Tuesday, January 8, 2013

Colorado: What To Do If Someone Needs Mental Health Care But Refuses It

There has been a lot of talk recently about the need to improve the nation's mental health system and to identify individuals who are at risk for violence before they act on their aggressive impulses. I agree that changes must be made and funding must be increased. But, there is already a little-known law on the books in Colorado that can have a huge impact now.

If you know of an individual--a family member, a friend, a co-worker, a neighbor--who you fear may have a mental illness and may be dangerous, there is something you can do about it. You can actually take the initiative to get the person evaluated, even if he or she does not think there is a problem.

It is possible to ask a judge to issue an order for an individual to undergo a mental health evaluation against his/her will. According to Colorado Revised Statutes § 27-65-106, any person can request that a court order a mental health evaluation of an individual who is suspected to have a mental illness and is a danger to self, a danger to others, or gravely disabled (for example, a person with dementia who lives alone and continually forgets the turn off the stove, running the risk of blowing up the house).

That is right--any person who suspects someone has a mental illness and is dangerous can ask the court to order an evaluation. The key is that you must suspect the person is both mentally ill and dangerous. There are plenty of mentally ill individuals who refuse treatment but are harmless. They would not qualify under this law.

Here are the necessary steps, if you are thinking of asking the court to order an evaluation for someone you know:

1. You need to send the request to the correct court: It must be done in the county where the mentally ill individual is living or is currently located (for example, if the person has an apartment in Denver but is staying with a friend in Centennial, you would petition the court in Arapahoe County, not Denver County). You can find contact information for the Colorado Court System here.

2. The petition must be in writing.

3. The petition must contain your name and address, along with your interest in the case (in other words, you must explain why you care about the individual--you are a relative, or an employer, or a friend).

4. The petition must also contain the name of the person you want to have evaluated. If known, you should also include the person's address, age, gender, marital status, and occupation.

5. In the petition, you must include "allegations of fact indicating that the respondent may have a mental illness." In other words, you must include your reasons for thinking the person is mentally ill. Be specific in your allegations--the person cries all the time, he talks about dying, she is angry, he talks to voices only he can hear, etc.

6. The petition must also include the reason why the person's mental illness causes him/her to be a danger to self, a danger to others, or gravely disabled. Again, be specific: He talks about suicide, she has been getting more and more physically aggressive with her family, his coworkers have talked to HR about how they are afraid of him, she uses illegal substances, he just bought three guns, etc.

7. If the information is available, you should include the name and address of all people who are legally responsible for the care of the person (like parents or guardians).

8. The petition should also include the name and address of the person's attorney, if he/she has one. If the person does not have an attorney (which is almost always the case), you should write whether, to your best knowledge, the person "meets the criteria established by the legal aid agency operating in the county or city and county for it to represent a client." If you know this information, great. If you don't, you can write the following statement:

"To the best of my knowledge, I do not know if [my sister/brother/employee/cousin/etc.] meets the criteria established by the legal aid agency operating in the county or city and county for it to represent a client."

After the petition is submitted, the judge can appoint an evaluator and order a mental health evaluation. Typically, a licensed community mental health center employee goes to the person's home (with law enforcement) and conducts the evaluation. That evaluator then provides a report to the court, and if the court believes there is probable cause that the person has a mental illness and is dangerous, it can order the person into involuntary inpatient treatment for up to 72 hours. After that, there are legal procedures the inpatient unit can use to keep the person longer, if needed.

An important to note: if the licensed evaluator thinks the person poses an immediate risk, that evaluator can have the person hospitalized against his or her will for up to 72 hours immediately (without having to wait for the court to receive the report, order the inpatient treatment, and have a sheriff's deputy transport the person to a hospital).

It is up to all of us to help those we care about get the treatment they need, even if they don't want to accept it at first. And, although the vast majority of individuals with mental illness are not dangerous, some are. Using this law to help those potentially dangerous people get into treatment can be one way to avoid a another tragedy before it occurs.

Thanks for reading-- Max Wachtel, Ph.D.


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