Involuntary Commitment in Texas

Involuntary commitment is the use of legal means to commit a person to a mental health facility against their will or over their protests. Involuntary commitments are used to get a person necessary medical treatment for their mental health. 

In the mental health community, involuntary commitment is considered a “last resort” option. It is mainly issued when an individual is unable to care for him or herself and has demonstrated behaviors indicating they are a danger to themselves or others. 

It is important to note that involuntary commitment is civil in nature and not criminal. 

You can be detained in two ways: 

• a judge can order a peace officer to take you to an inpatient mental health facility based on an application filed by an adult, or 

• a peace officer can detain you and take you to an inpatient mental health facility without a court order or a warrant. 

The decision to detain you on an emergency basis must be based on either personal observation or another person’s reliable observation of your recent behavior that makes them believe that: 

• you are mentally ill,  

• you pose a substantial and imminent risk of serious harm to yourself or others if you are not immediately detained, and 

• there is not sufficient time to obtain a warrant before taking you into custody. 

Examples of this kind of behavior include attempting to commit suicide, striking another person, or a recent pattern of severe emotional distress. 

Contact your local county clerk’s office or Justice of the Peace Office to find out where to file the application. Most counties have a specific office where an application for a warrant may be filed. 

In order to obtain a mental health warrant, an applicant must provide information about the individual in need of treatment.  

That information includes, but is not limited to: 

• contact information,  

• medical history,  

• prior alcohol and substance abuse, and 

• current information about the individual’s mental health status. 

The application for detention must contain:  

• a statement that the guardian [or applicant] has reason to believe and does believe that the ward evidences mental illness;  

• a statement that the guardian [or applicant] has reason to believe and does believe that the ward evidences a substantial risk of serious harm to the ward or others;  

• a specific description of the risk of harm;  

• a statement that the guardian [or applicant] has reason to believe and does believe that the risk of harm is imminent unless the ward is immediately restrained;  

• a statement that the guardian’s [or applicant’s] beliefs are derived from specific recent behavior, overt acts, attempts, or threats that were observed by the guardian [or applicant]; and 

• a detailed description of the specific behavior, acts, attempts, or threats. 

It is important that you are truthful in the application and provide all facts necessary to support your belief that the person you are trying to help is mentally ill and, as a result of the mental illness, is substantially likely to cause serious harm to themselves or others. 

In order to approve the application, the magistrate must find that there is reasonable cause to believe that: 

• the person evidences mental illness; 

• the person evidences a substantial risk of serious harm to himself or others; 

• the risk of harm is imminent unless the person is immediately restrained; and 

• the necessary restraint cannot be accomplished without emergency detention. 

If the application for a warrant is approved, then a warrant is issued and the local sheriff or constable’s office will locate and detain the individual. The sheriff or constable will then transport the individual to a local mental health facility. 

This warrant serves as a Magistrate's Order for Emergency Apprehension and Detention. The “magistrate” is the judge who will issue the warrant.  

Keep in mind that this warrant does not guarantee that the person will be admitted to a mental health facility. Rather, the warrant guarantees that the person will be evaluated for the need of treatment in the least restrictive environment. 

After the peace officer detains you, you must be immediately taken to the nearest appropriate mental health facility for an evaluation. This evaluation will determine whether you can be held longer or whether you must be released.  

Some facilities may want the peace officer to first take you to an emergency room for a medical clearance evaluation. However, unless you request or require medical attention, you should be taken straight to a mental health facility. You do not have to consent to a medical clearance evaluation. 

You must be placed in the nearest appropriate inpatient mental health facility or, in some cases, you may be placed in an alternative approved facility. 

After you are detained, you can only be placed in a jail or other non-medical facility in an emergency. If you are placed in a jail or other detention facility, you must be kept separate from people who have been charged with a crime. 

You have the following rights after you have been taken to an inpatient mental health facility following an emergency detention: 

• You must be examined by a doctor as soon as possible within 12 hours of arriving at the facility. 

• You may not be detained for more than 48 hours after you arrive at the facility unless a judge signs an Order of Protective Custody (OPC). If the 48-hour period ends on a weekend or holiday, you may be detained until 4 p.m. on the next business day. If the 48-hour period ends at a different time, you may only be detained until 4 p.m. that day. 

• You can only be admitted to the facility if the doctor who examines you determines that you are mentally ill, you pose a substantial and imminent risk of serious harm to yourself or others, and emergency detention is the least restrictive way to restrain you from harm. 

If an OPC is issued, a probable cause hearing must be held within 72 hours. At this hearing the judge decides whether the patient will be held at a mental health facility or released, while awaiting the mental health hearing.

The mental health hearing must take place within two weeks of the patient’s detention. At this hearing, the court may listen to testimony from the applicant for the warrant, medical experts, and the patient themselves.  

Prior to this hearing, two Physician Certificates are required to be on file; one of these must be by a psychiatrist. 

The court may decide to dismiss the case, issue a court order for outpatient treatment, or order inpatient hospitalization.  

The hearings are generally held at the hospital at which the patient is detained if they were not released following the OPC. 

Within 24 hours after you have been admitted to the mental health facility, you must be told both orally and in writing in the language you understand best, or if you are hearing or visually impaired, in the way you communicate best, the following: 

• You must be told where you are and why you have been detained. 

• You must be told that this emergency detention could turn into a longer commitment if an involuntary commitment proceeding is started. 

• You must be allowed to find an attorney of your choice and to talk with your attorney. 

• You must be told that anything you say or how you act while you are at the facility may be used by the judge in further proceedings, such as an involuntary commitment, to decide if you need to stay in the facility and how long you need to stay. 

• You must be allowed to leave the facility immediately unless the examining doctor finds that you are mentally ill and that you pose a substantial and imminent danger to yourself or others and that you cannot be treated in a less restrictive manner. 

• Whenever you are released from emergency commitment, the facility must arrange, at no charge to you, to take you back to where you were picked up, or to your home in Texas, or to another suitable place. 

If you are a minor or if you have a guardian, information about these rights must also be given to your parent or guardian. 

Providing court-ordered, emergency, or voluntary mental health services to a person is not a determination or adjudication of mental incompetency and does not limit the person's rights as a citizen, or the person's property rights or legal capacity. A person is presumed mentally competent unless a court has determined otherwise.  

A person living with mental illness has the rights, benefits, responsibilities, and privileges guaranteed by the constitution. A patient of an institution has: 

• the right to register and vote at an election; 

• the right to acquire, use, and dispose of property, including contractual rights; 

• the right to sue and be sued; 

• all rights relating to the grant, use, and revocation of a license, permit, privilege, or benefit under law; 

• the right to religious freedom; and 

• all rights relating to domestic relations. 

An individual who is a patient in an inpatient mental health facility also has the right to: 

• receive visitors; 

• communicate with a person outside the facility by telephone or mail; and 

• communicate by telephone or mail with legal counsel, the state agency, the courts, and the state attorney general. 

• be informed in writing, at the time of admission and discharge at an inpatient facility, of the existence, purpose, telephone number, and address of the protection and advocacy system in Texas. 

• appropriate treatment in the least restrictive appropriate setting available; 

• not receive unnecessary or excessive medication; 

• refuse to participate in a research program; 

• an individualized treatment plan and to participate in developing the plan; and 

• a humane treatment environment that provides reasonable protection from harm and appropriate privacy for personal needs. 

A person may not administer a psychoactive medication to a patient receiving voluntary or involuntary mental health services who refuses unless: 

• the patient is having a medication-related emergency; 

• the patient is younger than 16 years of age, or the patient is younger than 18 years of age and is a patient admitted for voluntary mental health services, and the parent, managing conservator, or guardian consents to the administration on behalf of the patient; or 

• the refusing patient's representative authorized by law to consent on their behalf has consented to the administration. 

A patient receiving inpatient mental health services is entitled to obtain at the patient's cost an independent psychiatric, psychological, or medical examination or evaluation by a psychiatrist, physician, or no physician mental health professional chosen by the patient. The facility administrator allows the patient to obtain the examination or evaluation at any time. 

If the patient is a minor, the minor and the minor's parent, legal guardian, or conservator is entitled to obtain the examination or evaluation. The cost of the examination or evaluation will be billed by the professional who performed the examination or evaluation to the person responsible for payment of the minor's treatment. 

You have some rights that no one, not even a judge or a doctor, can take away from you: 

• The right to treatment in the least restrictive appropriate setting. This means you have the right to treatment in a place that restricts your day-to-day life only as much as is necessary to protect you and others around you. It also means that your treatment should interfere as little as possible with your thinking, taking care of personal needs or your ability to work. 

• The right to a humane treatment environment that is clean and safe and the right to be free from abuse and neglect. 

• The right to proper mental health and medical treatment. 

• The right to an independent evaluation by another doctor of your choice as long as you pay the cost. 

• The right to religious freedom. 

• The right to enough privacy for your personal needs, as long as this does not place you or other people in danger. 

• The right to be told about your rights within one day (24 hours) of your admission to the facility. You must be told about these rights both orally and in writing, in the language you understand best. If you are hearing or vision impaired, these rights must be communicated to you in the way you understand best. If you are a minor, or if you have a guardian, information about these rights must also be given to your parent or guardian. 

• The right to a written individual treatment plan based on your own needs that describes your diagnosis, specific problems and specific needs. It must also contain a description of the short-term and long-term treatment goals and an estimation of how long it will take to meet those goals. The responsibilities of individual staff must be stated and criteria that must be met for discharge to a less restrictive environment must also be stated. The plan must be reviewed on a regular basis to make sure it is the best way to help you. 

• The right to participate in the development of your treatment plan, if you want to participate. If you are under 16 years old, or if you have a guardian, your parent or guardian can also participate in developing your treatment plan. 

• The right to information about the medications your doctor has prescribed, including the name of the medication, the dosage and schedule, the type of medication, the benefits expected from that type of medication and the side effects and risks of the medication. 

• The right to refuse to be a part of a research program. You do not have to agree to try new, experimental drugs or treatment. 

• The right to be informed, in writing, at admission and discharge of the address and telephone number for Disability Rights Texas. 

• The right to send and receive uncensored mail. 

• The right to find a lawyer to represent you and the right to talk with and to write to your lawyer. 

• The right to have your family notified of your discharge, if you want them to know. 

You have the right to refuse electroconvulsive therapy (ECT). However, if you are 16 years old or older and you have a guardian because a court has determined that you are incapacitated, then your guardian can consent to ECT, but only if you would have agreed to the treatment if you were not incapacitated. If you are under 16, ECT may not be used under any circumstances. 

If you have made an Advance Directive and included information about ECT, the Advance Directive must be followed when you become incapacitated, regardless of what your guardian may desire. 

You have the right of habeas corpus. In certain cases, you can ask a judge to decide if it is legal to keep you in a mental health facility against your will. If the judge decides that you should not be kept against your will, you must be immediately discharged. This might happen if, for instance, the judge thinks you are not likely to hurt yourself or others. 

You have all of the following rights when receiving involuntary mental health services, unless a judge has held a hearing and made a written order restricting a particular right: 

• The right to register and vote in elections. 

• The right to buy and sell property and to sign contracts. 

• The right to sue and be sued. 

• The right to have a driver’s license and other kinds of permits, privileges and benefits under the law. 

• The right to have your treatment records kept confidential, unless you sign a release or file a lawsuit, or a court orders the release of your records. 

• All rights concerning your family, such as the right to marry and have children. Unless a judge has taken custody of your children away from you, you can still make decisions for your children. 

• The right to give consent or refuse to give consent to treatment with medication. If you refuse to consent to medication and you are in a psychiatric hospital, the law says that you cannot be forced to take medication unless the hospital gets a court order or you are having a medication-related emergency. A medication-related emergency is a situation in which it is immediately necessary to administer medication to a patient to prevent immediate and serious harm to you or someone else because of your actions or threats. If the hospital wants you take medication that you do not want to take, the doctor must petition the court to order the medication and you can only be forced to take the medication after a hearing. You have the right to be present at the hearing and be represented by an attorney at the hearing at no cost to you. If the judge orders the medication, you can be required to take it. 

• If you have made an Advance Directive and included information about medications and preferences in emergencies, the judge and doctor must follow your instructions in the Advance Directive. 

The court proceedings that can limit your rights are guardianship, child custody and mental health commitment proceedings. 

Your doctor can restrict some of your rights while you are receiving involuntary services in a mental health facility. 

Only your doctor can order that physical restraints be used on you. If restraints are ordered, they must be taken off as soon as possible. Anytime physical restraints are used on you, it must be noted in your treatment record by your doctor. 

Unless your doctor orders a restriction, you have these rights: 

• The right to wear your own clothes and use your personal belongings. Some personal belongings may be prohibited at the facility if they are a safety risk. But if your personal belongings are not considered contraband, then you have a right to them unless the doctor orders a restriction. 

• The right to have visitors in the facility, to speak with by phone or write to people outside the facility. Your letters must not be opened, read or changed by anyone in the facility unless you want them to be. The facility can never open your packages for you, although if they suspect that you may be receiving contraband, your doctor can order that you open the package in front of staff. Your doctor can sometimes limit your right to have visitors and to write and talk with other people if the reasons for limiting these rights are necessary for your safety or the safety of others and put in your treatment record. Even if the doctor does set limits, you always have the right to talk with and to write confidentially a lawyer who has agreed to represent you. You also always have a right to contact Disability Rights Texas and to report abuse/neglect to the abuse/neglect hotline. 

• The right to socialize with others, including the opposite sex. Your doctor may order these activities to be supervised. 

• The right to physical activity and grounds privileges. 

• The right, when you are discharged, to a plan for your continued treatment (if you need continued treatment) that covers both your mental health and physical needs. You have the right to refuse the services in this plan, unless a judge says you do not have this right. 

If you believe any of these rights have been violated, you should first contact your treatment team at the facility where you are located. Additionally, you have the right to file a complaint with any of the following: 

• the Client Rights Officer for the facility 

• the Texas Health and Human Services (HHS) Ombudsman at 877-787-8999 if you are in a state hospital 

• Disability Rights Texas at 1-800-252-9108, then press 1 for English or 2 for Spanish 

If you are in a private psychiatric facility, you have a right to complain to the HHSC Health Facility Compliance Group by calling 1-800-458-9858 Option 5 or emailing hfc.complaints@hhs.texas.gov.