Amendments to Mental Health Act Take Effect In April 2019

Brian C. Caffrey, Esq.

Amendments to the Pa. Mental Health Procedures Act, allowing for out-patient involuntary mental health commitments, take effect April 22, 2019. Up to now, involuntary mental health commitments, mostly under Sections 302 and 303 of the Act, have exclusively involved commitment to an in-patient mental health facility. Now, under the concept of “involuntary outpatient civil commitment,” courts will have the authority to order persons covered by the statute to attend out-patient treatment and counseling. This will affect people who are not pursuing needed treatment, as well as people concerned about Second Amendment firearms rights.

The existing Act begins by stating, “It is the policy of the Commonwealth of Pennsylvania to seek to assure the availability of adequate treatment to persons who are mentally ill[.]” The amendments introduce the concept of “assisted outpatient treatment,” which means “community-based outpatient social, medical and behavioral health treatment services ordered by a court for a severely mentally disabled person.” Assisted outpatient treatment may include community psychiatric supportive treatment, “assertive community treatment,” medications, individual or group therapy, peer support services, financial services, housing or supervised living services, alcohol or substance abuse treatments when the treatment is a co-occurring condition for a person with a primary diagnosis of mental health illness, and “any other service prescribed to treat the person’s mental illness that either assists the person in living and functioning in the community or helps to prevent a relapse or a deterioration of the person’s condition that would be likely to result in a substantial risk of serious harm to the person or others.”

County mental health and intellectual disabilities programs may elect not to provide assisted outpatient treatment.

The need for assisted outpatient treatment will be shown by establishing by clear and convincing evidence that the person would benefit from such treatment because:

1. The person is unlikely to survive safely in the community without supervision, based on a clinical determination;
2. The person has a history of lack of voluntary adherence to treatment for mental illness;
3. The person, as a result of the person’s mental illness, is unlikely to voluntarily participate in necessary treatment and has previously been offered and refused voluntary treatment; and
4. Based on the person’s treatment history and current behavior, the person needs treatment in order to prevent a relapse or deterioration that would likely result in substantial risk of serious harm to others or himself.

Under existing § 304 of the act, which allows Court-ordered involuntary treatment for up to ninety days, there will be separate procedures for initiating assisted outpatient treatment for persons already subject to involuntary treatment and for those not in involuntary treatment. Under the former, the county mental health administrator or the facility director may file a petition stating that the patient no longer needs inpatient treatment but needs assisted outpatient treatment. The patient will have the right to an attorney and the services of an expert in the field of mental health, and a hearing must be held within five days after the petition is filed.

Under the latter procedure, the petition, which may be filed by “any responsible party,” must state reasonable grounds to believe that the person is within the criteria for assisted outpatient treatment and must be supported by a statement of a psychiatrist or licensed clinical psychologist. The court, by summons, will direct the person to appear for the hearing. If the person is unwilling to appear, the court may issue a warrant directing a peace officer to bring the person before the court. The court, on its own motion, may order the person to be examined by a psychiatrist or other qualified professional appointed by the court.

A decision must be rendered within 48 hours after the close of the evidence. If the criteria of the Act are met, the court shall order the person to receive assisted outpatient treatment for a period not to exceed 90 days. If the person fails materially to adhere to the treatment plan and comply with the court order, the court may order the person to submit to an involuntary evaluation under § 302 and, if appropriate, file a petition that the person poses a clear and present danger under § 301.

A person may be subject to assisted outpatient treatment for a period of up to 180 days if the person continues to meet the requirements for ordering such treatment or is being discharged from involuntary inpatient treatment. The amendments authorize treatment for an additional 180-day period upon a finding of a need for continuing assisted outpatient treatment.

Future articles will focus on the rationale for these amendments, and the effect of the amendments on the application of federal and state firearms disqualifications.

If you have questions concerning involuntary in-patient or assisted outpatient treatment, call our office 717 657 7770 to ask about a consultation.