What are Involuntary Commitment Laws and the Baker Act?

Involuntary commitment laws are laws that allow a person to receive inpatient care in a psychiatric hospital, against their will, due to a treatable mental disorder. Involuntary commitment laws vary on a state-by-state basis.

What can we learn from Florida?

The Florida Mental Health Act, also known as the Florida Baker Act, was passed so that mental health programs could be created to reduce the occurrence, severity, duration, and disabling aspects of mental, emotional, and behavioral disorders. The Baker Act is most known for its involuntary evaluation and confinement provisions.

Involuntary evaluation

There are three different types of people that can determine whether a person with mental illness should be involuntarily evaluated. They are:

1. A court may enter an ex parte order stating that a person appears to meet the criteria for involuntary examination.
2. A law enforcement officer may take a person who appears to meet the criteria for involuntary examination into custody and deliver the person or have him or her delivered to the nearest receiving facility for examination.
3. A physician, clinical psychologist, psychiatric nurse, mental health counselor, marriage and family therapist, or clinical social worker may execute a certificate stating that he or she has examined a person within the last 48 hours and finds that the person appears to meet the criteria for involuntary examination.

The next 72 hours

Upon initiating an involuntary examination, a patient can be involuntarily held by a facility for a maximum of 72 hours. Physicians and counselors at the facility have a total of 72 hours to examine the patient, determine the patient’s mental state, and determine what further treatment may be needed.

Within the 72-hour period, the facility must:

1. Release the patient without condition
2. Release the patient for voluntary outpatient treatment
3. Request that the patient gives consent to being admitted for voluntary inpatient treatment, or
4. As Thomson Reuter reports "File a petition for involuntary placement with the appropriate circuit court when outpatient or inpatient treatment is necessary but the patient refuses to consent" − see the Florida Statute for the expanded provision. 

Patient’s rights

Being involuntarily committed to a facility does not eliminate a patient’s rights. In fact, the Baker Act takes great lengths to highlight the rights of patients (though advocates question the consistency in which these rights are upheld). These include:

• The right to individual dignity: the patient shall be respected at all times, including when the patient is taken into custody, held, and/or transported.
• The right to treatment: the patient shall not be denied treatment or have services delayed due to an inability to pay.
• The right to express and informed patient consent: the patient, the patient’s guardian, or the guardian’s advocate shall give express and informed consent for admission or treatment.
• The right to quality of treatment: the patient shall receive treatment suited to their needs which is administered skillfully, safely, and humanely.
• The right to communication, abuse reporting, and visits: the patient shall have the right to communicate freely and privately with those outside of the facility, have access to a telephone in order to report abuse, and the right to communicate or receive visitors.
• The right to care and custody of the patient’s personal effects: all of a patient’s clothing and personal effects held by the facility shall be returned to the patient immediately upon the discharge or transfer from the facility.
• The right to vote in public elections: the patient may vote in public elections, such as the primary and general elections if they are eligible to vote according to state laws.
• The right to petition for a writ of habeas corpus: the patient, or a relative/friend/guardian/attorney, may petition for a writ of habeas corpus on behalf of the patient to question the cause and legality of involuntary confinement.

Involuntary commitment

The court must find that the patient had a mental illness at the time of the incident, and due to that mental illness, the patient:

1. Has refused voluntary inpatient placement
2. Is unable to determine whether inpatient placement is necessary
3. Is incapable of surviving neither alone nor with the support of friends and family

Additionally, there can be no less restrictive alternatives available to involuntary commitment. If a less restrictive alternative exists and fulfills the patient’s needs, such as the option for involuntary outpatient services, then that alternative will be made available.

There is much debate about how involuntary commitment laws impact persons with disabilities. Given the shared history of institutionalization that ultimately led the Independent Living Movement, many in the community question whether persons with disabilities, particularly those with intellectual and cognitive disabilities, are misdiagnosed as having a mental health impairment that threatens their safety or the safety of others and needlessly shuffled into a system that is not built to properly treat them. 

Many persons with disabilities and advocates are cautious of law enforcement and local government's ability to properly recognize the difference between persons with mental health concerns and those who may have difficulty communicating, for example. 

Ongoing debates about how to properly diagnose and treat persons with mental health issues continue, with many lawmakers undecided about which model best serves their local community. 

Given the impact that COVID-19 has had on persons with mental health conditions and persons with disabilities, expect that debate to continue throughout 2022 and beyond.