Know Your Rights
What is an “involuntary commitment?”
A court can order you to be held against your wishes at a psychiatric facility, like New Hampshire Hospital or another designated facility, if you are found to have a mental illness that causes you to be a danger to yourself or others. In most cases, the process starts with an Involuntary Emergency Admission or IEA.
For a chart of the IEA and Commitment Process visit https://drcnh.org/know-your-rights/iea-chart/.
Who makes the decision to hold someone involuntarily?
Before you can be held against your wishes, a doctor must examine you and decide whether they think you are a danger to yourself or others due to a mental illness. This examination often occurs at the emergency department of a hospital. Once a doctor decides that you are a danger and should be held on IEA, you will be transferred by a police officer to a psychiatric facility or what is known as a designated receiving facility. These facilities include the Cypress Center and Elliott Hospital in Manchester, Franklin Hospital in Franklin, New Hampshire Hospital in Concord, Parkland Hospital in Derry, and Portsmouth Regional Hospital in Portsmouth.
Once you arrive at one of these facilities, you will have a hearing before a Circuit Court judge. The hearing must occur within three (3) days of your arrival, not including Sundays and holidays. At this hearing, which can be held either in-person or over the phone, the judge will decide whether you meet the standard for an IEA. An attorney is appointed to represent you at the hearing.
At your hearing, the person who requested that you be involuntarily admitted (“the petitioner”) must provide enough information to the judge to show that there is “probable cause” to hold you on an Involuntary Emergency Admission, including information from a doctor that supports that you meet the IEA standard. The judge is required to decide whether you can continue to be held as soon as possible after the hearing and no later than the end of the next business day.
If you lose at your hearing and the judge decides that you should be held on an IEA, you can be held up to ten days, not including Saturdays and Sundays. Before those ten days run out, one of three things may happen:
- The hospital may ask the court for permission to hold you longer
than ten days (called a ‘petition for commitment’).
- A second IEA may be put into place. This second IEA must be based
on a new dangerous act that you committed while you were being
held under the first IEA. Another three-day period would start, and
you would have another hearing with a judge.
- You will be discharged from the facility, either because the hospital
determines that you are no longer mentally ill and dangerous, or
because the ten-day period runs out.
What is the commitment process?
The Probate Division of the Circuit Court handles requests for longer-term confinement when someone files a petition for commitment. In most cases, a petition for commitment is brought against people who are being held under an IEA, but they can also be filed in relation to a criminal case.
To begin the commitment process, a formal petition must be filed which includes:
- A description of specific acts that show you are in a dangerous condition due to mental illness. The danger alleged in the petition may be either to self or to others;
- A certification from a doctor who has examined you and agrees that you are dangerous due to mental illness; and
- A list of witnesses who can testify to the contents of the petition.
The court must hold a hearing on the petition within 15 days, excluding weekends and holidays, from when the petition is filed. A lawyer is appointed to represent you, and a psychiatric examination is ordered. If you are already being held under an IEA, then you can continue to be held while the probate court considers the petition.
The doctor files a report with the court and a copy is given to your lawyer. The doctor must report on whether you are dangerous, the appropriate treatment for you, and whether hospitalization is necessary for that treatment. The doctor should provide an estimate of how long treatment is needed. In some cases, the doctor may recommend that a person be discharged into the community with certain conditions – this is called a conditional discharge. You, with the help of your attorney, may question the doctor at the hearing and present other evidence, including witnesses, to challenge the proposed commitment.
After the hearing is completed, the judge must decide if you should be committed with a conditional discharge. A commitment with conditional discharge cannot be for more than five years. If the judge decides to commit you, you can appeal that decision to the NH Supreme Court. The attorney who represented you at your commitment hearing is required to file your appeal for you but is not required to represent you at the appeal. You will be held while your appeal is pending, unless the hospital determines you no longer need in-patient treatment.
What rights do I have while I am committed?
You do not lose your civil rights just because you are in the hospital. You still have the right to vote, to make contracts, to marry or divorce, and to hold driver’s or professional licenses. If a guardian is appointed by the probate court, the court can take away some of your rights and give them to the guardian.
Learn more about guardianship and less restrictive alternatives at https://drcnh.org/issue-areas/guardianship/.
If I am under a commitment, what happens when my treatment team decides I am ready to be discharged from the hospital?
You will either be released with a conditional discharge or an absolute discharge:
- A conditional discharge (CD) means you are released back into the community, but you must follow certain conditions which include a requirement that you get services from your local community mental health center. Your specific conditions are decided by the hospital and the community mental health center before your release, and you must agree to the conditions in order to be discharged. An example of a condition under a conditional discharge is that you follow all of the treatment recommendations made by the community health center, such as taking medications or attending appointments.
- An absolute discharge means that you are no longer required to accept mental health treatment if you don’t want to.
What happens if I violate my Conditional Discharge?
If you violate the conditions of your discharge, you may be returned to a designated receiving facility to be evaluated in order to determine whether or not you will be re-committed to a hospital. There are specific procedures that must be followed both before and after you are recommitted. You have the right to challenge the revocation of your conditional discharge by requesting a hearing. If you request a hearing the court will appoint an attorney to represent you. Learn more at https://drcnh.org/issue-areas/mental-health/conditional-discharge/.
Can a commitment be renewed?
Yes, the probate court can renew a commitment if you are still dangerous to yourself or others. You can also be recommitted in order to require you to remain on a conditional discharge if you still need treatment to keep you and others safe. If you are recommitted, you are entitled to the same safeguards as you were the first time you were committed.
