Mental Health Law
Psychiatric Boarding: How Some Arizona Hospitals Misuse the Law to Involuntarily Detain Patients
Involuntary civil commitment of suspected mental health patients is an extreme infringement of a person’s liberty and cannot be accomplished without strict compliance to due process procedures designed to protect the individual.
In June 2016, Phoenix-area residents “John Doe” and his wife “Jane” got into a heated
discussion at their home. Each had a few too many drinks, and their
discussion soon became an argument. Admittedly intoxicated and
therefore not careful with her words, Jane told John that she was
going to leave him. John, understandably surprised and upset, and
also intoxicated, told Jane that if she left him he would jump in
front of a bus.
When John made this quasi-suicidal statement, the conversation came
to a screeching halt. Both John and Jane were concerned about where
the comment came from, why he made such a statement, and if it was
actually his intention to hurt himself. Because they wanted to have
the situation addressed properly, they asked their son to drive them
to the nearest emergency room.
After John and Jane
waited at the emergency room for several hours, John’s intoxication
cleared. He explained to staff that, at the time of the statement,
he was drunk, was upset at the thought of his wife leaving him, but
never intended to kill himself. He told the staff that he did not
need inpatient treatment, and that he would be leaving.
John’s explanation and decision, the hospital labeled him unwilling
to undergo inpatient treatment and filed an Application for
Involuntary Evaluation, or petition, pursuant to Title 36 of the
Arizona Revised Statutes. The hospital then
took John’s clothes, put him in nothing but a blue hospital gown,
and isolated him in a room filled with others clothed in blue
hospital gowns. Security guards were posted at each door.
later, a social worker met with John and incorrectly explained the
Title 36 process. John was told that the hospital had the right to
hold him until a bed was available for him elsewhere and that, if he
tried to leave, hospital security would physically restrain him and
he would be taken to “UPC” (urgent psychiatric care). There was no explanation of what or
where this was.
John waited. And
waited. During his week of confinement, he did not see a psychiatrist or
psychiatric nurse or receive psychiatric treatment of any kind. He was not
allowed to leave the room except to go to the bathroom across the hall, and even
then, he was accompanied and watched by security. John asked for a shower, but
after being told that security must watch him while he showered, he decided not
to do so.
John repeatedly told
staff that he was not suicidal and that he would be willing to
accept outpatient mental health treatment. Nonetheless, the hospital
repeatedly told John it would not release him. Finally, after
missing a week with his wife and two kids and a week of work, John
called our law office, and with our help he was released within
If this nightmare
seems implausible, our experience in these matters tells us that it
is not. While the facts of John and Jane’s experience are
exceedingly egregious, the facts of these cases are always
egregious. A person in need reaches out for help; rather than
receiving it, he or she is held involuntarily, illegally, and
without treatment. This type of psychiatric boarding, or involuntary
civil commitment, is not permitted under Arizona law.
Our courts have
repeatedly held that the involuntary civil commitment process is an
extreme infringement of a person’s liberty and cannot be
accomplished without strict compliance to due process procedures
designed to protect the individual. While upholding the
constitutionality of Arizona’s civil commitment laws, the courts
have stated clearly that the laws must be “strictly followed” and
that failure to do so will render the commitment proceedings void.
emergency rooms in Maricopa County are not licensed to participate
in the involuntary civil commitment process under Title 36 and have
no authority under Arizona law to “hold” a person in their facility
until a bed in another licensed facility is available. Therefore,
the hospital’s process is likely void, and the patient is entitled
to be released.
Over the last
several years our firm has handled dozens of situations similar to
John Doe’s. In his case, our firm contacted the hospital and, based
on our reputation in this area and our relationships with the
hospital and their counsel, he was promptly released. In other
cases, we are forced to go to court to seek a release. In all cases,
the involuntary confinement of a mental health patient in an
emergency room is not permitted under Title 36.
If you have
questions about this process, please do not hesitate to contact us.