In the recent case of In the Matter of the Civil Commitment of D.E., a person who was committed to inpatient mental health care challenged her commitment and won because the hospital had not produced “clear and convincing evidence” of her being a danger to herself or others, despite a less than ideal discharge plan. The appellate division took on the case despite the fact that she had been discharged shortly after, because if D.E.’s commitment was upheld, she or her insurer would have been liable for the cost of the hospitalization.
In D.E.’s favor was the longstanding involvement of a PACT team that she said she would work with again upon discharge for medication management and other services. D.E., and all civilly committed people, get legal representation through the Division of Mental Health Advocacy in the NJ Public Defender’s Office. Kudos to this office on the decision, which drives the point home that a commitment is not a rubber stamp for the hospital psych unit.
It is important for mental health consumers to have a plan to deal with future incidents of psychosis, major depression or decompensation. Draft and sign a Psychiatric Advance Directive to appoint a representative to advocate for you when you are in crisis, and lay out you preferred methods of treatment in advance. Use this document to indicate involvement with outpatient resources, and if you have a problem with a particular psychiatric unit or hospital, put that preference in the document. Keep an electronic copy of this document as well as your financial and medical Durable Powers of Attorney on a zip drive on a key chain, and give copies to trusted individuals.