(I am not an attorney so my explanation is just a summary of what the law says and my example is purely for demonstrative purposes. If you think that your rights have been violated, you should contact an attorney in your state)
Well, for those that don’t know what The Baker Act is, it is also known as the Florida Mental Health Act. It provides for voluntary and involuntary mental health emergency services, and temporary detention for mental health evaluation and treatment when necessary. It also makes sure that people with a mental illness are treated in a humane way and are provided treatment. In addition, the Act encourages consent, regulates the quality of treatment, gives the right to a representative, ensures confidentiality, and assigns liability for violation of those rights among other things. Now, what exactly does this lingo mean?
Let’s start with a little bit of history first. In 1971 Maxine Baker, a former State Representative from Miami, sponsored this Act after serving as chairperson of the House Committee on Mental Health. Previous mental health statutes in Florida dated all the way back to 1874!!! Back then, the laws said a person could be placed in a state hospital if three people signed affidavits and received approval by the judge. They also allowed for children as young as 12 years old to be placed in state hospitals alongside adults. A hospitalized person was only allowed ONE individual to openly and privately correspond with and there was NO specific time period that they could be confined before the judge would reconsider their confinement. Ms. Baker decided these statutes were out of date (I think so too!!!) and proposed the “Baker Act” to encourage voluntary commitments instead of involuntary (http://www.floridasupremecourt.org/ )
So what EXACTLY does this Baker Act say?? Well, the Baker Act is a long statute filled with all kinds of legal and technical jargon. I will provide a link at the bottom of this post that will take you to the full text, but for now, I’ll just give you the “Baker Act for the Layperson” version.
For a voluntary admission under the Baker Act, any person 18 years old (or age 17 and under if application is made by legal guardian) who shows evidence of mental illness and found suitable for treatment may present themselves for observation, diagnosis, or treatment. Within 24 hours after a voluntary admission, the admitting doctor must document that the person is able to give voluntary consent. If they can NOT give consent, the person must be discharged or transferred to involuntary status. Under a voluntary admission, if the person makes a request for discharge, it must be communicated to the doctor/psychiatrist ASAP, but not later than 12 hours after the request is made.
A discharge must be made in these instances:
- The person has sufficiently improved so that keeping them is no longer appropriate;
- The person must be discharged within 24 hours of the request (unless they are transferred to involuntary status);
- The person refuses to consent to or revokes treatment
Are you shaking your head confused yet? Well, here’s an example. Let’s say Christi (who is 18 yrs old) goes to the emergency room because her roommate found her wandering around outside in the middle of the night claiming she was Jesus. She is clearly experiencing mania and is also a danger to herself because walking the streets could be dangerous since she believes she can’t get hurt because she is Jesus. She is 18 yrs old, so she is old enough to consent. After being under the hospital’s care for several days, Christi is no longer a danger and has improved greatly. She asks her nurse to be discharged. Within 12 hours of Christi’s request, the nurse has to inform the doctor in charge of Christi that she wants to be discharged and Christi has to be discharged within 24 hours of her request.
What if Christi’s roommate brought her to the hospital and Christi was refusing treatment? According to the Baker Act, she would have to be discharged.
What if Christi’s roommate could not even get her to the hospital? Christi obviously needs treatment, so what happens when Christi is not consenting? This is when the involuntary examination part of the Baker Act becomes applicable.
The Baker Act allows a person to be detained involuntarily for an examination for up to 72 hours. To qualify for an involuntary exam, the person:
- Must have a mental illness
- Be unable or unwilling to provide express and informed consent to a voluntary exam; AND
- As a result of the mental illness, must be a danger to themselves or others, or seriously neglectful of themselves.
How do you get this person detained for 72 hours involuntarily? There are three ways to begin the process:
- Any person may sign an affidavit that describes why there should be an involuntary exam. A circuit judge enters an order (if the affidavit meets the criteria) and a law enforcement officer takes the person into custody bringing them to the nearest facility; OR
- A law enforcement officer encounters someone who meets the criteria and brings them to the nearest facility; OR
- A doctor or other health care provider who has examined a person within the preceding 48 hours determines the person meets the criteria and a law enforcement officer takes them to the nearest facility.
The person who is involuntarily admitted cannot be held longer than 72 hours and must be given the opportunity to notify others of their whereabouts promptly. Within those 72 hours, the person must be released unless they are charged with a crime (they will be returned to law enforcement custody), the individual gives express and informed consent to placement on a voluntary status, or a petition for involuntary placement is completed within the 72 hours and filed with the circuit court.
So how does this work in Christi’s case? Let’s say that Christi’s roommate calls the police because she can’t find Christi. After helping the officers search, they find Christi wandering the streets claiming she is Jesus. Her roommate explains that Christi is bipolar and the officers determine that she is a danger to herself, so they can bring her to the hospital where she can be held up to 72 hours. During those 72 hours, if she becomes stabilized, and consents to stay longer, she becomes a voluntary admission. If she does not get better, and does not consent, the hospital has to ask the court for approval to keep Christi there longer because they believe she is still a danger to herself and Christi will not consent. If the court does not agree, then the hospital has to release her. Make sense? I hope so!!!
(Information above obtained from the Baker Act Handbook and User Reference Guide-2011)
Florida Agencies You Should Know
- The Department of Children and Family Services (DCF) is designated the Mental Health Authority of Florida.
- Department and the Agency for Health Care Administration (AHCA) supervise all mental health facilities, programs, and services in Florida.
- Disability Rights Florida is a private nonprofit organization which prioritizes services to people who have psychiatric disabilities in institutional, inpatient and residential treatment.
Links for Florida Baker Act Information
Mental Health Laws for All 50 States
All states have some version of the Baker Act that provides the criteria and standards for involuntary and voluntary admissions to mental health facilities: Florida calls it the Baker Act; California calls it Section 5150. Here is a link for you to check out the laws in your own state.
If you have any further questions on the Baker Act or how to locate information for your specific state, feel free to email me at Christi@askabipolar.com! I will be happy to assist you in obtaining more information or directing you to where you can find it!