Section 9 Absent Without Permission

• Library: Mental Health 2006

If a patient leaves a mental health facility or program without permission and disclosure is necessary for the protection of the patient or others, “notice of the disappearance, along with relevant information, may be made to relatives, governmental law enforcement agencies and other persons.” Section 630.150.1, RSMo 2000. If the patient was committed to the custody of the Department of Mental Health as a result of a criminal proceeding in which the patient’s mental illness prevented prosecution of the criminal charges, the head of the mental health facility “shall immediately give notice of the disappearance, along with relevant information, to the prosecutor and sheriff of the county wherein the [patient] is detained, the prosecutor and sheriff of the county wherein the [patient] was tried and acquitted, all known surviving victims . . ., [and] any other agencies or persons” necessary for the protection of the patient. Section 630.150.2.

The head of a mental health facility or program may request a sheriff to apprehend and return a patient to the facility under any of the following circumstances:

• The patient is a minor whose admission was applied for by a parent or legal custodian, who has not requested the patient’s release

• “The patient is a minor under jurisdiction of the juvenile court.”

• The patient has been declared legally incapacitated and the patient’s guardian has not requested release of the patient

• The patient was committed to the Department of Mental Health

• The patient’s condition is of such a nature that, for the protection of the patient or others, “the patient’s return to the program is necessary as noted in the patient’s records, in which case civil detention procedures shall be initiated upon return to the program.”

Section 632.455, RSMo 2000.

(§5.10) Abuse or Neglect

Patients in mental health facilities and programs are entitled to be free from verbal and physical abuse. Section 630.115.1(15), RSMo 2000. “[A]buse or neglect” includes any of the following:

• Beating, striking, or injuring a patient

• Mistreating or maltreating a patient, or handling or treating a patient in a brutal or inhuman manner

• Using any more force than is reasonably necessary for the proper control, treatment, or management of a patient

• Failing to provide services that are reasonable and necessary to maintain the physical and mental health of a patient when the failure presents either an imminent danger to the health, safety, or welfare of the patient or a substantial probability that death or serious harm will result

Section 630.155, RSMo 2000.

If there is reasonable cause to believe that a patient has been abused or neglected, the following persons shall immediately report or cause a report to be made to the Department of Mental Health or the Department of Health and Senior Services: “physician, dentist, chiropractor, optometrist, podiatrist, intern, nurse, medical examiner, social worker, psychologist, minister, Christian Science practitioner, police officer, pharmacist, physical therapist, facility administrator, nurse’s aide or orderly.” Section 630.165.1, RSMo Supp. 2005. “The report shall contain the name and address of the residential facility, day program or specialized service; the name of the patient . . .; information regarding the nature of the abuse or neglect; the name of the complainant; and any other information which might be helpful in an investigation.” Section 630.165.2.

If it is alleged or suspected that a patient who has been admitted to or is currently in a facility or program has been subjected to abuse that results in physical injury or is sexual abuse, the head of the facility or program “shall promptly notify local law enforcement authorities and cooperate fully with any investigation by them.” Section 630.168, RSMo 2000.

(§5.11) Immunities and Defenses

There are various immunities and defenses afforded for implementing measures to protect patients from harming themselves or others.

Missouri has statutorily provided qualified immunity related to civil detention actions. Section 632.440, RSMo 2000, provides the following immunity:

No officer of a public or private agency, mental health facility or mental health program; no head, attending staff or consultant of any such agency, facility or mental health program; no mental health coordinator, registered professional nurse, licensed physician, mental health professional nor any other public official performing functions necessary for the administration of this chapter [Comprehensive Psychiatric Services]; no peace officer responsible for detaining a person pursuant to this chapter; and no peace officer responsible for detaining or transporting, or both, any person upon the request of any mental...