A Reflection on Meteorological Considerations in Civil Commitment Evaluations

Journal of the American Academy of Psychiatry and the Law

article

Yi Wang¹ 

[1] Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania

关键词: civil commitment;    mental capacity;    human rights;   

DOI  :  10.29158/JAAPL.210026-21

学科分类：儿科学

来源: American Academy of Psychiatry The Law

【 摘 要 】

civil commitmentmental capacityhuman rightsA few winters ago, on a cold, clear night with the temperature dipping into the twenties, I worked a shift as the on-call psychiatric resident at a busy Crisis Response Center in the middle of a sprawling city. Midway through my shift, a homeless outreach team brought in a man for an involuntary psychiatric examination under the auspices of Code Blue, a citywide humanitarian initiative triggered by freezing winter weather conditions. Each winter, Code Blue mobilizes outreach teams to find homeless men and women on the streets and bring them to shelters. Those who decline transportation to a shelter, such as the man I was asked to evaluate, are instead brought involuntarily by outreach workers or police to a Crisis Response Center under court-ordered transportation to shelter (also called a COTS or a Code Blue 302, the number reflecting the section in the state's statute that provides for involuntary mental health assessment), with the help of the city solicitor and Common Pleas Court judge on call. The rationale for this procedure is that persons so indifferent to obvious danger (e.g., freezing temperatures) may have a mental illness impairing their ability to make rational decisions, leading either to inability to care for self or active dangerousness to self. Either way, an emergency psychiatric evaluation is needed. If, on psychiatric evaluation, there is a finding of mental illness and a finding of imminent danger, the person can then be involuntarily committed to a psychiatric facility. In the state where I practice, this initial commitment can last up to 120 hours, or five days, before a hearing occurs. Through this mechanism, the state exercises its parens patriae interests to provide care to its citizens who are unable to care for themselves.

【 授权许可】

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