NC
Who can petition to have someone involuntarily committed?
Anyone with first-hand knowledge of an individual's behavior or state of mind
What is Medical Paternalism?
healthcare approach where physicians make decisions for pt's medical care without consent or override pt's preferences
Who pays for this? (You can take a guess)
1. County of residence is responsible for transportation cost **if not covered by health insurance** BUT may recover costs from pt, legal responsible/liable entities.
(§ 122C-251. Custody and transportation. NC general assembly )
When is an Involuntary Hold Necessary? (3 criteria)
1. Danger to themselves
2. Danger to others
3. Gravely Disabled
What can get you institutionalized in a 19th-century insane asylum? (multiple)
-Bad Company
-Bad Habits
-Business Nerves
-Crime
-Death of Sons in the War
-Deranged Masturbation
-Desertion by Husband
-Disappointment
-Domestic Trouble
-Doubt about Mother’s Ancestry
-Feebleness of Intellect
-Female Disease
-Hard Study
-Imaginary Female Trouble
-Laziness
-Medicine to Prevent Conception
-Menstrual Deranged
-Novel Reading
-Parents were Cousins
-Political or Religious Excitement
-Suppressed Masturbation
According to the Treatment Advocacy Center, what grade did NC receive (A-F)?
B- (score of 80)
-10pts= citizen access to court inpatient/AOT
-5pts=at least 48-72hour hold (NC is 24hrs)
What are the two legal bases for involuntary detainment?
Parens patriae- responsibility for those unable to care for themselves
Police power- The authority to prevent harm (ex. seatbelt laws)
How can this hurt the pt? (4)
1. psychological distress
2. loss of autonomy
3. Stigmatization
4. mistrust of theraputic tx & facilities
You've been handed IVC paperwork. Now what?
1. Transport to a 24hour psychiatric-capable facility
2. physician examination
3. inpatient/outpatient/substance abuse commitment OR termination of proceedings
(https://www.sog.unc.edu/sites/default/files/course_materials/Fall%202011%20Conf-Botts.pdf)
O'Connor v. Donaldson (1975) Supreme Court Case ruled:
"civil commitment was ______ based solely on mental illness and that the patient must be ______ to either self or others"
"civil commitment was unconstitutional based solely on mental illness and that the patient must be dangerous to either self or others"
Overturned the original practice of "presumed incompetence"
(https://www.sciencedirect.com/topics/nursing-and-health-professions/involuntary-commitment)
How many IVC petitions have been filed in NC 2024? (The number may shock you)
TRICK QUESTION, WE DON'T KNOW!
*Mecklenberg Lawyer Robert Ward and Promise Rescue Network reported there was a 91% increase in IVC petitions from 2009-2018*
What rights does the involuntarily committed retain? (5)
1. right to an attornery & to be present at the hearing
3.Access to the least restrictive form of treatment
4. right to appeal treatment decisions
5. entitlement to dignity, respect, and protection from discrimination and abuse
(Stallman HM, Gupta V. Involuntary Commitment. [Updated 2025 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557377/ )
How does this hurt the provider?
1. ethical dilemnas
2. legal/regulatory burdern
3. resource constraints
4. Burnout/compassion fatigue
(Stallman HM, Gupta V. Involuntary Commitment. [Updated 2025 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557377/ )
Doc says I gotta stay! What do I do?
CALL YOUR LAWYER!
You have a right to an attorney. A court hearing must be held no later than 10 days after you are taken into custody.
The last supreme court ruling in 19-- ruled that _____ of people with disabilities is discrimination.
Olmstead v L.C. (1999)
ruled that segregation of people with disabilities is discrimination.
ADA requires state provide community-based services to people with disabilities