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Last updated December 2003
TITLE 21. FIDUCIARY RELATIONS AND THE
MENTALLY ILL.
CHAPTER 5 –
HOSPITALIZATION OF THE MENTALLY ILL
§ 21-501. Definitions.
As used in the chapter:
(1) "Administrator" means a person in charge of a
public or private hospital or his delegate;
(1A) "Chief clinical officer" means the
psychiatrist or qualified psychologist for the Department who is responsible
for coordinating the treatment of persons receiving mental health supports or
mental health services from the Department;
(2) "Chief of service" means the physician or
qualified psychologist charged with overall responsibility for the professional
program of care and treatment in the particular administrative unit of the
hospital to which the patient has been admitted or such other member of the medical
staff as the chief of service designates;
(3) "Commission" means the Commission on Mental
Health;
(3A) "Core services agency" means a
community-based provider of mental health services and mental health supports
that is certified by the Department and that acts as a clinical home for
consumers of mental health services by providing a single point of access and
accountability for diagnostic assessment, medication-somatic treatment,
counseling and psychotherapy, community support services, and access to other
needed services;
(4) "Court" means the Superior Court of the
(4A) "Department" means the Department of Mental
Health;
(4B) "Mental health services" means the services
funded or regulated by the Department for the purpose of addressing mental
illness or mental health problems;
(4C) "Mental health supports" means the supports
funded or regulated by the Department for the purpose of addressing mental
illness or mental health problems;
(5) "Mental illness" means a psychosis or other
disease which substantially impairs the mental health of a person;
(6) Repealed.
(7) "Physician" means a person licensed under the
laws of the
(8) "Private hospital" means a nongovernmental
hospital or institution, or part thereof, in the District of Columbia, equipped
and qualified to provide inpatient care and treatment for a person suffering
from a physical or mental illness;
(8A) "Provider" means an individual or entity
that:
(A) Is duly licensed or certified by
the Department to provide mental health services or mental health supports; or
(B) Has entered into an agreement with
the Department to provide mental health services or mental health supports;
(8B) "Psychiatrist" means a physician who is
licensed to practice medicine in the
(9) "Public hospital" means a hospital or
institution, or part thereof, in the District of Columbia, owned and operated
by the Government of the United States or of the District of Columbia, equipped
and qualified to provide inpatient care and treatment for persons suffering
from physical or mental illness;
(9A) "Qualified physician" means a person licensed
under the laws of the District of Columbia to practice medicine who is
board-certified in emergency medicine and certified by the Department to
examine persons and prepare admission certificates pursuant to section 21-522;
and
(10) "Qualified psychologist" means a person who
is licensed pursuant to section 501 of the District of Columbia Health
Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C.
Official Code § 3- 1205.01), and has (1) one year of formal training within a
hospital setting; or (2) two years of supervised clinical experience in an
organized health care setting, one of which must be post-doctoral.
§ 21-501.01. Qualified
psychologists.
(a) Qualified psychologists are subject to the restrictions
and qualifications for practice contained in the District of Columbia Health
Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C.
Official Code § 3-1201.01 et seq.).
(b) Whenever a qualified psychologist has the responsibility
for the voluntary, nonprotesting, emergency, or
court-ordered admission or hospitalization of a person who is mentally ill,
that qualified psychologist or the provider shall, prior to or at the time of
admission or commitment, identify a psychiatrist or other appropriate physician
who shall be responsible for the medical evaluation and medical management of
the person who is mentally ill during the period in which the person is
receiving treatment from that provider. The qualified psychologist may be
responsible for all other evaluation and management of the mental health
services or mental health services or supports for the person who is mentally
ill.
SUBCHAPTER II.
VOLUNTARY AND NONPROTESTING HOSPITALIZATION.
§ 21-511. Voluntary
hospitalization and treatment.
(a) A person may apply to a public or private hospital, the
Department, or any mental health provider in the
(b) If an examination reveals that the person requesting
admission is not in need of hospitalization but is in need of outpatient
treatment, the administrator of the hospital to which the application was made,
or his designee, shall facilitate the admission of the person for voluntary
outpatient treatment to the Department, a core services agency, or another
provider. A person who is under 18 years of age may, consistent with the
provisions of the Mental Health Service Delivery Reform Act of 2001, effective
§ 21-512. Release of
voluntary patients.
(a) A person accepted for voluntary treatment by a hospital,
the Department, or a mental health provider, pursuant to section 21-511 may, at
any time, if the person is 18 years of age or over, obtain his or her release
from the hospital or other treatment by filing a written request with the chief
of service or, in the case of the Department, the chief clinical officer.
Within a period of 48 hours after the receipt of the request, the chief of
service or the chief clinical officer shall ensure that discharge planning is
completed and release the person making the request. A person admitted into
treatment pursuant to section 21-511 who is under 18 years of age may, at any
time, obtain his or her release from the hospital or other treatment in the
same manner, upon the written request of the person's spouse, parent, or legal
guardian. A person under 18 years of age who has sought voluntary outpatient
treatment without the consent of a parent or legal guardian may obtain his or
her release from that treatment by filing a written request with the chief of
service or chief clinical officer.
(b) When the chief of service or chief clinical officer
determines that the person voluntarily receiving treatment pursuant to section
21-511 has recovered or that continued treatment of the person is no longer
beneficial to the person, or advisable, the chief of service or chief clinical
officer may discharge the person from the hospital or from other treatment.
§ 21-513.
Hospitalization of nonprotesting persons.
A friend or relative of a person believed to be suffering
from a mental illness may apply on behalf of that person to the admitting
psychiatrist or the admitting qualified psychologist of a hospital by
presenting the person, together with a referral from a practicing physician or
qualified psychologist. For the purpose of examination and treatment, a private
hospital may accept a person so presented and referred, and a public hospital
shall accept a person so presented and referred, if, in the judgment of the
admitting psychiatrist or the admitting qualified psychologist, the need for
examination and treatment is indicated on the basis of the person's mental
condition and the person signs a statement at the time of the admission stating
that he does not object to hospitalization. The statement shall contain in
simple, nontechnical language the fact that the
person is to be hospitalized and a description of the right to release set out
in section 21-514. The admitting psychiatrist or the admitting qualified
psychologist may admit a person so presented, without referral from a
practicing physician or qualified psychologist, if the need for an immediate
admission is apparent to the admitting psychiatrist or the admitting qualified
psychologist upon preliminary examination.
§ 21-514. Release of
patients hospitalized under section 21-513.
Unless proceedings for hospitalization under court order
have been initiated under subchapter IV of this chapter, a hospital, upon the
written request of a patient hospitalized pursuant to section 21-513, shall
immediately release him.
SUBCHAPTER III.
EMERGENCY HOSPITALIZATION.
§ 21-521. Detention of
persons believed to be mentally ill; transportation and application to
hospital.
An accredited officer or agent of the Department of Mental
Health of the District of Columbia, or an officer authorized to make arrests in
the District of Columbia, or a physician or qualified psychologist of the
person in question, who has reason to believe that a person is mentally ill
and, because of the illness, is likely to injure himself or others if he is not
immediately detained may, without a warrant, take the person into custody,
transport him to a public or private hospital, or to the Department, and make
application for his admission thereto for purposes of emergency observation and
diagnosis. The application shall reveal the circumstances under which the
person was taken into custody and the reasons therefor.
§ 21-522. Examination
and admission to hospital; notice.
(a) Subject to the provisions of section 21-523, the
administrator of a private hospital may, and the administrator of a public
hospital or the chief clinical officer of the Department or his designee shall,
admit and detain for purposes of emergency observation and diagnosis a person
with respect to whom application is made under section 21-521, if the
application is accompanied by a certificate of a psychiatrist, qualified
physician, or qualified psychologist on duty at the hospital or the Department
stating that he or she:
(1) Has examined the person;
(2) Is of the opinion that the
person has symptoms of a mental illness and, because of the mental illness, is
likely to injure himself or others unless the person is immediately detained;
and
(3) Is of the opinion that
hospitalization is the least restrictive form of treatment available to prevent
the person from injuring himself or others.
(b) Subject to the provisions of section 21-523, the chief
clinical officer of the Department shall admit and detain, for purposes of
emergency observation and diagnosis at a facility certified by the Department
for emergency detention, a person with respect to whom application is made
under section 21-521, if the application is accompanied by a certificate of a
psychiatrist, qualified physician, or qualified psychologist on duty at the
Department stating that he or she:
(1) Has examined the person;
(2) Is of the opinion that the
person has symptoms of a mental illness and, because of the mental illness, is
likely to injure himself or others unless the person
is immediately detained;
(3) Is of the opinion that
hospitalization is not the least restrictive form of treatment available to
ensure that the person will not injure himself or others; and
(4) Is of the opinion that detention
in a certified facility for observation and diagnosis is the least restrictive
treatment alternative to prevent the person from injuring himself or others.
(c) If the psychiatrist, qualified physician, or qualified
psychologist determines, after examining the person who has been presented for
emergency observation and diagnosis, that the person is not mentally ill, not
likely to injure himself or others unless immediately detained, or that
hospitalization or detention in a facility certified for emergency observation
and diagnosis is not the least restrictive form of treatment, the psychiatrist,
qualified physician, or qualified psychologist shall not admit the person to
the hospital or facility as an inpatient and shall facilitate the person's
outpatient treatment through the Department or a provider, as appropriate.
(d) Immediately upon the admission of a mentally ill person
to a hospital pursuant to this subchapter, the administrator of the hospital
shall notify the chief clinical officer of the Department of the admission by
telephone, telefax, or electronically. Not later than
24 hours after the admission pursuant to this subchapter, the administrator of
the hospital or the chief clinical officer of the Department shall serve notice
of the admission to the Commission, the parent or legal guardian of a person
under 18 years of age who was admitted pursuant to this subchapter, and, if
authorized by the person who was admitted to the hospital or the Department
consistent with the provisions of the District of Columbia Mental Health
Information Act of 1978, effective March 3, 1979 (D.C. Law 2-136; D.C. Official
Code § 7-1201.01 et seq.), to the spouse, parent of an admitted person who is
18 years of age or older, or legal guardian of the person.
§ 21-523. Court order
requirement for hospital detention beyond 48 hours; maximum period for
observation.
A person admitted to a hospital or the Department under
section 21-522 may not be detained in the hospital or by the Department for a
period in excess of 48 hours from the time of the person's admission, unless
the administrator of the hospital, the chief clinical officer of the
Department, or the administrator's or chief clinical officer's designee has,
within that period, filed a written petition with the court for an order
authorizing the continued detention of the person for emergency observation and
diagnosis for a period not to exceed 7 days from the time the order is entered.
§ 21-524.
Determination and order of court.
(a) Within a period of 24 hours after the court receives a
petition for hospitalization of a person for emergency observation and
diagnosis, filed by the administrator of a hospital or chief clinical officer
of the Department pursuant to section 21-523, the court shall:
(1) order
the hospitalization; or
(2) order
the person's immediate release.
(b) The court, in making its determination under this
section, shall consider the written reports of the agent, officer, physician or
qualified psychologist who made the application under section 21-522, the
certificate of the examining psychiatrist or examining qualified psychologist
which accompanied it, and any other relevant information.
§ 21-525. Hearing by
court.
The court shall grant a hearing to a person whose continued
hospitalization is ordered under section 21-524, if he requests the hearing.
The hearing shall be held within 24 hours after receipt of the request.
§ 21-526. Extension of
maximum periods of time.
(a) If the maximum period of time prescribed by section
21-512, 21-523, 21-524, 21-525 or 21-548, during which an action or
determination may or shall be taken, expires on a Saturday, Sunday, or legal
holiday, the period may be extended to not later than noon of the next
succeeding day which is not a Saturday, Sunday, or legal holiday.
(b) If the maximum period of time prescribed by the sections
listed in subsection (a) of this section expires between 12:01 a.m. and 12:00
noon on a Monday or the next business day following a legal holiday, the period
shall be extended until 12:00 noon of that day, or, when the maximum period of
time prescribed by the sections listed in subsection (a) of this section
expires on a legal holiday, the period shall be extended until 12:00 noon of
the next business day.
§ 21-527. Examination
and release of person; notice.
(a)(1) The chief clinical officer of the Department or the
chief of service of a hospital in which a person is hospitalized under a court
order entered pursuant to section 21-524 shall, within 48 hours after the order
is entered, have the person examined by a psychiatrist or qualified
psychologist.
(2) If the psychiatrist or qualified
psychologist, after his examination, certifies that in his opinion the person
is not mentally ill to the extent that the person is likely to injure himself
or others if not presently detained, the person shall be immediately released.
(3) After the examination required
under paragraph (1) of this subsection has been completed, the chief of service
of the hospital:
(A) Shall immediately notify the
chief clinical officer of the Department of the results of the examination by
telephone, telefax, or other electronic means;
(B) Shall immediately send a copy of
the results of the examination by mail to the Commission;
(C) Shall immediately send a copy of
the results of the examination by mail to the parent or legal guardian of a
person under 18 years of age who was committed; and
(D) Shall, within 48 hours, send a
copy of the results by mail to the spouse, parents, attorney, legal guardian,
or nearest known adult relative of the person examined, if authorized by the
person who was examined consistent with the provisions of the District of
Columbia Mental Health Information Act of 1978, effective March 3, 1979 (D.C.
Law 2-136; D.C. Official Code § 7- 1201.01 et seq.).
(b)(1) The chief clinical officer of the Department or the
chief of service of a hospital in which a person is detained under a court
order entered pursuant to section 21-524 or under section 21-526(c) shall
immediately release the person from the emergency detention in a hospital if,
at any time during the detention, a psychiatrist or qualified psychologist at
the hospital or the Department certifies that, based on an examination, it is
his opinion that the person is no longer mentally ill to the extent that the
person is likely to injure himself or others if not presently detained or that
the person could be treated in a less restrictive setting.
(2) After the examination required
under paragraph (1) of this subsection has been completed, the chief of service
of the hospital:
(A) Shall immediately notify the
chief clinical officer of the Department of the results of the examination by
telephone, telefax, or other electronic means;
(B) Shall immediately send a copy of
the results of the examination by mail to the Commission;
(C) Shall immediately send a copy of
the results of the examination by mail to the parent or legal guardian of a
person under 18 years of age who was committed; and
(D) Shall, within 48 hours, send a
copy of the results by mail to the spouse, parents, attorney, legal guardian,
or nearest known adult relative of the person examined, if authorized by the
person who was examined consistent with the provisions of the District of
Columbia Mental Health Information Act of 1978, effective March 3, 1979 (D.C.
Law 2-136; D.C. Official Code § 7- 1201.01 et seq.).
§ 21-528. Detention of
person pending judicial proceedings.
Notwithstanding any other provision of this subchapter, the
administrator of a hospital in which a person is hospitalized under this
subchapter may, if judicial proceedings for his hospitalization have been
commenced under subchapter IV of this chapter, detain the person in the
hospital during the course of the judicial proceedings.
SUBCHAPTER IV.
COMMITMENT UNDER COURT ORDER.
§ 21-541. Petition to
Commission; copy to person affected.
(a) Proceedings for the judicial commitment of a person in
the District of Columbia may be commenced by the filing of a petition with the
Commission by his spouse, parent, or legal guardian, by a physician or a
qualified psychologist, by a duly accredited officer or agent of the
Department, by the Director of the Department or the Director's designee, or by
an officer authorized to make arrests in the District of Columbia. The petition
shall be accompanied by:
(1) a certificate of a physician or
qualified psychologist stating that he has examined the person and is of the
opinion that the person is mentally ill, and because of the illness is likely
to injure himself or other persons if not committed; or
(2) a sworn
written statement by the petitioner that:
(A) the petitioner has good reason
to believe that the person is mentally ill, and, because of the illness, is
likely to injure himself or other persons if not committed; and
(B) the
person has refused to submit to examination by a physician or qualified
psychologist.
(b) Within three days after the Department receives a
petition filed under subsection (a) of this section, the Department shall send
a copy of the petition by registered mail to the person with respect to whom it
was filed.
§ 21-542. Hearing by
Commission; presence and rights of person affected; hearing regarding
liability.
(a) The Commission shall promptly examine a person alleged
to be mentally ill after the filing of a petition under section 21-541 and
shall thereafter promptly hold a hearing on the issue of his mental illness.
The hearing shall be conducted in a manner consistent with orderly procedure
and in a physical setting not likely to have a harmful effect on the mental
health of the person named in such petition. In conducting the hearing, the
Commission shall hear testimony of any person whose testimony may be relevant
and shall receive all relevant evidence which may be offered. A person with
respect to whom a hearing is held under this section may, in his discretion, be
present at the hearing, to testify, and to present and cross-examine witnesses.
(b) The Commission shall also hold a hearing in order to
determine liability under the provisions of section 21-586 for the expenses of
commitment of the alleged mentally ill person, if it is determined that he is
mentally ill and should be committed as provided under this chapter. The
hearing may be conducted separately from the hearing on the issue of mental
illness. If conducted separately, it may be conducted by the Chairman of the
Commission alone.
§ 21-543.
Representation by counsel; compensation; recess.
(a) The person alleged to be mentally ill and, because of
the mental illness, likely to injure himself or others shall be represented by
counsel in any proceeding before the Commission or the court, and if he fails
or refuses to obtain counsel, the court shall appoint counsel to represent him.
The counsel so appointed shall be awarded compensation by the court for his
services in an amount determined by it to be fair and reasonable. The
compensation shall be charged against the estate of the individual for whom the
counsel was appointed, or against any unobligated
funds of the Commission, as the court in its discretion directs. The Commission
or the court, as the case may be, shall, at the request of the counsel so
appointed, grant a recess in the proceeding to give the counsel an opportunity
to prepare his case. A recess may not be granted for more than five days.
§ 21-544.
Determinations of Commission; report to court; copy to person affected; right
to jury trial.
If the Commission finds, after a hearing under section
21-542, that the person with respect to whom the hearing was held is not
mentally ill or if mentally ill, is not mentally ill to the extent that he is
likely to injure himself or other persons if not committed, the Commission
shall immediately order his release and notify the court of that fact in
writing. If the Commission finds, after the hearing, that the person with
respect to whom the hearing was held is mentally ill,
and because of the illness is likely to injure himself or other persons if not
committed, the Commission shall promptly report that fact, in writing, to the
Superior Court of the
§ 21-545. Hearing and
determination by court or jury; order; witnesses; jurors.
(a) Upon the receipt by the court of a report referred to in
section 21- 544, the court shall promptly set the matter for hearing and shall
cause a written notice of the time and place of the final hearing to be served
personally upon the person with respect to whom the report was made and his
attorney, together with notice that he has five days following the date on
which he is so served within which to demand a jury trial. The demand may be
made by the person or by anyone in his behalf. If a jury trial is demanded
within the five-day period, it shall be accorded by the court with all
reasonable speed. If a timely demand for jury trial is not made, the court
shall determine the person's mental condition on the basis of the report of the
Commission, or on such further evidence in addition to the report as the court
requires.
(b) If the court or jury, as the case may be, finds that the
person is not mentally ill, the court shall dismiss the petition and order his
release. If the court or jury finds that the person is mentally ill and,
because of that illness, is likely to injure himself or other persons if
allowed to remain at liberty, the court may order his hospitalization for an
indeterminate period, or order any other alternative course of treatment which
the court believes will be in the best interests of the person or of the
public. The Commission, or a member thereof, shall be competent and compellable
witnesses at a hearing or jury trial held pursuant to this chapter. The jury to
be used in any case where a jury trial is demanded under this chapter shall be
impaneled, upon order of the court, from the jurors in attendance upon other branches
of the court, who shall perform the services in addition to and as part of
their duties in the court.
§ 21-546. Periodic
examinations of committed patients; procedure for examination and detention or
release; petition to court.
(a) A person who has been committed for treatment pursuant
to section 21- 545 or section 21-545.01 shall be monitored by the chief
clinical officer or the chief of service for the facility, hospital, or mental
health provider to which the person has been committed. In doing so, the chief
or service or chief clinical officer shall:
(1) Arrange for, at least every 90
days from the date on which the order was issued under section 21-545 or the
date on which the renewed period of commitment begins pursuant to an order
issued under section 21-545. 01, an examination of the mental health of the
committed person by a psychiatrist or qualified psychologist; and
(2) Promptly consider the reports of
the psychiatrists or qualified psychologists conducting the examination, and
order the committed person's immediate release from the commitment if the
person is no longer mentally ill to the extent that the person is likely to
injure himself or other persons if not committed.
(b) At the conclusion of an examination conducted pursuant
to subsection (a)(1) of this section, the psychiatrist
or qualified psychologist shall:
(1) Report his opinion as to whether
the committed person is mentally ill and, if mentally ill, whether the
committed person is likely to injure himself or others if not committed; and
(2) Determine whether the committed
person is being treated in the least restrictive alternative possible and, if
not, identify the least restrictive alternative for the committed person at
that time.
(c)(1) Within 180 days from the date on which the order was
issued under section 21-545 or the date on which the renewed period of
commitment begins pursuant to an order issued under section 21-545.01, and at
the committed person's own expense, the committed person may have an
independent examination conducted by a psychiatrist or qualified psychologist
obtained by the committed person. If a committed person who is indigent makes a
written request for assistance with an examination under this section, the
chief clinical officer shall assist the person in obtaining a psychiatrist or
qualified psychologist to conduct the independent examination. A psychiatrist
or qualified psychologist so obtained by an indigent person shall be
compensated for his services out of any unobligated
funds of the Department in an amount determined by the Department to be fair
and reasonable.
(2) A psychiatrist or qualified
psychologist who conducts an independent examination of the committed person
under this subsection shall submit a report that includes his opinion as to
whether the committed person is:
(A) Mentally ill;
(B) Likely to injure himself or
others as a result of mental illness if not committed; and
(C) Being treated in the least
restrictive alternative possible.
(3) If the psychiatrist or qualified
psychologist who conducted the independent examination determines that the
committed person is not being treated in the least restrictive alternative
possible, he shall identify the least restrictive treatment appropriate for the
committed person at that time.
(d)(1) If the chief clinical officer of the Department or
the chief of service for the facility, hospital, or mental health provider,
after considering the reports of the psychiatrists or qualified psychologists
conducting the examination pursuant to subsection (a)(1) of this section,
determines that the committed person continues to be mentally ill to the extent
that the person is likely to injure himself or other persons if not committed,
but one or more of the psychiatrists or qualified psychologists who conducted
independent examinations under subsection (c) of this section reports that the
committed person is not mentally ill to that extent, the committed person may
request a change of status or discharge from the chief clinical officer of the
Department or the chief of service for the facility, hospital, or mental health
provider, and, if denied, may petition the court for an order directing the
person's release.
(2) If the reports of the
psychiatrists or qualified psychologists who have examined the committed person
under subsection (a) or subsection (c) of this section identify less
restrictive treatment alternatives for the committed person and the chief
clinical officer of the Department or the chief of service for the hospital,
facility, or mental health provider does not implement the less restrictive
form of treatment within 30 days of receipt of the report, the committed person
may petition the court for an order directing the person's release to a less
restrictive form of commitment.
(3) A petition filed with the court
under this subsection shall be accompanied by the reports of the psychiatrists
or qualified psychologists who conducted the examinations of the committed
person, whether on behalf of the Department, hospital, or provider, or on
behalf of the committed person.
(e) If the chief clinical officer of the Department or the
chief of service for the facility, hospital, or mental health provider, after
considering the reports of psychiatrists or qualified psychologists conducting
an examination pursuant to subsections (a)(1) or (c)(1) of this section, orders
the committed person's release from the commitment pursuant to subsections
(a)(2) or (d)(1) of this section, then the chief clinical officer of the
Department or the chief of service for the facility, hospital, or mental health
provider shall promptly notify the court that ordered the commitment of that
fact. If, as a result of a report of the psychiatrists or qualified
psychologists conducting an examination pursuant to subsections (a)(1) or (c)(1) of this section, the committed person is
moved from an inpatient treatment setting to a less restrictive treatment
setting, the chief clinical officer of the Department or the chief of service
for the facility, hospital, or mental health provider shall promptly notify the
court that ordered the commitment of that fact.
§ 21-547. Judicial
determination of petition filed under section 21-546; order; psychiatrists and
qualified psychologists as witnesses.
(a) In considering a petition filed under section 21-546,
the court shall consider the testimony of the psychiatrists or qualified
psychologists who participated in the examination of the committed person, and
the reports of the psychiatrists or qualified psychologists accompanying the
petition. After considering the testimony and reports, the court shall either:
(1) Reject the petition and order
the continued commitment of the person; or
(2) Order the chief clinical officer
of the Department or the chief of service for the hospital, facility, or mental
health provider to immediately implement the least restrictive treatment or
immediately release the committed person from the commitment.
(b) A psychiatrist or qualified psychologist participating
in the examination of the committed person shall be a competent and compellable
witness at any trial or hearing held pursuant to this chapter.
§ 21-548. Request for
revocation of outpatient status; confinement pending decision on revocation of
outpatient status; hearing on outpatient revocation petition.
(a) A person who has been committed under section 21-545 or
section 21- 545.01 and is receiving outpatient treatment may be transferred to
a more restrictive treatment setting, including inpatient hospitalization, or a
facility certified for emergency observation and diagnosis, pursuant to a court
order, after a hearing, upon the court finding, based upon clear and convincing
evidence, that:
(1) The person who is committed has
failed to comply with a material condition of his outpatient treatment and a
more restrictive treatment alternative is required to prevent the person from
injuring himself or others; or
(2) There has been a significant
change in the mental illness of the person who is committed and a more
restrictive treatment alternative is required to prevent the person from
injuring himself or others.
(b)(1) If the Department, hospital, facility, or mental
health provider providing treatment to a person committed under section 21-545
or section 21-545.01 determines that a committed person who is receiving
outpatient treatment is, as a result of mental illness, likely to injure
himself or others if he is not immediately detained, the chief clinical officer
of the Department, or his designee, or the chief of service of a hospital,
facility, or mental health provider, may take the committed person into custody
and transfer the person to an inpatient hospital setting or a facility
certified for emergency observation and diagnosis, or may request that an
officer authorized to make arrests in the District of Columbia take the
committed person into custody and transfer the person to an inpatient hospital
setting or to a facility certified for emergency observation and diagnosis. If
the committed person is hospitalized or detained at a facility not operated by
the Department, the chief of service, or his designee, from that hospital or
facility shall immediately notify the chief clinical officer for the Department
of the admission by telephone.
(2) Within 24 hours of a committed
person's transfer from outpatient to inpatient treatment, the Department, the
hospital, or the facility certified for emergency observation and diagnosis
where the person is detained shall notify the court of:
(A) The committed person's detention
and provide the court with a detailed affidavit reciting the circumstances of
the person's transfer from outpatient status;
(B) The recent actions of the
committed person that brought about the inpatient detention; and
(C) If known, whether the hospital,
facility, or the Department has determined whether to seek a revocation of the
committed person's outpatient status for a period of more than 5 days.
(3) Within 24 hours of the committed
person's transfer to a more restrictive treatment setting, the hospital or
facility shall give the committed person a copy of the notice and affidavit
filed with the court as well as written notice of the person's rights to
release or to an adversarial judicial hearing. The hospital or facility shall
notify the attorney of record of the committed person's hospitalization or
transfer to a facility certified for emergency observation and diagnosis and
provide the attorney with a copy of the notice and affidavit filed with the
court.
(4) The court shall conduct an ex
parte review of the notice and affidavit within 24 hours of filing and
determine whether the change from outpatient status to inpatient status at a
hospital or facility certified for emergency observation and diagnosis is
supported by probable cause that the committed person was likely to injure
himself or other persons unless immediately hospitalized or transferred to a
facility certified for emergency observation and diagnosis. If the court finds
that the change in the treatment setting is supported by probable cause, the
hospital may detain the committed patient for 5 days from the date of the
order. If the court finds that the change in the treatment setting is not
supported by probable cause, the court shall order the committed person's
immediate release from the hospital or facility certified for emergency
observation and diagnosis. The court shall appoint counsel to represent the
committed person if it is determined that the attorney of record is no longer
available to represent the person about whom a notice of rehospitalization
has been filed.
(5) The hospital or facility shall
release the committed person at the end of 5 days from the date of the order,
unless during that time the hospital, Department, or facility has filed a
petition with the court to revoke outpatient treatment. The court shall
schedule a hearing on the petition to revoke outpatient treatment within 21
days of the committed person's hospitalization or detention. The court, for
good cause, may continue the hearing. At the conclusion of the hearing, if the
court finds that inpatient treatment at a hospital or facility certified for
emergency observation and diagnosis is the least restrictive treatment
alternative available and required to prevent the person from injuring himself
or others as a result of mental illness, the hospital or facility may continue
to detain the committed person for the remainder of the term of commitment. If
the court finds that inpatient treatment at a hospital or facility certified
for emergency observation and diagnosis is not supported, the court shall order
the committed person's immediate release and return to outpatient status.
(6) The criteria set forth in
section 21-526 for determining when the maximum periods of time may be extended
shall apply to this section.
§ 21-549. Preservation
of other rights to release.
Nothing in this chapter prohibits a person from exercising a
right presently available to him for obtaining release from confinement,
including the right to petition for a writ of habeas corpus.
§ 21-550. Surety.
The court in its discretion may require a petitioner under
this subchapter to file an undertaking with surety to be approved by the court
in such amount as the court deems proper, conditioned to save harmless the
respondent by reason of costs incurred, including attorney's fees, if any, and
damages suffered by the respondent, as a result of any action under this
subchapter.
§ 21-551.
Nonresidents.
(a) If a person ordered committed to the Department by the
court pursuant to section 21-545 is found by the Commission, subject to a
review by the court, not to be a resident of the District of Columbia, and to
be a resident of another place, he shall be transferred to the State of his
residence if an appropriate institution of that State is willing to accept him.
If the person is an indigent, the expense of transferring him, including the
traveling expenses of necessary attendants, shall be borne by the
(b) For the purposes of this section, the term
"resident of the
SUBCHAPTER V. RIGHT TO
COMMUNICATION; EXERCISE OF OTHER RIGHTS.
§ 21-561. Mail
privileges; censored mail; return to sender; visiting hours.
(a) A person hospitalized in a public or private hospital
pursuant to this chapter, or committed under sections 21-545, 21-545.01, or
21-548, may exercise the right to communicate with others as set forth in the
Mental Health Consumers' Rights Protection Act of 2001, effective December 18,
2001 (D.C. Law 14-56; D.C. Official Code § 7-1231.01 et seq.).
(b) Repealed.
(c) This section does not prohibit the administrator of a
hospital from making reasonable rules regarding visitation hours.
§ 21-562. Medical and
psychiatric care and treatment; records.
A person detained as an emergency involuntary patient by or
committed to the care of the Department, a provider, or a hospital for mental
illness shall, during the detention or commitment, be entitled to medical and
psychiatric care and treatment. The administrator or director of the
Department, a provider, or a hospital shall keep records detailing all medical
and psychiatric care and treatment received by a person admitted for treatment
as a voluntary, non- protesting, emergency or committed patient under this
chapter and the records shall be made available, consistent with the provisions
of the District of Columbia Mental Health Information Act of 1978, effective
March 3, 1979 (D.C. Law 2-136; D.C. Official Code § 7-1201.01 et seq.), to the
person's attorney, personal physician, or other treatment provider. The records
shall be preserved by the administrator or director of the Department,
hospital, facility, or mental health provider until the person has been
released from treatment, or longer, as required by
§ 21-563. Use of
restraints or seclusion; record of use.
A person who is hospitalized in a public or private hospital
pursuant to this chapter has the right to be free from seclusion and restraint
of any form that is not medically necessary or that is used as a means of
coercion, discipline, convenience, or retaliation by staff, pursuant to the
Mental Health Consumers' Rights Protection Act of 2001, effective December 18,
2001 (D.C. Law 14-56; D.C. Official Code § 7-1231.01 et seq.).
§ 21-564. Exercise of
property and other rights; notice of inability; persons hospitalized prior to
September 15, 1964.
(a) A person admitted or committed for treatment pursuant to
this chapter may not, by reason of the admission or treatment, be denied the
right to dispose of property, execute instruments, make purchases, enter into
contractual relationships, vote, and hold a driver's license, unless the person
has been adjudicated incompetent by a court of competent jurisdiction and has
not been restored to legal capacity. If the chief clinical officer of the
Department or the chief of service for the public or private hospital,
facility, or provider in which the committed person is housed is of the opinion
that the person is unable to exercise any of the rights referred to in this
section, the chief clinical officer or chief of service shall immediately
notify the person and the person's attorney, legal guardian, spouse, parents,
or other nearest known adult relative, the Superior Court of the District of
Columbia, the Commission, and the Mayor of that fact.
(b) A person in the District of Columbia who, by reason of a
judicial decree ordering his hospitalization entered prior to September 15,
1964, is considered to be mentally incompetent and is denied the right to
dispose of property, execute instruments, make purchases, enter into
contractual relationships, vote, or hold a driver's license solely by reason of
the decree, shall, upon the expiration of the one-year period immediately
following September 15, 1964, be deemed to have been restored to legal capacity
unless, within the one-year period, affirmative action is commenced to have the
person adjudicated mentally incompetent by a court of competent jurisdiction;
provided, however, that in those cases in which a committee has heretofore been
appointed and the committeeship has not been
terminated by court action, such committee shall continue to act under the
supervision of the Superior Court of the District of Columbia under its equity
powers.
§ 21-565. Statement of
release and adjudication procedures and of other rights.
Upon the admission of a person to a hospital under a
provision of this chapter, the administrator shall deliver to him, and to his
spouse, parents, or other nearest known adult relative, a written statement
outlining in simple, nontechnical language all
release procedures provided by this chapter, setting out all rights accorded to
patients by this chapter, and describing procedures provided by law for
adjudication of incompetency and appointment of trustees or committees for the
hospitalized person.
SUBCHAPTER VI.
MISCELLANEOUS PROVISIONS.
§ 21-581. Proceedings
instituted by Mayor of the
Proceedings instituted by the Mayor of the District of
Columbia to determine the mental condition of an alleged indigent mentally ill
person or a person alleged to be mentally ill, with homicidal or otherwise
dangerous tendencies, shall be according to the provisions of subchapter IV of
this chapter.
§ 21-582. Petitions,
applications, or certificates of physicians or qualified psychologists.
(a) A petition, application, or certificate authorized under
section 21- 521, section 21-541(a), section 21-545.01, or section 21-548 may
not be considered if made by a psychiatrist, physician, or qualified
psychologist who:
(1) Is related by blood or marriage
to the person about whom the petition, application, or certificate is made;
(2) Is financially interested in the
hospital in which the person is to be detained; or
(3) Except in the case of
psychiatrists, physicians, or qualified psychologists employed by the
(b) A petition, application, or certificate of a physician
or qualified psychologist may not be considered unless it is based on personal
observation and examination of the person made by the physician or qualified
psychologist not more than 72 hours prior to the making of the petition,
application, or certificate. The certificate shall set forth in detail the
facts and reasons on which the physician or qualified psychologist based his
opinions and conclusions.
§ 21-583. Physicians,
psychiatrists and qualified psychologists as witnesses.
A physician, psychiatrist or qualified psychologist making
application or conducting an examination under this chapter is a competent and
compellable witness at any trial, hearing or other proceeding conducted
pursuant to this chapter and the physician- or psychologist-patient privilege
is not applicable.
§ 21-584. Witness
fees.
Witnesses subpoenaed under the provisions of this chapter
shall be paid the same fees and mileage as are paid to other witnesses in the
court.
§ 21-585. Confinement
in jail prohibited.
A person apprehended, detained, or hospitalized under any
provision of this chapter may not be confined in jail or in a penal or
correctional institution.
§ 21-586. Financial
responsibility for care of hospitalized persons; judicial enforcement.
(a) The father, mother, husband, wife, and adult children of
a mentally ill person, if of sufficient ability, and the estate of the mentally
ill person, if the estate is sufficient for the purpose, shall pay the cost to
the District of Columbia of the mentally ill person's maintenance, including
treatment, in a hospital in which the person is hospitalized under this
chapter. The Commission on Mental Health shall examine, under oath, the father,
mother, husband, wife, and adult children of an alleged mentally ill person
whenever those relatives live within the
(b) If a person made liable by subsection (a) of this
section for the maintenance of a mentally ill person fails so to provide or pay
for the maintenance, the court shall issue to him a citation to show cause why
he should not be adjudged to pay a portion or all of the expenses of
maintenance of the patient. The citation shall be served at least 10 days
before the hearing thereon. If, upon the hearing, it appears to the court that
the mentally ill person has not sufficient estate out of which his maintenance
may properly be fully met and that he has relatives of the degree referred to
in subsection (a) of this section who are parties to the proceedings, and who
are able to contribute thereto, the court may make an order requiring payment
by the relatives of such sums as it finds that they are reasonably able to pay
and as may be necessary to provide for the maintenance and treatment of the
mentally ill person. The order shall require the payment of the sums to the
(c) For purposes of this section only, the term
"mentally ill person" means a person who has a mental illness, but
does not include a person committed to a private or public hospital in the
§ 21-587. Veterans'
Administration and military hospital facilities.
This chapter does not require the admission of a person to a
Veterans' Administration or military hospital facility unless the person is
otherwise eligible for care and treatment in the facility.
§ 21-588. Forms.
All applications and certificates for the hospitalization of
a person in the
§ 21-589. Persons
hospitalized prior to September 15, 1964.
(a) Subject to subsection (b) of this section, the
provisions of sections 21-546 to 21-551, subchapter V of this chapter and
sections 21-585 and 21-588 apply to a person, who, on or after January 1, 1966,
is a patient in a hospital in the District of Columbia by reason of having been
declared insane or of unsound mind pursuant to a court order entered in a noncriminal proceeding prior to September 15, 1964.
(b) A request made by a patient referred to in subsection
(a) of this section for an examination authorized by section 21-546 may be made
on April 15, 1966, by the patient, or his attorney, legal guardian, spouse,
parent, or other nearest adult relative, and not more frequently than every six
months thereafter.
§ 21-589.01. Interim
provisions for term of commitment for persons committed prior to January 1,
2003.
Any person committed for an indeterminate period of time
pursuant to section 21-545 prior to
§ 21-591. Offenses and
penalties.
Whoever:
(1) without
probable cause for believing a person to be mentally ill:
(A) causes
or conspires with or assists another person to cause the hospitalization, under
this chapter, of the person first referred to; or
(B) executes a petition,
application, or certificate pursuant to this chapter, by which he secures or
attempts to secure the apprehension, hospitalization, detention, or restraint
of the person first referred to;
or
(2) causes
or conspires with or assists another person to cause the denial to a person of
a right accorded to him by this chapter;
or
(3) being a
physician, psychiatrist or qualified psychologist, knowingly makes a false
certificate or application pursuant to this chapter as to the mental condition
of a person--
shall be fined not more than $5,000 or
imprisoned not more than three years, or both.
§ 21-592. Return to
hospital of an escaped mentally ill person.
When a person has been ordered confined in a hospital or
institution for the mentally ill pursuant to this chapter and has left such
hospital or institution without authorization or has failed to return as
directed, the court which ordered confinement shall, upon the request of the
administrator of such hospital or institution, order the return of such person
to such hospital or institution.
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