Involuntary Treatment in Arizona: Legal Process, Criteria, Laws, and Rights
Key Points
- This article will outline the involuntary treatment process in Arizona and define who is eligible for the protections of these laws.
- Learn what legal criteria and civil commitment standards are in place for Arizona Courts.
- Learn about the individual rights of individuals during mental health involuntary commitment proceedings in Arizona.
- Discusses benefits, challenges, and ethical concerns related to involuntary treatment laws in Arizona.
- Provides families with direction on next steps to take after the court has been involved, as well as available resources and support.
Involuntary treatment can be a daunting experience for both the individual and their family. When someone you love has gone into crisis, is experiencing extreme mental health symptoms, and is unable to acknowledge their need for assistance, their family members typically face painful choices that are rooted in concern for their safety and trust in the possibility of the individual achieving recovery.
Understanding Involuntary Treatment in Arizona will aid family members and loved ones in ensuring that the individual’s health and safety, as well as their legal rights, are maintained during this challenging time.
Involuntary treatment differs from voluntary treatment in that it is legally mandated and not a choice of the individual. Involuntary treatment is available only when a person is non-compliant with the required criteria and has not agreed to treatment of their own volition. Understanding how the process for obtaining involuntary care and treatment is accomplished will provide families with reduced fear and confusion, as well as help them to make informed decisions regarding their loved ones.
What is Involuntary Treatment?
Involuntary treatment refers to a court-mandated mental health evaluation and/or treatment pursuant to a civil, not criminal, law. The goal of Involuntary Treatment is to assist and stabilize the individual’s condition, and not to punish them.
A mental health evaluation through the court process occurs once there has been documentation presented to the court that clearly illustrates the individual is at risk to themselves or others due to an impairment in their mental health.
Scope: Mental Health vs. Substance Use
Involuntary Treatment applies to an individual who has been diagnosed with a severe mental illness as defined under Arizona law, even when an individual may have exhibited inappropriate or illegal behaviour due to their use of drugs or alcohol (substance-induced psychosis), and that this behaviour causes them to be at increased risk of becoming involved with law enforcement.
Terminology
Knowing the terminology used will be helpful for anyone involved in the Arizona Involuntary Treatment process:
- Court-Ordered Evaluation (COE): A Court-mandated mental health evaluation.
- Court-Ordered Treatment (COT): Treatment mandated by the Court following evaluation.
- Civil Commitment: The legal process(s) to authorise involuntary Mental Health treatment.
- Gravely Disabled: Unable to provide basic needs such as food, shelter, or medical care.
- Persistently/Acutely Disabled: Severe impairment of an individual’s ability to function and/or to make sound decisions.
- Danger to Self/Others: An individual is at a high risk of suffering physical harm.
The Involuntary Treatment Process in Arizona
A Brief Overview of the Civil Commitment Process
The involuntary treatment process in Arizona follows a standardised civil pathway as follows:
- A pre-petition screening occurs at a state-designated mental health agency.
- A petition for Court-Ordered Evaluation is filed with the Court.
- The individual is evaluated. This typically takes approximately 72 hours.
- A hearing is held during which a judge reviews the evidence and testimonies presented.
- If the evidence presented demonstrates that the criteria for involuntary treatment have been met, the court may order treatment.
Each step is designed to balance the rights of individuals with the safety of others.
Who Can Initiate the Emergency Petition Process
The Emergency Petition Mental Health Process in Arizona may be initiated by:
- Family members/guardians
- Physicians and Mental Health Professionals
- Law Enforcement Officers
- Other Community members with verifiable and credible concerns
Criteria for Civil Commitment
Arizona requires that the court review the following four criteria under Title 36 of the Arizona Revised Statutes before authorising Involuntary Treatment:[1]
- An individual may harm themselves
- An individual may harm another individual
- An individual is persistently or acutely disabled
- An individual is gravely disabled
In addition, a court must also determine that the individual has been unwilling to accept their own voluntary treatment or is unable to accept their own voluntary treatment.
Length of Treatment and Type of Treatment
Involuntary treatment and/or evaluation may occur in an inpatient or outpatient setting. An individual evaluated as requiring assisted outpatient treatment will be allowed to continue living in the community while adhering to the terms of the treatment plan mandated by the court. Treatments ordered may be for a maximum of one year and must include periods of review of the individual.
Judicial Review and Renewal of Treatment Orders
All individuals preserve their legal rights and the right to seek court review, modification, or termination of treatment orders. In addition, prior to renewing any involuntary treatment orders, all courts must review whether the treatment remains necessary.
What Laws Regulate this Process in Arizona?
- Arizona Revised Statutes Title 36 Chapter 5: The primary legal framework governing involuntary treatment of mental health in Arizona is Title 36. Section 5: Statutes pertaining to Arizona Civil Commitment. The statutes describe the eligibility criteria, procedures, rights, and limitations regarding civil commitment in Arizona.[1]
- Arizona Administrative Code: This is also a source of guidance for evaluation agencies and treatment facilities, as well as for procedural safeguards.[2]
- Recent Legal Developments and Changes: Even though the statutory bases are generally consistent, case law and legislative changes sometimes provide clarity on patient rights, evidentiary requirements, and standards of proof. Therefore, family members should seek legal counsel for advice on the most current interpretation of Arizona’s involuntary commitment laws.
Rights of Individuals Engaged in the Involuntary Treatment Process
Legal Protection of Individuals
Individuals who are being subjected to involuntary treatment in Arizona continue to have basic rights, including:
- Right to counsel
- Right to appear at hearings/predicate evidence
- Right to confidentiality and dignified treatment
- Right of appeal of court rulings
Court’s Burden of Proof
To impose an order for involuntary treatment, courts must have clear and convincing evidence of the need for such treatment. This burden is greater than that which applies in most civil cases, which reflects the serious nature attached to restricting a person’s freedom.
Benefits of Involuntary Treatment in Arizona
- Safe Environment: If a person poses a serious threat to themselves or to another person, civil commitment permits a formal order for involuntary treatment in order to avoid any physical injury or death of that individual or others.
- Structured Psychiatric Care: When a person is receiving care through involuntary commitment, they will typically have access to psychiatric evaluations, medication management, and other types of therapeutic or supportive services, which they may have otherwise been unable to receive due to their impaired insight.
- Opportunity for Stabilization/Recovery: While involuntary treatment does not represent optimal conditions, it can create a window of opportunity for stabilization and recovery to occur. For many individuals, the experience of receiving symptom relief and improved functionality will serve as the prerequisite for entering into voluntary treatment.
Concerns/Controversies
- Ethics of Balancing Autonomy and Protection: Finding that balance is difficult when individuals are unable to agree with the level of treatment that is being provided to them.
- Legal Implications: The process for involuntary commitment that is established under Arizona law requires compliance with specific procedural rules regarding documentation and evidence; failure to produce either of these could delay treatment for an individual.
- Practical Barriers: Individuals may face difficulties obtaining follow-up care, stable housing, and community support after discharge from an involuntary treatment order. Thus, continuity of care is critical for long-term recovery.
Next Steps and Resources
Individuals or families wishing to explore involuntary treatment options in Arizona can find support through Arizona Crisis Services, their respective County Behavioral Health Authority, legal assistance organizations, and patient advocacy groups. In addition, individuals can access court websites for emergency petitions for mental health treatment forms. Consultation with treating mental health professional(s) may assist families in determining whether involuntary treatment is appropriate, as well as what other viable alternatives may be available.
Frequently Asked Questions About Involuntary Treatment in Arizona
Can family members force a loved one into family substance abuse treatment in Arizona?
Arizona does have involuntary treatment laws; however, at the time of this writing, substance use treatment is not typically addressed through these laws. However, the court could possibly order substance use treatment if the use would pose an immediate danger to oneself due to involvement or substantial impairment as a result of mental illness.
What takes place after the court’s order for treatment expires?
Once an individual who has been treated has completed treatment, they typically move into either voluntary treatment or into supportive community services after discharge. Additionally, if the court determines that a person continues to meet the criteria for treatment, they are able to extend the treatment order.
Can an involuntary treatment order be challenged?
Yes, individuals possess the right to challenge an involuntary treatment order. Furthermore, they may challenge the evidence presented in the original court hearing, request a hearing for further evaluation, or appeal the order.
Does an involuntary treatment order mean that the individual needs to be hospitalized?
No, under Arizona’s Involuntary Commitment Law, courts may order outpatient treatment for the individual when deemed appropriate, and the individual can live in the community and still follow their court-ordered treatment plan.
How does Arizona’s involuntary commitment law protect patients’ rights?
Arizona’s Involuntary Commitment Law requires clear and convincing evidence of need for involuntary treatment, provides a right to an attorney, and requires that the court conduct a regular review of the need for treatment. These mechanisms should help to reduce the use of the Involuntary Treatment Law whenever possible.
How do you determine if a person qualifies for involuntary commitment to mental health treatment in Arizona?
People may qualify for involuntary commitment to mental health treatment if they pose a risk of harm to themselves or to others, demonstrate persistent or acute disability due to mental illness, or are unable or unwilling to accept voluntary treatment.
What is an emergency petition for mental health in Arizona?
Emergency petitions allow an individual to request an immediate evaluation when a person poses an immediate and severe risk of harm to themselves or others.
How long will involuntary treatment last in Arizona?
An involuntary treatment order’s duration is determined by the judicial findings that were made during the court hearing. Some orders could be for a few months, while others could be extended for up to 365 days if there is a mandatory review/renewal of the order.
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