Involuntarily Psychiatric Patients

The NH Supreme Court has ruled that those held involuntarily at ERs across the state must have a probable cause hearing on their Involuntary Emergency Admission petition within three days. Prior to this ruling, a hearing was not required until they had actually been admitted to the New Hampshire state hospital or other designated receiving facility (DRF). 

It is the correct ruling, but implementing it is going to be expensive. There are judges and attorneys used to such hearings near the few DRFs and especially in Concord near the state hospital, but now things will have to be patched together anywhere there is a hospital with an ER. If probable cause is found the clock starts ticking on other legal requirements which emergency departments are not used to handling.  Things that are second-nature to me in the concentrated specialised environment of IEAs and involuntary commitments are now going to need to be taught to ER workers who will only see a few cases a year. 

I know many of the people involved, including the NAMI spokesman Ken Norton who I have been friends with since the mid-80s. This did not used to be a problem, as the hospital used to just make room for however many patients the ERs and courts sent us, sometimes to levels of ridiculous overcrowding.  That was ruled unsafe decades ago, and because of the increase in psychiatric cases and the downsizing of the hospital about six years ago, NH Hospital no longer takes everyone immediately and patients stay - the usual word is is "languish" - in ERs until a vacancy opens up. 

It is another version of "Freedom isn't Free."  Enforcing rights is expensive. I was not privy to any discussion on this in particular, but I suspect this is a situation where the AGs office did not much mind losing, because it is now established in law that the mental health system has to provide such services rather than scramble day after day to deliver a pale approximation of rights, and funding will have to be provided rather than everyone just blaming others for the fact that things suck.