2012 Winter, Pg. 44. BALANCING CIVIL LIBERTIES WITH CLINICAL CARE: Reviewing the Recent Change in the involuntary Jrmssbris Statute.

AuthorBy Alexander de Nesnera, M.D., DFAPA, Paul Shagoury, Ph.D, and Elizabeth Howell Woodbury, Psy.D.

New Hampshire Bar Journal

2012.

2012 Winter, Pg. 44.

BALANCING CIVIL LIBERTIES WITH CLINICAL CARE: Reviewing the Recent Change in the involuntary Jrmssbris Statute

New Hampshire State Bar JournalVolume 52, No. 4Winter 2012BALANCING CIVIL LIBERTIES WITH CLINICAL CARE: Reviewing the Recent Change in the involuntary Jrmssbris StatuteBy Alexander de Nesnera, M.D., DFAPA, Paul Shagoury, Ph.D, and Elizabeth Howell Woodbury, Psy.D.INTRODUCTION

New Hampshire statutes clearly delineate procedures allowing the involuntary hospitalization of individuals suffering from mental illness who are a danger to themselves or others.(fn1) These statutes, along with appropriate judicial review, ensure individuals' due process rights when involuntarily admitted to New Hampshire Hospital or another designated receiving facility.

Several articles in the Bar Journal over the past few years have reported on the evolution of the involuntary hospitalization process for the mentally ill in New Hampshire. Attorney David Burns in the December 1997 BarJournal(fn2) provides a legal description of the process and in summer 2007, de Nesnera and Vidaver(fn3) describe the process from a clinician's perspective. Last year, de Nesnera and Folks(fn4) delineated the New Hampshire administrative rules allowing the involuntary treatment of individuals admitted to New Hampshire Hospital on non-emergency involuntary status.

New Hampshire Hospital is a 152-bed subspecialty hospital caring for the great majority of individuals involuntarily admitted due to being a danger to themselves or others as a result of mental illness. Persons admitted involuntarily have two court hearings if they need longer-term hospitalization to treat their mental illness symptoms. The first court hearing, held within three days (excluding Sundays and holidays) of admission to New Hampshire Hospital, determines if there is probable cause for the admission. The second court hearing occurs if the treating psychiatrist files a petition for non-emergency involuntary admission. Before September 2010, this petition was filed by day 10 of an individuals' involuntary admission, and if filed, individuals waited about 10 days for this second hearing. During this 10-day period, about 17 percent of petitions filed were withdrawn as the clinical improvement of some individuals during that time frame made a longer hospitalization unnecessary. This observation led to a request for a change in the involuntary admissions statute that would extend the time individuals may need to initially stay involuntarily. The hypothesis was that increasing the initial stay by a few days would allow adequate time for treatment, possibly leading to an overall decrease in petitions for non-emergency involuntary admissions.

Only one published study, by Tanya Wanchek, a researcher at the School of Medicine, University of Virginia...

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