Wild Water Mental Health

 5150.  M-1.  Kendra's Law.  The Baker Act.

These are the descriptions or names in California, Colorado, New York, and Florida that allow the legal, temporary involuntary civil detainment of individuals exhibiting symptoms of mental illness that put them and/or the public at imminent risk of death or severe life-threatening bodily harm.  Every US state and territory has a legal process for this.  These "holds" last for a specific period of time which varies from state to state, although 72 hours is most typical.  These holds are specific to mental illness, although some states include people who are a life-threatening danger to themselves or others because they are under the influence of drugs and/or alcohol.  These holds can be initiated by specific professionals and statutes vary from state to state.  For purposes of description on my website, I will be referring specifically to Colorado which is where I am currently licensed and practice psychotherapy.  In Colorado, there is a separate involuntary detainment process for individuals under the influence of substances. 

In Colorado we call it simply an "M-1".  M-1s are legally binding when written by authorized professionals such as law enforcement officers (including park rangers), physicians, and licensed mental health professionals.  These holds are not criminal and do not show up in background checks.  They are written documents and describe the symptoms that justify initiation of the mental health hold.  There's a second form, the "M-1.5", which is a supplement to the M-1.  There is an "M-2", which describes the patient's rights.  The professional initiating the M-1 must time and date it and describe the circumstances justifying detainment of the individual; that professional is also required to attempt to read the detained person his/her rights and ask the individual to sign the M-2 indicating their rights were read to them.  It's not uncommon for some patients/clients to refuse to listen to their rights being read and/or sign the M-2; this does not invalidate the M-1.  Sometimes the detained person is unable to comprehend the content being read to them so reading of the rights is delayed until such time that the person is able to comprehend.  This also does not invalidate the M-1.  A copy of the M-1 and M-2 are given to the patient/client when it is initiated, or as soon as possible thereafter.  The original copy accompanies the patient/client to inpatient treatment and remains with the facility as part of the patient's record.

The most common use of an M-1 is for an individual who is actively suicidal (has a plan, intent, access to lethal means) or has just attempted suicide.  The M-1 is also used when someone who is acutely mentally ill has made a credible threat to kill or harm another person (homicidal), or who is so detached from reality that they can't make safe life-or-limb decisions for themselves (gravely disabled) in spite of having access to safety.  Grave disability does not apply to disabled individuals (unless they have a qualifying mental health condition/emergency).

The only professionals in Colorado who can "vacate" or cancel an M-1 are magistrates, judges, or physicians.

Here are some examples of people who don't meet criteria for a mental health hold IN COLORADO:

• Someone who has lung cancer but won't stop smoking cigarettes
• A runaway youth who isn't mentally ill 
• A person with dementia who is aggressive and/or wanders 
• A drug addict or alcoholic who can't/won't stop using
• A developmentally delayed person who gets easily frustrated and angry
• A person determined to have the capacity to make his or her own medical decisions and chooses to decline life-saving treatment

To review, once an M-1 has been initiated by an appropriate professional, that professional is required by law to tell the person being put on the hold what their rights are during the period of involuntary confinement.  If the person being detained is unable to comprehend such a discussion (as is often the case with someone who is psychotic--hallucinating, delusional), this can be postponed until they are able to exhibit comprehension.  Everyone put on an M-1 must be given a copy of their M-1 at some point during the period of confinement.  Remember: Once a legally binding M-1 has been initiated the only professionals in Colorado who can discontinue the M-1 before 72 hours have elapsed is a judge or magistrate; or a physician, most often a treating psychiatrist or an ER physician.

Mental health holds are not appropriate to control criminal behavior unless that behavior is VERY SPECIFICALLY due to mental illness.  The tendency to believe that all unwanted, undesirable, strange, and criminal behavior must be due to mental illness is not only incorrect, it adds to the stigma of mental illness and discourages people from seeking care.  

Detaining an individual against their will for an unjustifiable reason, whether civil or criminal, is a violation of their civil rights.

For more details click on this link:  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392176/