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If you aren’t aware, except in rare circumstances Probate Court is the venue for mental health commitment hearings.
We have many people wanting to talk to the judge about committing a family member or a friend. Most often these people have valid concerns about a person’s mental health; however, occasionally we have someone who wants to use the commitment procedure to get someone out of jail or for drug and/or alcohol abuse treatment. None of which in and of themselves are valid reasons for a mental health commitment.
Most often, the chief clerk will ask questions to gain very basic information and then explain the process for setting a hearing. The chief clerk also explains why I, as the judge, cannot discuss/hear any details of the case until a petition is filed and the hearing is held.
The chief clerk will also inquire if the alleged mentally deficient person has insurance, Medicare, Medicaid, or other means to pay the treatment expense if he/she is committed. Finally, the chief clerk will advise the person to contact an attorney (of his/her choosing) to discuss details and determine if a hearing for involuntary mental health commitment is proper.
If there are no means to pay expenses, the chief clerk also explains to the petitioner the process to get the Alabama Mental Health Department to pay attorney fees, court costs and treatment expenses. If the Mental Health Department is to pay, these costs are paid after the hearing and proper paperwork is filed with the Mental Health Department.
After all I’s are dotted and T’s crossed, a hearing will be set. If after hearing all the evidence presented the court finds involuntary treatment is warranted, an order will be issued for involuntary commitment either to inpatient treatment or outpatient treatment.
However, Alabama is greatly deficient in mental health facilities. At one point Alabama had 14 mental health facilities. Today Alabama has three mental health facilities.
In addition, we have many hospitals offering some type mental health services, but it is extremely difficult for them to keep up with the demand. Many are overwhelmed. The sad part is, with the estimated 220,000 Alabamians who suffer some type mental disability, the mental health system becomes quickly overloaded.
As a judge, it is extremely frustrating to conduct a mental health commitment hearing and, when warranted, to issue an order for treatment only to be told a bed isn’t available for the person to immediately obtain the treatment ordered by the court.
This is extremely trying and difficult for the person’s family members – family members who are often fearful or concerned for a myriad of reasons. Fear of the person, fear the person might do harm to self or others, and concerned the person may continue to deteriorate mentally.
However, one should not jump to the conclusion that Alabama is doing nothing to help those with mental disabilities. Alabama has opened four mental health centers around the state and is planning to open two additional centers.
The four centers are helping to reduce the burden on other facilities, but there are a lot of rules to get a person treatment at one of the centers. One rule is the treatment must be “voluntary” on the part of the patient. However, many mental health patients often believe they need no treatment.
Often, the only thing that needs to be accomplished is to get the patient on, or back on, his/her mental health medications. During this last year, the Department of Mental Health has been able to get a bed immediately except in one instance. In that case, the department obtained a bed within 24 hours.
I believe the centers mentioned above have helped, and the additional centers will help even more. This is one area in which I really believe spending tax dollars is justified.
Now, as last thoughts. Committing a person involuntarily is a big deal. It restricts a person’s liberty and is not to be taken lightly. With that in mind, involuntary commitment should not be the first alternative considered.
Some alternatives may include group therapy, individual therapy, medication, group homes, voluntary hospitalization, nursing homes, etc. These alternatives vary as to the amount of supervision involved. Each of these alternatives is voluntary and requires the approval of the person sought to be committed.
If one of these alternatives will work and the patient gets the care needed, then it helps reduce demand for beds in mental health facilities and increases access to those for whom judges have issued involuntarily commitment orders.
Finally, whether an alternative is appropriate, or not, will depend upon the specific circumstances as they relate to the person with the mental deficiency. Every case is different.
As always, the information provided here is meant to inform and provide insight. No one should ever apply or interpret any law without the aid of an attorney who analyzes the facts of that case. Until next month, stay safe!