Involuntary Outpatient Commitment

FAQ – INVOLUNTARY OUTPATIENT COMMITMENT

1.    What is involuntary outpatient commitment?

Outpatient commitment refers to mental health laws which exists in 42 states and now in New Jersey which allows for the compulsory, community-based treatment of individuals with mental illness who as a result of a mental illness meet a legal standard for commitment. When a person is assessed by a mental health screener and psychiatrist and involuntary commitment to treatment seems necessary, screening service staff shall determine the treatment that is appropriate to the person’s condition and is the least restrictive environment. Outpatient treatment may include, but is not limited to, day treatment services, case management, residential services, outpatient counseling and psychotherapy, and medication treatment.
2.     Who will it benefit?

The Governor’s Task Force on Mental Health estimated that approximately 400 individuals will be affected by this law, P.L. 2009, CHAPTER 112, at any given time once it is fully implemented. These are individuals who are experiencing serious psychiatric deterioration but are unable to access mental health services on a voluntary basis. The use of the less restrictive alternative of outpatient commitment has led to significant reductions in hospitalizations, incarceration and homelessness in other states, most notably New York.
3.     When will it be implemented?

This act shall take effect on August 11, 2010 one year after the date of enactment. The law will be phased in over a three year period with seven counties to be selected by the Commissioner of Human Services in each of the three years.
4.      Who will oversee it?

During the time a patient is assigned to the outpatient treatment provider for services pursuant to a commitment to outpatient treatment, the outpatient treatment provider shall provide and coordinate the provision of care consistent with the plan of outpatient treatment. If a patient fails to materially comply with the plan of outpatient treatment during the time the patient is assigned by a court to the outpatient treatment provider for services pursuant to a commitment to outpatient treatment, or if the outpatient treatment provider determines that the plan of outpatient treatment is inadequate to meet the patient’s mental health needs, the provider shall notify the court and screening service of the material noncompliance or plan inadequacy, as applicable, and the patient shall be referred to a screening service for an assessment to determine what mental health services are appropriate and where those services may be provided.

The Commissioner of Human Services is to monitor and evaluate the implementation of involuntary commitment to outpatient treatment and report to the Governor and to the Legislature.
5.      Comments?

Over the coming months The Division of Mental Health Services will be developing regulations that will be the framework for the implementation of outpatient commitment. It is time for advocates who have been on both sides of the issue to come together to assure that outpatient commitment is employed only after an array of voluntary services have been offered and rejected and that the services provided under the plan of outpatient treatment are clinically appropriate and based on proven or promising treatments directed to wellness and recovery.
6.       Current Standard

Dangerous to self means that by reason of mental illness the person has threatened or attempted suicide or serious bodily harm, or has behaved in such a manner as to indicate that the person is unable to satisfy his need for nourishment, essential medical care or shelter, so that it is probable that substantial bodily injury, serious physical harm or death will result within the reasonably foreseeable future; however, no person shall be deemed to be unable to satisfy his need for nourishment, essential medical care or shelter if he is able to satisfy such needs with the supervision and assistance of others who are willing and available.  This determination shall take into account a person’s history, recent behavior and any recent act, threat or serious psychiatric deterioration.

• This determination shall take into account a person’s history, recent behavior and any recent act, threat or serious psychiatric deterioration.
• “Reasonably foreseeable future” means a time frame that may be beyond the immediate or imminent, but not longer than a time frame as to which reasonably certain judgments about a person’s likely behavior can be reached.