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A BILL TO BE ENTITLED
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AN ACT
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relating to the criteria for commitment or detention of a person |
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with mental illness. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 571.003, Health and Safety Code, is |
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amended by adding Subdivision (7-a) to read as follows: |
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(7-a) "Gravely disabled" means a person who, as a |
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result of mental illness, is: |
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(A) suffering severe and ongoing mental, |
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emotional, or physical distress; |
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(B) in danger of serious physical harm or serious |
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illness due to the person's inability to function independently, |
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which is exhibited by the person's inability due to mental illness, |
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except for reasons of indigence, to provide for the person's basic |
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needs, including food, clothing, shelter, medical care, health, or |
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safety; and |
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(C) unable to make a rational and informed |
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decision as to whether to submit to treatment. |
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SECTION 2. The heading to Subchapter A, Chapter 573, Health |
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and Safety Code, is amended to read as follows: |
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SUBCHAPTER A. APPREHENSION, [BY PEACE OFFICER OR] TRANSPORTATION, |
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OR DETENTION WITHOUT JUDGE'S OR MAGISTRATE'S ORDER [FOR EMERGENCY
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DETENTION BY GUARDIAN] |
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SECTION 3. Section 573.001, Health and Safety Code, is |
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amended by amending Subsection (b) and adding Subsection (g) to |
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read as follows: |
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(b) A substantial risk of serious harm to the person or |
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others under Subsection (a)(1)(B) may be demonstrated by: |
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(1) the person's behavior; or |
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(2) evidence of the person being gravely disabled |
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[severe emotional distress and deterioration in the person's mental
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condition] to the extent that the person cannot remain at liberty. |
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(g) A peace officer may take a person who has been admitted |
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to a facility into custody under this section. For purposes of this |
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subsection, "facility" has the meaning assigned by Section 573.005. |
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SECTION 4. Section 573.003(b), Health and Safety Code, is |
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amended to read as follows: |
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(b) A substantial risk of serious harm to the ward or others |
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under Subsection (a)(2) may be demonstrated by: |
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(1) the ward's behavior; or |
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(2) evidence of the ward being gravely disabled |
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[severe emotional distress and deterioration in the ward's mental
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condition] to the extent that the ward cannot remain at liberty. |
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SECTION 5. Subchapter A, Chapter 573, Health and Safety |
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Code, is amended by adding Section 573.005 to read as follows: |
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Sec. 573.005. TEMPORARY DETENTION BY CERTAIN FACILITIES. |
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(a) In this section, "facility" means: |
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(1) a mental health facility; |
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(2) a hospital, or the emergency department of a |
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hospital, licensed under Chapter 241; and |
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(3) a freestanding emergency medical care facility |
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licensed under Chapter 254. |
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(b) This section does not apply to a person who has been |
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transported to a facility for emergency detention under this |
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chapter. |
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(c) A facility may detain a person who voluntarily requested |
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treatment from the facility or who lacks the capacity to consent to |
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treatment, as provided by this section, if: |
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(1) the person expresses a desire to leave the |
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facility or attempts to leave the facility before the examination |
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or treatment is completed; and |
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(2) a physician at the facility: |
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(A) has reason to believe and does believe that: |
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(i) the person has a mental illness; and |
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(ii) because of that mental illness there |
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is a substantial risk of serious harm to the person or to others |
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unless the person is immediately restrained; and |
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(B) believes that there is not sufficient time to |
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file an application for emergency detention or for an order of |
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protective custody. |
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(d) The facility staff or physician shall notify the person |
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if the facility intends to detain the person under this section. |
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(e) The physician shall document a decision to detain a |
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person under this section and place that notice of detention in the |
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person's medical record. The notice of detention must contain: |
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(1) a statement that the physician has reason to |
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believe and does believe that the person evidences mental illness; |
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(2) a statement that the physician has reason to |
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believe and does believe that the person evidences a substantial |
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risk of serious harm to the person or others; |
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(3) a specific description of the risk of harm; |
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(4) a statement that the physician has reason to |
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believe and does believe that the risk of harm is imminent unless |
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the person is immediately restrained; |
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(5) a statement that the physician's beliefs are |
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derived from specific recent behavior, overt acts, attempts, or |
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threats that were observed by or reliably reported to the |
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physician; and |
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(6) a detailed description of the specific behavior, |
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acts, attempts, or threats. |
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(f) The period of a person's detention authorized by this |
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section may not exceed four hours following the time the person |
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first expressed a desire to leave, or attempted to leave, the |
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facility. The facility shall release the person not later than the |
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end of the four-hour period unless the facility arranges for a peace |
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officer to take the person into custody under Section 573.001 or an |
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order of protective custody is issued. |
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(g) A physician, person, or facility that detains or fails |
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to detain a person under this section and who acts in good faith and |
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without malice is not civilly or criminally liable for that action. |
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SECTION 6. Section 573.012(c), Health and Safety Code, is |
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amended to read as follows: |
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(c) A substantial risk of serious harm to the person or |
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others under Subsection (b)(2) may be demonstrated by: |
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(1) the person's behavior; or |
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(2) evidence of the person being gravely disabled |
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[severe emotional distress and deterioration in the person's mental
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condition] to the extent that the person cannot remain at liberty. |
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SECTION 7. Section 573.022(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) A person may be admitted to a facility for emergency |
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detention only if the physician who conducted the preliminary |
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examination of the person makes a written statement that: |
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(1) is acceptable to the facility; |
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(2) states that after a preliminary examination it is |
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the physician's opinion that: |
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(A) the person is mentally ill; |
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(B) the person evidences a substantial risk of |
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serious harm to himself or others; |
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(C) the described risk of harm is imminent unless |
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the person is immediately restrained; and |
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(D) emergency detention is the least restrictive |
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means by which the necessary restraint may be accomplished; and |
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(3) includes: |
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(A) a description of the nature of the person's |
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mental illness; |
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(B) a specific description of the risk of harm |
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the person evidences that may be demonstrated either by the |
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person's behavior or by evidence of the person being gravely |
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disabled [severe emotional distress and deterioration in the
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person's mental condition] to the extent that the person cannot |
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remain at liberty; and |
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(C) the specific detailed information from which |
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the physician formed the opinion in Subdivision (2). |
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SECTION 8. Section 574.011(d), Health and Safety Code, is |
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amended to read as follows: |
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(d) If the certificate is offered in support of a motion for |
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a protective custody order, the certificate must also include the |
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examining physician's opinion that the examined person presents a |
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substantial risk of serious harm to himself or others if not |
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immediately restrained. The harm may be demonstrated by the |
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examined person's behavior or by evidence of the person being |
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gravely disabled [severe emotional distress and deterioration in
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the examined person's mental condition] to the extent that the |
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examined person cannot remain at liberty. |
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SECTION 9. Section 574.022(b), Health and Safety Code, is |
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amended to read as follows: |
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(b) The determination that the proposed patient presents a |
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substantial risk of serious harm may be demonstrated by the |
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proposed patient's behavior or by evidence of the person being |
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gravely disabled [severe emotional distress and deterioration in
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the proposed patient's mental condition] to the extent that the |
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proposed patient cannot remain at liberty. |
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SECTION 10. Sections 574.034(a) and (d), Health and Safety |
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Code, are amended to read as follows: |
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(a) The judge may order a proposed patient to receive |
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court-ordered temporary inpatient mental health services only if |
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the judge or jury finds, from clear and convincing evidence, that: |
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(1) the proposed patient is mentally ill; and |
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(2) as a result of that mental illness the proposed |
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patient: |
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(A) is likely to cause serious harm to himself; |
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(B) is likely to cause serious harm to others; or |
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(C) is gravely disabled [:
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[(i)
suffering severe and abnormal mental,
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emotional, or physical distress;
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[(ii)
experiencing substantial mental or
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physical deterioration of the proposed patient's ability to
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function independently, which is exhibited by the proposed
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patient's inability, except for reasons of indigence, to provide
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for the proposed patient's basic needs, including food, clothing,
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health, or safety; and
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[(iii)
unable to make a rational and
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informed decision as to whether or not to submit to treatment]. |
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(d) To be clear and convincing under Subsection (a), the |
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evidence must include expert testimony and, unless waived, evidence |
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of a recent overt act or a continuing pattern of behavior that tends |
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to confirm: |
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(1) the likelihood of serious harm to the proposed |
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patient or others; or |
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(2) the proposed patient being gravely disabled |
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[patient's distress and the deterioration of the proposed patient's
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ability to function]. |
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SECTION 11. Sections 574.035(a) and (e), Health and Safety |
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Code, are amended to read as follows: |
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(a) The judge may order a proposed patient to receive |
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court-ordered extended inpatient mental health services only if the |
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jury, or the judge if the right to a jury is waived, finds, from |
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clear and convincing evidence, that: |
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(1) the proposed patient is mentally ill; |
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(2) as a result of that mental illness the proposed |
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patient: |
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(A) is likely to cause serious harm to himself; |
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(B) is likely to cause serious harm to others; or |
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(C) is gravely disabled [:
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[(i)
suffering severe and abnormal mental,
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emotional, or physical distress;
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[(ii)
experiencing substantial mental or
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physical deterioration of the proposed patient's ability to
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function independently, which is exhibited by the proposed
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patient's inability, except for reasons of indigence, to provide
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for the proposed patient's basic needs, including food, clothing,
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health, or safety; and
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[(iii)
unable to make a rational and
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informed decision as to whether or not to submit to treatment]; |
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(3) the proposed patient's condition is expected to |
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continue for more than 90 days; and |
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(4) the proposed patient has received court-ordered |
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inpatient mental health services under this subtitle or under |
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Chapter 46B, Code of Criminal Procedure, for at least 60 |
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consecutive days during the preceding 12 months. |
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(e) To be clear and convincing under Subsection (a), the |
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evidence must include expert testimony and evidence of a recent |
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overt act or a continuing pattern of behavior that tends to confirm: |
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(1) the likelihood of serious harm to the proposed |
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patient or others; or |
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(2) the proposed patient being gravely disabled |
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[patient's distress and the deterioration of the proposed patient's
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ability to function]. |
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SECTION 12. This Act takes effect September 1, 2013. |
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* * * * * |