	Yes; appeals of doctor’s decision of involuntary care are made to Administrative Court
Finland	Mental health act 1990	Mental disease	Need for treatment or serious danger to one’s health	Doctor employed in public health service or licensed physician or chief municipal medical officer	Within 3 days by a psychiatrist or trainee examines or three independent doctors	4 days of observation	By patient, next of kin, supervisor of commission
Norway	Amendment to the Mental Health Act; LOV–2012–06–22–48 Mental Health Care Act 1999 2007	Serious mental disorder	The prospects of their health being restored or significantly improved considerably reduced; it is highly probable that the condition of the person concerned will significantly deteriorate in the very near future; constituting an obvious and serious risk to their own life and health or those of others	Responsible mental health professional	Two physicians, one of whom shall be independent of the responsible institution	10 days	Yes; by the patient and their next of kin
Denmark	LBK nr 1729 af 02/12/2010 (Act on the use of coercion in psychiatry)	Someone who is supposed to be insane	The prospect of healing or a significant and decisive improvement in the condition will otherwise be significantly impaired or the patient presents an imminent and significant danger to themselves or others	Physician; the statement must not be issued by a doctor who is employed at the psychiatric hospital or the psychiatric ward where the hospitalization takes place	Chief physician in 48 h	–	Yes
Romania	Mental Health Law and protection of persons with mental disorders. Law 487/2002	Person with severe mental disorders: a person with mental disorders who is unable to understand the meaning and consequences of their behavior, so that they need immediate psychiatric help	The patient’s behavior presents an imminent danger of harm to themselves or to others; the patient does not have the psychic ability to understand the condition of the illness and the necessity of setting up medical treatment and has no legal representative or is not accompanied by a conventional representative	The family doctor or the psychiatrist specialist who takes care of this person; the family of the patient; representatives of the local public administration with attributions in the social–medical and public order domain; the gendarmerie or firemen, as well as the prosecutor; the civil court	Psychiatrist informs legal representative special committee: two psychiatrists and one specialist or a representative of civil society	Within 24 h of the psychiatric evaluation, the proposal for involuntary admission shall be examined by a special committee established within 48 h	Yes
Russia	Law on Mental Healthcare and Guarantees of the Citizens’ Rights in the Course of Care Provision 1993	Mental illness	Patients have to exhibit dangerous behavior toward themselves or others, they must be helpless and unable to provide for their basic daily needs, and there is a danger of “essential harm” to their mental health if they do not receive mental care	One psychiatrist	A commission of psychiatrists	48 h for assessment; documentation is sent to the local court, which has 5 days to review it; need for admission reevaluated every month for 6 months; then every 6 months; then every year	Yes; within 10 days from admission

Scotland has similar criteria but also considers the patient’s significantly impaired ability to make decisions regarding medical treatment ( 26 ). The procedures are quite different as, in Scotland, doctors can propose detention that the tribunal implements, while in England and Wales, relatives and police can also apply for third-party detention that doctors implement.

The introduction of Supervised Community Treatment and Community Treatment Orders and the right to be supported by an independent Mental Health Advocate is an important recent change. Northern Ireland ( 27 ) bases its involuntary admission on the presence of a mental disorder plus serious risk to oneself or others and the necessity of treatment ( 28 ).

The first evaluator must be a psychiatrist, and proposals and validations of involuntary admission are made by doctors and appeals are made to the Mental Health Review Tribunal. In 2018, the criteria for discharge by the Mental Health Review Tribunal changed to be less restrictive.

Italy, Spain, and Sweden are the only countries in which the danger to oneself or others is not considered a criterion for involuntary treatment.
However, they do require, in addition to the presence of a mental disorder, “necessity” for treatment.
An Italian law regarding “Voluntary and Obligatory Health Checks and Treatments for Mental Illness” provides that involuntary treatment can be implemented as a hospital stay: only if there are psychic alterations such as to require urgent therapeutic interventions that are not accepted by the patient, and there are no conditions and circumstances that allow alternative measures to be taken ( 29 ).

This limitation of freedom takes place with a view to safeguarding another constitutional relief—that of the right to health. It is interesting to note that judgments of the Italian Court of Cassation and the Italian Constitutional Court hold different positions regarding the duty of the psychiatrist to ensure public safety ( 9 ).

More specifically, there is a divide between the idea of the psychiatrist being responsible for public safety with regard to their patients and that of the responsibility being within the ambit of the police authority. Any doctor can propose a compulsory medical treatment if the conditions are met. The validation of this procedure must be done by a psychiatrist of the public service and provides for a forced 7-day, renewable, hospitalization.

This document is sent to the mayor’s office, which makes a validation ordinance within 48 h. There is no separate law exclusively for the treatment of mental disorders in Spain, but there is an insertion in a civil law that regulates the rights and dignity of the person with regard to medical and biological interventions ( 30 ).

This law does not propose guidelines, nor does it indicate precise requirements necessary for involuntary treatment. Chapter II, Article 763 regards involuntary admission for mental disorders and does not speak of the involuntariness of the treatment, but of the inability to take decisions and care for oneself.

As a consequence of this, involuntary admission implies that the psychiatrist responsible for the patient has the authority to order any treatment that falls under their professional responsibility ( 31, 32 ). Spain requires the first evaluator to be a psychiatrist ( 15 ).

There are no defined laws regarding the maximum duration for mandatory (initial) treatments ( 15 ). The criteria in Portugal 3 are that the patient suffers from a serious mental disorder, which causes them to be a danger to themselves or others, refuses treatment, or is incapable of giving consent, and the lack of treatment could result in significant deterioration of their condition.

The final decision of compulsory hospitalization is taken by a judge at the request of psychiatrists. The institution at which involuntary admission is carried out must communicate the admission to the court and a judge must request a psychiatric evaluation of the patient and decide within 48 h on the validity of the admission.

The patient must be informed of their rights, especially with regard to appealing a decision ( 33 ). In Greece, the regulations issued in 1992 authorized involuntary admission when there was an inability to judge one’s own health interests or if the nonadmission could lead to ineffective treatment or aggravation of the disease ( 34, 35 ).

The dangerousness criterion is sufficient for an involuntary admission ( 15 ). The law provides for standard and emergency procedures. The first requires two individual assessments by psychiatrists to be completed prior to admission. Once the psychiatrists have completed their reports, the closest relative brings them to a judge authorized to issue a warrant for police to escort the patient to a hospital for admission.

The emergency procedure overrides the requirement of the initial psychiatric assessments and allows a family member to apply directly to the judge.
It is important to note that the emergency procedure is almost invariably the one used.
In the absence of the “closest relative,” the procedure for requesting a mental health assessment is done ex ufficio : Upon notification by the police or concerned subject, the judge makes the request and communicates this order in writing to the police who bring the individual in for assessment.

Once the individual arrives to the hospital, they are assessed by two qualified psychiatrists ( 35, 36 ). In Belgium, the law states that protective measures may not be taken in the absence of any other appropriate treatment unless: the person concerned has a mental disorder (not including substance abuse), their condition requires urgent treatment, or they seriously endanger themselves or others.

Any interested person may address a request to a Justice of the Peace who, after a hearing with the patient and all relevant persons, reviews the medical and social information, and makes a decision. During the hospitalization, the chief medical officer may prescribe an aftercare regimen for a maximum duration of 1 year ( 37 ).

In the Netherlands, the law contains two different sections for compulsory admission. The first procedure regards a brief hospitalization due to imminent danger for oneself and others and is prepared by the mayor together with a certificate written by the doctor.

The other procedure is performed by a judge and relates to long-term hospitalizations for patients with severe mental disorders that constitute a danger to themselves or others, including severe negligence or social inadequacy. After discharge, treatment in the community is generally available ( 38 ).

In France, the law provides for two modalities of involuntary hospitalization: admission at the request of a third party in case of imminent peril, and admission by decision of a representative of the state. The criteria for the first are that the gravity of the mental disorder or episode makes consent impossible and the patient’s mental state requires immediate care and medical observation.

The director of the medical facility takes the admission decision on the basis of two medical certificates.
At the end of the initial period of admission, hospitalization can extended for 1 month, renewable.
Admission by decision of the representative of the state concerns people whose mental disorders require care and compromise the security interests of the people or undermine the public order in a serious way.

The representative of the state takes the admission decision in view of the psychiatric certificates ( 39 ). In Germany, coercive interventions in psychiatry are regulated through the federal laws of guardianship, Betreuungsrecht, valid everywhere in the country, and in public laws with slightly different regulations in the 16 German federal states, Bundesländer ( 40 ).

An overall tendency to emphasize civil rights is the most common characteristic of the legal mental health frameworks in Germany. The German Constitutional Court found that the law regarding involuntary pharmacological treatments was unconstitutional as written but that it could be applied in restricted circumstances to people who were unable to give consent, following a court decision based on the opinion of an independent expert ( 38 ).

Compulsory admission can be required by a court order or, in some federal states, by a decision of the police, and more informally (but not infrequently) by psychological pressure from doctors and relatives. Hospitalization is defined by three types of court decisions: hospitalization in the field of forensic psychiatry, civil shelter under the guardianship law for danger to oneself or others, and civil hospitalization under public law due to acute danger for oneself or others ( 38 ).

After the reunification of Germany, an improved nationwide guardianship law was passed in 1992, which shaped a new generation of state commitment laws in effect today. By adopting the basic philosophy of the national guardianship law, the Federal States adjusted their legal frameworks by placing a much stronger emphasis on the constitutional and basic human rights or safeguards of mentally ill patients as well as on the principles of community-based mental health care.

The decision of the National Constitutional Court of Germany confirmed an overall “right to be ill” and exempted society at large from being responsible for improving the condition of citizens by infringing upon their personal freedom. Some State Acts permit coercive treatments in life-threatening emergencies; others restrict this only to cases in which the life of another person might be in acute danger.

There are controversial positions even within Federal States and Higher Regional Court ( 31 ).
The Third Section (on the Protection of Adults) of the 2013 Swiss Civil Code states that a person suffering from a mental disorder, mental disability, or serious neglect may be committed to an appropriate institution if the required treatment or care cannot be provided otherwise, and the burden the patient places on family members and third parties and their protection must be taken into account.

The Adult Protection Authority is responsible for ordering hospitalization and discharge, but the law invested the administrative authority of the Swiss Federal States (cantons) with the power to delegate the responsibility for hospitalization orders to the doctors.

In 2013, a revised federal legislation came into force that was in line with international provisions. The aim was to reduce involuntary admissions and increase attention on human rights, e.g., by introducing advance directives or requiring the involvement of a legal representative. The majority of the cantons continue to delegate hospitalization powers to the doctors and the cantons assess the legitimacy of the hospitalization after 6 weeks.

This study confirms that only 2% of admissions were prepared by the cantons and that the revised law did not affect the length of hospitalization ( 41 ). The 1991 Swedish law on Psychiatric Compulsory Care established mandatory criteria for involuntary treatment: the establishment of a severe mental disorder, an absolute (essential) need for care, the patient refuses or cannot make a full judgment on the need for care, and there is a risk of harming themselves or others due to the severe mental disorder ( 42, 43 ).

A decision on admission for compulsory care may not be taken without a medical certificate by a doctor in public service responsible for conducting examinations for health certificates. The question of admission must be settled within 24 h of arrival at the hospital. The admission decision is made by the chief physician of the psychiatric care unit and must not be made by the doctor who issued the health certificate.

If the patient needs compulsory care beyond 4 weeks from the date of the admission decision, an application for consent must be made to the administrative court. The Finnish Mental Health Act considers the general “right to receive care” rather than on individual civil liberties.

The criteria are the presence of a mental illness, the need for treatment due to serious danger to one’s health, dangerousness, and outpatient services not being available or being inadequate ( 31, 44 ). The dangerousness criterion is sufficient for an involuntary admission ( 15 ). The patient’s opinion about their need for treatment is obtained before a decision is made, and is documented in their records.

The final decision of compulsory admission requires that three independent doctors consider it justified ( 31 ). In Norway, mental health care is provided on the basis of consent pursuant to the provisions in the Act relating to Patients’ Rights ( 45 ).

On the basis of information from the medical examination, the responsible mental health professional will assess whether the following conditions for compulsory care are satisfied: voluntary mental health care has been tried, the patient has been examined by two physicians (one of whom shall be independent of the responsible institution), the patient is suffering from a serious mental disorder and application of compulsory care is necessary, it is probable that their condition will significantly deteriorate in the very near future, or they constitute an obvious and serious risk to themselves or others on account of their mental disorder.

The responsible mental health professional will make a decision on the basis of an examination. The patient may appeal a decision to apply compulsory mental health care for up to 3 months after the care has terminated. Compulsory observation may not be carried out for more than 10 days from the start of the observation; then, the patient’s consent is needed.

Compulsory care may also be provided on an outpatient basis when this is a better alternative for the patient. In Denmark, the law recommends avoiding the use of coercion as far as possible ( 46 ). Admissions to psychiatric wards and pharmacological treatments should take place with the patient’s consent, and lesser interventions should be used when possible.

Forced hospitalization may only take place if the patient is insane, and there is the possibility that the nonintervention would significantly compromise the healing process, or if the patient presents a significant danger to themselves or others. Anyone can call the police, who then alert a doctor to visit the patient.

Involuntary admission of a person admitted to a psychiatric ward must be done only if the chief physician considers the conditions met.
The chief’s decision must be taken no later than 48 h from the time of admission.
Historical sociopolitical conditions strongly influenced psychiatry and the management of the conditions of involuntarily admitted patients in Eastern Europe.

In the 1990s, Eastern European countries used involuntary admissions as a political tool and a means of detention by the secret services. For example, in Romania, in the time of Ceausescu, one of the methods of oppression of political dissidents was mandatory hospitalization with politically motivated false diagnoses, made by abuses of power, which caused physical and psychic damage.

Romania’s legislative decree 313/1980 established that a single psychiatric opinion was sufficient to order an involuntary hospitalization, although it is important to note that often the doctors were under government pressure ( 47 ). Article 14 of the relevant mental health law specifies that in the assessment of mental health, the psychiatrist must not take into account nonclinical criteria, such as political, economic, social, racial, and religious conflicts; family or professional conflicts; or nonconformism toward dominant moral, social, cultural, and religious mores in society ( 48 ).

In Russia, reforms to the mental healthcare system took place during the last decade of the 20th century against a background of great social and economic change. The legal regulation of mental healthcare and psychiatric care in the Russian Federation is principally through the Law on Mental Healthcare and Guarantees of the Citizens’ Rights in the Course of Care Provision.

That law was developed in accordance with principles recommended by the United Nations, and came into force on 1 January 1993. The criteria for involuntary hospitalization are as follows: patients must exhibit dangerous behavior toward themselves or others, they must be helpless and unable to provide for their basic daily needs, and there is a danger of “essential harm” to their mental health if they do not receive mental care.

A psychiatrist, who must provide a detailed description of the patient’s mental condition, makes the decision. A commission of psychiatrists must assess, within 48 h, whether the decision was justified, and the patient has the right to invite any specialist to participate in this process.

If the admission is considered justified, documentation is sent to the local court within the next 24 h and the court has 5 days to review it. In the next 10 days, the patient, his representative, the director of the mental health facility, or an organization authorized to protect the patient’s rights may appeal against the judge’s decision regarding the hospitalization.

The patient’s need for hospitalization should be reevaluated every month for the first 6 months. From then on, it should be reevaluated every 6 months. After 6 months, the commission sends the decision (regarding the necessity for continued hospitalization) to the local court, and any further continuation of treatment is approved annually by the judge ( 49 ).

What’s the difference between Baker Act and Marchman Act?

What’s the Difference Between the Baker Act and the Marchman Act? – The Baker Act and Marchman Act are similar, but they’re used in two different situations. Both of these acts allow law enforcement to step in and get Florida citizens to help if they might be of harm to themselves or others.

The person is refusing examination or can’t determine if they need an examination (Baker Act)There is a strong likelihood that of harm through self-neglect or refusal to take care of oneself(Baker Act)There is a strong likelihood that the person can cause harm to themselves or others(Baker Act)The person using substances may harm themselves or others(Marchman Act)The person is unable to make the decision about getting help due to substance abuse(Marchman Act)

It’s important to understand both of these acts because those who are struggling with the disease of can be extremely irrational and sometimes dangerous. Many of those who have an addiction also have another mental health issue, which may or may not be caused by the substances themselves.

If you’re the loved one of someone who has an addiction, you need to always remember that they aren’t someone who is bad, but they’re someone who is very sick. Physicians, psychiatric nurses, psychologists, law enforcement and others can assist you with the Baker or Marchman Act. If you’d like more information about how to help your loved one overcome their addiction, give us a call today at,

: What Should I Know About the Baker Act and Marchman Act for Drug Treatment?

What are the three recovery options?

3 DISASTER RECOVERY TECHNIQUES Main Disaster Recovery techniques are three : synchronous replication, asynchronous replication and mixed technique. In the following lines we will shortly describe each of them, highlighting the differences among the available solutions.

To better understand the specific characteristic of any type is good to make a small premise about Disaster Recovery. This kind of solution assume that business essential processes and data should be replicated on a secondary site, therefore to assure a greater availability and security of systems and business continuity,

The secondary site will become operational when the primary site is unavailable for any reason.

Synchronous replication When data and systems are replicated both on the secondary site and locally, the replication is named synchronous. This kind of technique guarantees the business continuity and a fast restore of processes, consequently very low RTO and RPO. It is the best solution to minimise downtimes and assure a high infrastructural availability. But the synchronous replication has a geographic limit: the two sites cannot be far away from each other more than 100 kilometers, otherwise the synchronous couple become less effective and performances decreased. Asynchronous replication To remedy the distance issue, you can choose the asynchronous replication. This technique has not distance limits at all and allows you to protect your business even in case of large scale disasters which would damage both sites (for instance, an earthquake). Besides, this solution can be implemented via software, by avoiding to use sophisticated and expensive storage technology. Mixed technique Finally, we have the mixed technique, which enables to minimise recovery times and, at the same time, is effective in ensuring the availability of services even with expanded disasters. It consists of replicating systems with the synchronous technique on a relatively close site and make a second replication on a distant place.

According to particular needs of each company, as zero RTO or minimum loss of data, you can choose this or that solution. But the main purpose of any Disaster Recovery solution is always to protect business continuity and vital data and systems. : 3 DISASTER RECOVERY TECHNIQUES

What are the 5 stages in the recovery process?

We are New Jersey’s leading addiction treatment center – What Are the Five Stages of Change? The five stages of addiction recovery are precontemplation, contemplation, preparation, action and maintenance. Read on to find out more about the various stages.

What are the rules of recovery?

The Five Rules of Recovery (National Institute of Health) – In recovery from a substance use disorder, one must stay away from the substance completely. You may be sober for months, or even years, but you can still slip up and relapse. This is why you must never get too comfortable in your recovery.

You may need to ask for an extra layer of support here and there so that you do not have a relapse.
If you’re struggling, remember the coping skills that you’ve learned.
It can also help to keep in mind the National Institute of Health’s (NIH) Five Rules of Recovery: (1) change your life, (2) be completely honest, (3) ask for help, (4) practice self-care, and (5) don’t bend the rules.

These five rules can help keep you on track in your recovery.

Can you be involuntarily committed in Indiana?

Public Psychiatric Beds in Indiana – A minimum of 50 beds per 100,000 people is considered necessary to provide minimally adequate treatment for individuals with severe mental illness. Like every state, Indiana fails to meet this minimum standard.

Beds in 2016	Beds in 2010	Beds lost or gained	Beds per 100,000 people	Census of forensic patients	% of all beds occupied forensic	State ranking in beds per capita
818	908	-90	12.4	267	32.6	22

SOURCE: GOING, GOING, GONE: TRENDS AND CONSEQUENCES OF ELIMINATING STATE PSYCHIATRIC BEDS, Treatment Advocacy Center, 2016)

Can I stand my ground in Indiana?

CAN I “STAND MY GROUND” IN INDIANA? | Allen Wellman McNew Harvey, LLP | Greenfield, Indiana by James W. McNew May, 2012 The short answer is “Yes”, as Indiana is one of about thirty-one states that has legislation addressing this issue. Historically, laws of property protection were known as “Castle” laws, coming from the English common-law wherein every person’s home is his or her “Castle”.

Under English common law, an individual has a right to protect his or her property from harm from another person. The “Stand Your Ground” laws have expanded the “Castle” doctrine to include persons as well as property. The Trayvon Martin case has renewed focus and interest in the “Stand Your Ground” laws.

It has long been recognized that every person has a right to self defense and all states in one form or another recognize this basic principle. Most self defense statutes contain an obligation on the part of the person being threatened to retreat if that is reasonable.

However, in the states that have incorporated the “Stand Your Ground” laws, it appears that the requirement to retreat if practical may no longer exist.
Some argue that a “Stand Your Ground” defense is a complete bar to prosecution.
Indiana’s “Stand Your Ground” law provides, in part, that ” person is justified in using reasonable force against any other person to protect the person or a third person from what the person reasonably believes to be the imminent use of unlawful force.” However, a person “is justified in using deadly force”, and does not have “a duty to retreat”, if the person “reasonably believes” that deadly force is “necessary to prevent serious bodily injury to the person or a third person or the commission of a forcible felony.” This law makes it clear that “o person in this state shall be placed in legal jeopardy of any kind whatsoever for protecting the person or a third person by reasonable means necessary.” The words “reasonably believes” and “reasonable” means that every case of self-defense is going to be fact sensitive, and many times only one person is left to give an account of the events that purportedly occurred.

The statutes also contain several exceptions, which muddies the water even more. However, the current Indiana “Stand Your Ground” law, when applicable, appears to make taking another’s life legal even if you do not believe you are under the threat of death from the other person.

This is why there is so much controversy about the Trayvon Martin case and the “Stand Your Ground” law in Florida. Ultimately if charges are filed in a case it is up to the “fact finders” – the judge or the jury – to decide what really happened and how the law applies to these facts. The “Stand Your Ground” law was recently applicable in Indianapolis, when the manager of a Kroger grocery store shot and killed an armed robber.

The prosecutor decided that no charges would be filed. However, many questioned whether the manager acted appropriately in killing the would-be thief as the question was raised as to whether or not the manager actually felt threatened for his life. These are not easy questions nor are there any easy answers.

As seen in the Trayvon Martin case and many others that are now coming to light, there is a belief that these “Stand Your Ground” laws are nothing more than a license to kill. On the opposite end of the spectrum are those that argue that every person when threatened has a right to protect themselves in whatever manner they deem appropriate.

These two positions cannot be reconciled easily and those that have these views are not likely to change them regardless of what the law says they may or may not do. It would seem prudent and healthy for the national dialogue now taking place be allowed to play itself out.

Our legislative leaders should carefully listen to arguments on both sides of this issue and then enact a law or set of laws that would give more guidance to citizens about what self-protection measures can and can’t be taken in any given circumstance. The debate currently taking place should be an informed discussion and not just an emotionally reactive expression of opinions in support of a particular position.

Only then will a consensus be possible that strikes a balanced approach to the issue of protecting one’s self from danger. This debate will not be resolved soon, and I fully expect to see some states that currently have “Stand Your Ground” laws repeal them, and conversely some states that do not have such laws will elect to enact them – which at the end of the day will leave us with no consistent answers to this vexing problem.

While it would be impossible to draft legislation that would cover every conceivable fact situation one might encounter, it is possible for uniformity in the law to be developed and an ongoing effort to educate people as to what one can generally and reasonably do or not do.
In the meantime, we will have to see how this plays out not only in Florida but in the rest of the country as well.

: CAN I “STAND MY GROUND” IN INDIANA? | Allen Wellman McNew Harvey, LLP | Greenfield, Indiana

Is Indiana a zero tolerance state?

Indiana Zero Tolerance Policy – Indiana operates under a “zero tolerance” policy, which means drivers under the age of 21years old have a different legal BAC limit than the standard,08%. Minors can face charges for having a BAC of just,02%. These charges are considered a Class C Infraction and come with unique penalties adults would not face.

Can you have someone committed in California?

Civil Commitments People who come to a California state hospital through a civil commitment are individuals who require physically secure 24-hour care that is not available through a community programs. They have been found by the court to be a danger to themselves or others, or unable to provide for their own basic needs because of a mental illness.

Does California allow involuntary commitment?

Criminal Diversion in California – Criminal justice officials are responding to the criminalization of individuals with innovative programs designed to divert individuals with severe mental illness away from the criminal justice system. Two of the most promising programs are: mental health courts and crisis intervention training (CIT),

Population served by mental health court	Population served by CIT	Combined average	Grade
78%	79%	79%	A

SOURCE: PREVALENCE OF MENTAL HEALTH DIVERSION PRACTICES: A SURVEY OF THE STATES, Treatment Advocacy Center, 2013)

What is the maximum number of days a person can be involuntarily committed?

5150 is the number of the section of the Welfare and Institutions Code, which allows a person with a mental illness to be involuntarily detained for a 72-hour psychiatric hospitalization. A person on a 5150 can be held in the psychiatric hospital against their will for up to 72 hours.

How long can a psych ward keep you?

Other sections – Section 3 allows compulsory admission for treatment. It can be for up to 6 months, and may be renewed for a further 6 months, and after that 12 monthly. Section 136 allows a police constable to remove an apparently mentally disordered person from a public place to a place of safety for up to 72 hours for the specified purposes.

The place of safety could be a police station or hospital (often a special s136 suite). Section 5(2) is doctor’s holding power. It can only be used to detain in hospital a person who has consented to admission on an informal basis (i.e. not detained under the Act) but then changed their mind and wishes to leave.

It can be implemented following a (usually brief) assessment by the RC or his deputy, which, in effect, means any hospital doctor, including psychiatrists but also those based on medical or surgical wards. It lasts up to 72 hours, during which time a further assessment may result in either discharge from the section or detention under section 2 for assessment or section 3 for treatment.

Section 4 allows admission in an emergency and lasts up to 72 hours.
It can be converted to another section (usually section 2) if circumstances require.
Section 37 is a hospital order made by a court.
Section 38 an interim hospital order Section 41 indicates additional restrictions which require Ministry of Justice permissions.

Section 47 and Section 48 refer to transfers from prison to hospital. Section 117 – Health authorities and local social services have a legal duty to provide free aftercare for people who have been discharged under Mental Health Act sections 3, 37, 45A, 47 or 48.

The duty to provide aftercare also applies if you are given s17 leaven or are under a community treatment order. You should not be charged for the services provided to you under Section 117 as aftercare if they meet a need relating to your mental health problem and prevent you from returning to hospital.

Community Treatment Order When a person has been detained under certain sections of the Mental Health Act 1983 and options for discharge back into the community are being considered, one option is to discharge subject to ‘supervised community treatment’, known as a Community Treatment Order.

The Responsible Clinician (RC) makes an application for supervised community treatment and it must be accompanied by a recommendation from an Approved Mental Health Professional (AMHP).
A Community Treatment Order can include conditions on where a person will live or where they will go to receive treatment.

What sort of aftercare can I expect? For many people the time after you have been discharged is a difficult period. This is because returning to your home and community can be stressful, particularly if you have been in hospital for a long time. Before you are discharged, a care plan should be made under the Care Programme Approach (CPA) which will look at how your needs will be met.

Does Baker Act go on your record?

How Does Casey Law Work Yes. There will be a medical record, a police record if law enforcement was involved and if a petition is filed for involuntary placement then also a court record. There is no procedure in the law to remove or seal the records of a Baker Act. For more information on the Baker Act click here.

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How do you get someone involuntarily committed in Florida?

Why is it important to know where a person is at the time a petition is filed? – According to Florida law, a petition seeking to commit a person for examination, assessment or treatment of mental illness must be filed in the county where the person is located. It is also necessary for law enforcement to locate the person at the time the court order is filed.

How long do they hold you on a Marchman Act?

How do I File for the Marchman Act? – Ideally, before needing to utilize the Marchman Act, you will be able to convince your loved one to go to a treatment facility voluntarily. If it is determined at the facility that the person needs treatment, hopefully, they will then agree to a voluntary admission and no petition for a commitment under the Marchman Act will be needed.

However, if the person refuses treatment assessment for a substance use disorder, you have the option to petition the court to exercise the Marchman Act and commit the person involuntarily to addiction treatment.
You first need to contact a treatment facility to ensure that there is a bed available for your loved one.2 Your county clerk’s office, such as these in Pasco County or Miami-Date County, have links that provide the necessary forms that have to be completed.

These forms require you to: 2

Provide a full description of the person.
Provide details on where he or she can be found.
State which facility the person will be taken to.
State the day and time that the treatment facility has told you a bed will be available for admission.
Provide a list of any medical conditions he or she may have and a list of current medications.

Once the petition is filed, the hearing will be held within 10 days. If the judge agrees to the petition, law enforcement will serve the person with the Marchman Act order and try to get them to go to the treatment facility. If the person does not agree to go voluntarily, law enforcement will take them against their will.2

How long does the Marchman Act last in Florida?

However, if the person refuses treatment assessment for a substance use disorder, you have the option to petition the court to exercise the Marchman Act and commit the person involuntarily to addiction treatment.
You first need to contact a treatment facility to ensure that there is a bed available for your loved one.2 Your county clerk’s office, such as these in Pasco County or Miami-Date County, have links that provide the necessary forms that have to be completed.

These forms require you to: 2

Provide a full description of the person.
Provide details on where he or she can be found.
State which facility the person will be taken to.
State the day and time that the treatment facility has told you a bed will be available for admission.
Provide a list of any medical conditions he or she may have and a list of current medications.

What happens after a Marchman Act?

The Hal S. Marchman Alcohol and Other Drug Services Act of 1993, commonly referred to as the Marchman Act, is a Florida statute providing emergency intervention for those over-using drugs or alcohol. It’s meant primarily to address serious situations where a chronic substance user refuses to seek, or is incapable of seeking, help, and may be a danger to himself or others.

The act allows family members and certain other individuals to petition for court-ordered evaluation and, if indicated, mandated treatment even if the alleged addict doesn’t want it. Until their children turn 18, a parent who believes their child needs addiction services can admit them to a treatment facility against their child’s wishes.

But, when a person over age 18 refuses treatment that loved ones feel is vital, it’s more difficult to get them the help they need. That’s why some form of involuntary commitment is available in most states, including Florida. The National Institute on Drug Abuse reported in 2013 that of the almost 23 million U.S.

citizens in need of substance abuse services, only about 2.5 million received needed treatment. Between 1999 and 2015, drug overdose deaths in this country have more than tripled, according to Centers for Disease Control (CDC) statistics. Involuntary commitment laws like the Marchman Act are one tool that may help improve those numbers.

Who is the Marchman Act designed to help? The act is meant to provide a way for concerned loved ones to get help for someone who desperately needs, but won’t accept, substance abuse treatment. Criteria for an appropriate referral includes:

The individual cannot control or stop his or her drug/alcohol use AND is either:
- Unable to make rational decisions regarding treatment OR
- Has inflicted or attempted to inflict self-harm or harm to others

It should be noted that a judge may find that an individual’s refusal to seek treatment may not constitute an inability to make a rational decision regarding such treatment. Steps to initiate an evaluation and potential involuntary commitment under the Marchman Act

The petition can be filed by a spouse, relative, or guardian, or by three concerned unrelated individuals who have witnessed the uncontrollable drug/alcohol use. Emergency petitions can also be filed by a physician, therapist or law enforcement officer.
It may be helpful to enlist the help of an attorney who understands the Marchman Act. There are attorneys who work with families to get the petition filed correctly and will continue to assist throughout the process.
The petition paperwork must be filed with the clerk of the court in the county where the person who is uncontrollably using drugs/alcohol lives or is staying. The person completing the paperwork must swear to its veracity, then the petition is notarized and sent to a judge for review.
The judge (or magistrate) decides if the situation calls for an Ex Parte order, or an emergency situation calling for immediate action, or if the respondent (impaired person) can be served with a summons mandating him or her to attend a hearing. If the situation is determined to be an emergency, the judge issues an order for law enforcement to pick up the impaired person and bring him/her to a designated facility for evaluation.
If the situation is not deemed to meet the criteria for an Ex Parte order, the judge may opt to deny the petition or to set a hearing to take place within 10 days. If a hearing is set, the petitioner will be notified by mail and a summons will be issued for the respondent. Both parties must appear at the hearing.
Both parties are allowed to have legal counsel if they so choose. The respondent can have his or her own attorney or will be assigned a court-appointed lawyer.
Testimony is presented at the hearing and the judge decides if a court-ordered evaluation is appropriate. It is up to the petitioner to prove the respondent is substance use-impaired and in need of a professional evaluation. Most Florida counties have certain facilities designated to perform the evaluation. Facilities are given up to 5 days to complete the evaluation, although they can ask the court for an extension if needed.
After the evaluation, the facility may choose to discharge the client, change the status to voluntary, or file a request with the court for admission to involuntary treatment services. The judge may order treatment for up to 60 days. Some counties allow for initial treatment up to 90 days, with renewals every 90 days.

Why might the judge deny a petition? There are several reasons a petition can be denied. The petitioner may not have proven to the court’s satisfaction that the respondent meets the necessary criteria for evaluation or involuntary treatment, the respondent’s behaviors may be beyond safe management of the provider, treatment services may not be available or neither the petitioner nor the respondent may have the resources to pay for treatment.

What happens if the client leaves treatment before discharge? Even with involuntary commitment to treatment, the client will not be in a locked facility. If the client chooses to leave treatment before discharge, he or she may do so, but is then technically in contempt of a court order and could face jail time.

Whether or not a jail sentence is imposed in these cases often varies from county to county. Who pays evaluation and treatment costs? There is no charge for filing the petition with the court. If the petition is granted, a service fee payable to the Sheriff’s department is required and must be paid by the petitioner.

Costs for the evaluation and any court-ordered treatment can be submitted to the client’s insurance company or paid by the client or family. For costs not covered by insurance, some treatment facilities will work with clients on a sliding fee schedule based on income and other factors. Initiating a petition for involuntary commitment should always be a last resort.

If you feel a loved one is in desperate need of help, discuss the situation with a physician or an addiction specialist. Consider consulting with an intervention specialist, a mental health professional specially trained to plan and facilitate interventions.

If you’ve tried everything, but are still unable to convince your loved one to get help, the Marchman Act may be the best course of action. Turning Point of Tampa’s goal is to always provide a safe environment and a solid foundation in 12-Step recovery, in tandem with quality individual therapy and groups.

We have been offering Licensed Residential Treatment for Addiction, Eating Disorders and Dual Diagnosis in Tampa since 1987. If you need help or know someone who does, please contact our admissions department at 813-882-3003, 800-397-3006 or [email protected],

How much does the Marchman Act cost?

How do I file a Marchman Act Petition? – Filing the Marchman Act simple. Actually making the statute work effectively for your loved one battling an addiction is much more complicated. Although we know that time is of the essence when it comes to handling a crisis situation, we encourage our clients to carefully consider all of their options before taking action: Filing Option #1 The least expensive option is to file the Marchman Act yourself.

Simply go to your local county courthouse, complete the Marchman Act package, and submit it to the court.
However, keep in mind that since you are the petitioner it is your responsibility to make sure that all the details of the case are in order.
Any miscalculations or misfiled petitions may fall back on you and your ability to work through the system.

Although the cost may be the least on the front end, if your loved one falls through the cracks in the system, trying to file the Marchman Act yourself may actually become the most costly in the end. Filing Option #2 Hiring a lawyer to file the Marchman Act is generally the most expensive option, with retainers typically ranging anywhere from $7,500-$9,500.

A knowledgeable attorney will be able to help you prepare for the legal proceeding, however, is not necessarily responsible to help you create, implement, and monitor an effective treatment plan to ensure continuity of care. Filing Option #3 A caring a professional comprehensive intervention counselor will be able to create, implement, and monitor a treatment plan individualized to meet a variety of case management and therapeutic needs to help ensure continuity of care and compliance.

The fee for the comprehensive intervention counselor is typically half of that for the attorney while generally providing significantly more time with the client and all those concerned. The comprehensive intervention counselor will help to locate a treatment option that fits, help to establish an open channel of communication, and map out a care plan that sticks with the ongoing support of loved ones.