Delaware General Assembly

Signed 10/14/14

The General Assembly has ended, the current status is the final status.

5/15/14

Barbieri

Sen. Hall-Long
Rep. Heffernan

AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO THE COMMITMENT OF THE MENTALLY ILL.

The 146th General Assembly passed House Joint Resolution No. 17 establishing a Study Group to, inter alia, conduct a comprehensive evaluation of Delaware's civil mental health laws. HJR 17 noted that it has been decades since a comprehensive review was made of these laws. HJR 17 further noted that it is in the interest of the State that “people be able to access the most appropriate mental health treatment, in the most appropriate but least restrictive setting, at the most appropriate time.” This bill is the result of recommendations made by the HJR 17 Study Group. It is important to note at the outset that the changes in this bill appear more comprehensive than they actually are because one of the primary changes made by this Act is the combination of Chapter 50 with those portions of Chapter 51 dealing with civil commitment. Thus, much of the stricken language of Chapter 51 appears as underlined “new” language in Chapter 50, but has not actually been changed significantly. Combining the chapters creates consistent definitions and a logical and structured process. The language and definitions of both chapters have been updated to refelect modern usage, current terms and promote consistency across the Delaware Code. Substantive changes were made to modernize procedures and provide better civil rights protections to patients. Much attention was paid to making a consistent process, so that people enter civil mental treatment in a consistent manner with due process protections and that similar protections and treatment philosophies are applied across the different levels of treatment. The voluntary admission process was revised to require a clearer showing of informed consent by the individual requesting to be voluntarily admitted. The proposal also reduces the timeframe to discharge a voluntary patient who requests discharge in writing from the current 5 working days to 72 hours. The proposal broadly adds additional safeguards and removes the ability to provisionally admit someone based on property destruction; it removes the ability of psychiatrist to bypass emergency detention through the use of provisional admission; it adds in explicit language that an individual who is provisionally admitted shall not be considered “involuntarily committed” for any legal purpose; but it allows for 48-hour admission following a 24-hour emergency detention. The following due process protection have been added after an involuntary inpatient commitment has been ordered: the order may not exceed three months; shall be based on the court’s individualized assessment of the facts and circumstances; at the end of the three month period, an individual is entitled to a hearing with at least a 14 day notice if continued inpatient treatment is ordered, hearings are held every three months to review the case. Other changes include appeal rules that better reflect Superior Court rules. Discharge requirements will explicitly extend to private psychiatric hospitals as well as DPC. This will not functionally change services already being provided by psychiatric hospitals because the majority of what is covered by provision is already required elsewhere in Delaware Law. Due process protections were added for youth. Parallel to the adult system, the Study Group recommends that emergency detentions be done only by psychiatrists and “Juvenile Mental Health Screeners.” However, because they are minors, consent for voluntary admissions to designated psychiatric treatment facilities or hospitals may only be given by a parent or legal guardian and such requests must be signed by a parent or legal guardian. Once admitted, minors or their parents or legal guardians may make a written request to the psychiatrist to be discharged at any time. Discharge may be conditioned upon the consent of the parent or legal guardian. If the parent or legal guardian of a voluntary patient requests discharge against medical advice, the involuntary treatment procedures may be initiated. At the recommendation of the HJR17 Study Group, consent for voluntary outpatient mental health treatment for minors under the age of 14 requires the consent of a parent, legal custodian, or legal guardian. However, for minors age 14 to 18, the minor or the parent / legal custodian / legal guardian may provide the consent. A minor, including those 14-18, cannot overrule consent provided by a parent/legal guardian / legal custodian. A parent/legal custodian / legal guardian may not abrogate the consent provided by a minor age 14 or older. Psychotropic medication requires the consent of the parent, legal guardian, or legal custodian. A different time frame is proposed for minors than adults for emergency detentions. When minors are emergently detained, the evaluation and treatment shall occur within 24 hours unless the parent or legal guardian is unavailable during that initial 24 hour period. In such instances the time period may be extended to 72 hours. Finally, the proposed legislation establishes the ability for the Secretary of the Department of Services for Children, Youth and Their Families to designate a psychiatrist or Institutional Review Board to review the emergency detention decisions of Juvenile Mental Health Screeners on an individual case or aggregate basis.

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Takes effect upon being signed into law

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