Involuntary Commitment in Texas
This article will provide an introduction to the primary types of hearings a prosecutor may encounter under the Mental Health Code. It will then discuss that code as it pertains to commitments in the Code of Criminal Procedure.
- The Mental Health Code is contained in Title 7, Subtitle C of the Health & Safety Code. Of particular relevance to a county or district attorney handling involuntary commitment hearings is Subchapter 574, which relates to court-ordered mental health services.
Within 72 hours of being detained, a patient is entitled to a probable cause hearing, governed by §574.025 of the Health & Safety Code. The State’s evidence at this stage will be one certificate of medical examination as well as a supporting affidavit, executed by the affiant who swore out the Application for Detention (the CIRT officer in the above situation).1 The affiant need not be a peace officer; any adult may apply for emergency detention.
- A medical certificate is a sworn statement executed by a physician. Medical certificates are crucial to the State in any commitment hearing. At the probable cause hearing, the State may prove its case based solely on the medical certificate if there is no objection.3 The criteria for medical certificates are set forth in §§574.009 and 574.011. A medical certificate is executed by a physician (not a psychologist) who has examined the patient within the previous 30 days. Fortunately, most inpatient psychiatric facilities are familiar with the form and function of medical certificates. Basically, the physician will swear to whether, as a result of mental illness, the patient is likely to cause serious harm to self; is likely to cause serious harm to others; or is suffering severe distress, experiencing substantial deterioration, and is not able to make a rational and informed decision as to whether to submit to treatment.4 At the probable cause hearing, only the first two criteria (harm to self or others) are relevant.
- The court must appoint an attorney ad litem to represent the patient.6 A magistrate or justice of the peace will usually preside over the hearing, which is not on the record. Often, the patient will testify on his own behalf; friends or family members may also testify. At the hearing, the magistrate may sign an order for continued detention if he finds that the patient presents a substantial risk of harm to himself or others to the extent that he cannot remain at liberty. Otherwise, if the magistrate does not make these findings, the patient will be released, pending the final hearing.
State attorneys may ask a court to issue an order for extended mental health services.12 Unlike orders for temporary mental health services, these orders expire after one year. The hearing must include live testimony, unlike temporary commitments, which can be ordered solely based on the medical certificates. More importantly, this commitment applies only to a patient who has received court-ordered inpatient services for at least 30 days in the previous 12 months, either under the Mental Health Code or Chapter 46B of the Code of Criminal Procedure, which governs incompetent defendants. Practically speaking, this type of order is rare in probate courts, as most patients will be discharged within 60 days of commitment. However, the statute becomes relevant as it applies to hearings on criminal commitments.