MENTAL HEALTH WARRANTS: EMERGENCY APPREHENSION

AND DETENTION

MENTAL HEALTH CRISIS

STATISTICS

• Non-metro (rural) areas have a significantly higher suicide rate than metro areas. In 2015, the rate was 11% for metro areas and 17% for non-metro areas.

• From 2011 – 2015, Smith County had the highest average suicide rate in Texas.

• Approximately 20% of state prisoners and 21% of local jail prisoners have “a recent history” of a mental health condition

• Suicide is the 10th leading cause of death in the U.S.,and the 2nd leading cause of death for people aged 10–34.

• More than 90% of people who die by suicide show symptoms of a mental health condition.

• Serious mental illness costs America $193.2 billion in lost earnings per year. • Nehme E, Oppenheimer D, Elerian N, Lakey D. (2017) Suicide in Texas. Austin, TX: University of Texas Health Science

Center at Tyler/University of Texas System

WHAT IS AN EMERGENCY DETENTION WARRANT?

• Sometimes a person who has NOT been arrested is showing signs of mental illness. •Any person may file an application with a magistrate (you!) to issue a warrant to have the person arrested and taken to a mental health facility for evaluation.

WHO IS FILING?

•Law enforcement?

•Family members?

•Physicians?

WHAT IS AN EMERGENCY DETENTION WARRANT?

• The warrant may only be issued if there is an imminent risk (meaning it is about to happen) that the person will seriously harm themselves or someone else.

• A peace officer may also apprehend someone in this situation on their own if the officer does not have time to get a warrant before the person is likely to hurt themselves or someone else.

HOW DO YOU GET AN APPLICATION?

•An application must be presented personally to the magistrate.•Except for a physician who may send it electronically.

Health & Safety Code § 573.011, 573.012(a),(h)

What Does the Application Have to Show?

(1) That the applicant believes the person is showing signs of mental illness and a substantial risk of serious harm to himself or others;

(2) A specific description of the risk of harm;

(3) That the applicant believes the risk of harm is imminent unless the person is immediately restrained;

(4) That the applicant’s beliefs are derived from specific recent behavior, overt acts, attempts, or threats;

(5) A detailed description of those specific behavior, acts, attempts, or threats; and

(6) A detailed description of the applicant’s relationship to the person whose detention is sought.

-- Health & Safety Code § 573.011(b)

What Does the Application Have to Show?

WHAT IS A MENTAL ILLNESS?

(14) "Mental illness" means an illness, disease, or condition, other than epilepsy, dementia, substance abuse, or intellectual disability, that:

(A) substantially impairs a person's thought, perception of reality, emotional process, or judgment; or

(B) grossly impairs behavior as demonstrated by recent disturbed behavior.Health and Safety Code 571.003

EMERGENCY APPREHENSION:ISSUANCE OF WARRANT

• A substantial risk of serious harm may be demonstrated by:

(1) the person's behavior; or

(2) evidence of severe emotional distress and deterioration in the person's mental condition to the extent that the person cannot remain at liberty.

Health & Safety Code § 573.012(c)

Form for application for

warrant for immediate

apprehension and detention

THE MAGISTRATE MAY INTERVIEW THE

APPLICANT.

THE MAGISTRATE SHALL DENY THE

APPLICATION UNLESS THE

MAGISTRATE FINDS THERE IS

REASONABLE CAUSE TO BELIEVE THAT:

The person evidences mental illness;

The person evidences a substantial risk of serious harm to himself or others;

The risk of harm is imminent (about to happen) unless the person is immediately restrained; and

The necessary restraint cannot be accomplished without emergency detention.

ACTIVITY

SCENARIO

•Call for help with a family member•Resulted in an arrest• Family sought suicide watch•Moved, but no watch initiated•Hung self with clothes• ‘Bonded’ out and CPR started so died outside jail

HOW COULD THIS HAVE BEEN PREVENTED?

SCENARIO

•EPO clearly needed•Order granted by the judge•After executed, family calls •Now has a bed at their chosen facility and want the court to withdraw the warrant

CAN THIS BE DONE?

NURSING HOME

•A nursing home files an EDO for a patient with dementia that keeps wondering away.

•Can you grant this? Why or why not?

HOSPITAL

•A hospital files an EDO on a patient but asks for the detention to occur the next day after the patient’s treatment is completed. •Would you grant this EDO? Why or why not?

EDO FROM A FAMILY MEMBER

• You are concerned that family members might file EDO’s on people for ill-conceived reasons. (Child trying to get at elderly adult’s finances, divorce/custody cases, etc.)

• Can you refuse to consider any EDO’s from family members?

NOW WHAT?

WHAT DO YOU DO WITH THE WARRANT?

• The magistrate shall issue to an on-duty peace officer a warrant for the person's immediate apprehension if the magistrate finds that each element is satisfied.

Health & Safety Code § 573.012(d)

WHAT HAPPENS NEXT?

• A person apprehended under such a warrant must be transported for a preliminary examination to:

• The nearest appropriate inpatient mental health facility; or

• A mental health facility deemed suitable by the LMHA, if an appropriate inpatient mental health facility is not available.

Health & Safety Code § 573.012(e)

WHAT HAPPENS NEXT?

• The warrant serves as an application for detention in the facility.

• The warrant and a copy of the application for the warrant must be immediately transmitted to the facility.

Health & Safety Code § 573.012(f)

ISSUANCE OF WARRANT

•Once the warrant has issued the person is detained, transported and evaluated and the case is out of your hands.

Section 573.021, Health & Safety Code

Magistrate’s Order and

Warrant for Immediate

Apprehension and Detention

Peace Officer’s Emergency

Commitment

Peace Officer’s Emergency

Commitment

NOTIFICATION TO PERSON

DETAINED ON MENTAL HEALTH

WARRANT

TRANSPORTATION ISSUES

• You may encounter issues with transportation of persons who are detained on an emergency detention warrant.

• In some counties law enforcement is stretched thin with ordinary duties and feel they do not have the manpower to transport mentally ill patients a long distance to a facility.

• Sometimes they also have to wait at an emergency room while the person is examined before going to the mental facility.

TRANSPORTATION ISSUES:

• The Attorney General recently clarified a magistrate’s authority on these issues:

(1) You have authority to designate a specific peace officer to apprehend and transport the individual regardless of where the individual is found within the county.

• For example, a deputy sheriff may be ordered to transport someone found within a municipality rather than a municipal police officer.

TRANSPORTATION ISSUES:

(2) The officer who apprehends the person is responsible for transporting them to the nearest mental health facility for evaluation.

• They are responsible for transporting the person until the mental health evaluation occurs.

• Often, the first stop is at a hospital or ER to get “medical clearance.” The officer must transport the person from the hospital to the mental health facility unless the mental health evaluation occurs at the hospital.

AG OPINION KP-0206

BEST PRACTICES: BUILDING COALITIONS

BEST PRACTICES

• The key to addressing mental health issues is to work together as a team with all the stakeholders in your county.

• This means getting to know your LMHA.

• And working with the jail staff, other magistrates, prosecutors, your county judge, and mental health experts.

BEST PRACTICES

• Schedule regular meetings (quarterly or monthly) with all the stakeholders (LMHA, sheriff ’s office, magistrates, prosecutors) to go over what is working smoothly and what is not working and needs to be addressed.

• Grants may be available through the LMHA for telepsych or mental health deputies.

BEST PRACTICES

• Smaller counties may wish to band together and have an interlocal agreement. This may allow you to hire mental health deputies to work in each county.

• Some counties have worked out good procedures for getting assessments and treatment for the mentally ill but only after working for months with all interested parties in the county.

• It is all about good communication within your county.

MENTAL HEALTH MENTORS

• Another best practice is to identify a judge who has experience in this area to serve as a mentor if you have questions or concerns about how to handle a specific problem or matter.• TJCTC will help you find a mentor judge in your area, if

possible. • If you would like to connect to a mental health mentor, email

Jessica at jessforeman@txstate.edu.