CIT (second resource)

What are the severe mental illnesses (SMI)?

Schizophrenia, Bipolar Disorder, Major Depressive Disorder, and PTSD

1 in _____ US adults are affected by mental illness every year

5

LMHA

Local Mental Health Authority

What does Senate Bill 1849 outline?

Legislative mandates that resulted in "each law enforcement agency shall make a good faith effort to divert persons suffering from mental health crisis or substance abuse to proper treatment"

What are the four important factors that strongly affect the current mental health situation in America?

Deinstitutionalization, criminalization, medicalization, privatization

What is the definition of mental illness according to the HSC?

An illness, disease, or condition, other than epilepsy, dementia, substance abuse, or intellectual disability, that substantially impairs a person's thoughts, perception of reality, emotional process, or judgment, or grossly impairs behavior as demonstrated by recent disturbed behavior

What is competency?

Refers to a defendant's capacity to comprehend the allegations and participate in due process

What is insanity?

Refers to the mental state (ability to distinguish between right and wrong) of the defendant at the time of the crime (i.e. criminal responsibility)

What are the 5 categories of mental illness?

Mood disorders, thought disorders, neurocognitive disorders, anxiety disorders, stress related disorders

What are some examples of mood disorders?

depression and bipolar disorder

What are some examples of thought disorders?

Schizophrenia and psychosis

What are some examples of neurocognitive disorders?

Dementia, delirium, TBI

What are some examples of anxiety disorders?

OCD, eating disorders

What are some examples of stress-related disorders?

PTSD, adjustment disorders

What are some personality disorders?

Paranoid, anti-social borderline

What are some disorders that are first diagnosed in infancy, childhood, or adolescence?

ADHD, autism

What is stigma?

A mark of disgrace or shame

What is stereotyping?

creating a division between people

What are the three E's of trauma?

Events, experience, effects

What are some symptoms of major depressive disorder?

Depressed mood, loss of interest/pleasure, significant weight loss/gain, insomnia, hypersomnia, fatigue, feelings of worthlessness, excessive or inappropriate guilt, decreased concentration, thoughts of death/suicide

What is the criteria for diagnosing major depressive disorder?

At least 5 symptoms for longer than 2 weeks. Must occur most days, must interfere with functioning

What is DED?

Dedicated emergency department

What is MSE?

Medical screening examination

What is EMC?

Emergency medical condition

What is CMS?

Centers for Medicare and Medicaid Services

What is CFR?

Code of Federal Regulations

What is EMTALA?

Emergency Medical Treatment and Active Labor Act

What is CoP's?

Conditions of participation

What is THSC?

Texas Health and Safety Code

What is MI?

Mental illness

What is ID/IDD?

Intellectual disability

What is SI?

Suicidal ideations

What is HI?

Homicidal ideations

What is EDO?

Emergency detention order

What is a good-faith effort?

An implied contractual term and it is defined as "what a reasonable person would determine is a diligent and honest effort under the same set of facts or circumstances

What is reasonable cause?

To have knowledge of facts which, although not amounting to direct knowledge, would cause a reasonable person, knowing the same facts, to reasonably conclude the same thing

What are the two pieces of legislature that placed unfounded mandates for mental health services to be provided by the judicial system, sheriff's department (jails) and law enforcement?

Senate Bill 1849 and House Bill 1326

What is the period of time the jail has for completing the interview and report for MI or ID?

12 hours

Is medication required to be available for mental health care to persons incarcerated in jail?

Yes

Is personal bond mandated for a defendant with mental illness or intellectual disability?

If certain criteria are met

How long does an officer or jailer have to notify the magistrate if they have reasonable cause to believe that a defendant has a MI or ID?

12 hours

What is the magistrate required to order when there is reasonable cause to believe that the defendant has a MI or ID?

Shall order the LMHA or LIDDA, or another qualified mental health or intellectual disability expert to perform a 16.22 interview and report

What are some resources that LE may divert a subject with MI to?

LMHA, mobile crisis outreach team, crisis hotline, crisis stabilization unit, diversion centers, sobering centers, private MH hospitals, local emergency rooms

When may a subject be diverted when they have MI?

The offense the subject is accused of is a misdemeanor other than a misdemeanor involving violence AND the mental health crisis or substance abuse issue is suspected to be the reason the person committed the alleged offense

What are the certain intoxication offenses that disqualify a subject from diversion?

DWI, DWI with a child passenger, flying while intoxicated, boating while intoxicated, assembling or operating an amusement ride while intoxicated, intoxicated assault, intoxicated manslaughter

Is an EDO an arrest?

No

What is an EDO?

An emergency detention by which a person experiencing a severe mental health crisis may be detained for a preliminary examination and crisis stabilization

What is APOWW?

Apprehension by Police Officer Without a Warrant

Where must a subject be placed during an EDO?

The person must be placed in the least restrictive, most appropriate setting, while safeguarding the person's legal rights to a subsequent judicial determination of their need for involuntary mental health services

What are the three ways to initiate a mental health emergency detention?

APOWW, transportation for emergency detention by guardian, judge's or magistrate's order for emergency apprehension and detention

Who may apply for an any adult warrant?

Any adult who is not a guardian or law enforcement - family members, friends, EMS

What is required for a guardian transport - no warrant?

Apprehension, notice to court

Can a parent or guardian of a person younger than 18 years of age request the admission of the person to an inpatient mental health facility by filing a request with the administrator of the facility even if the person does not consent?

Yes

What are the requirements for APOWW?

The officer has reason to believe and does believe that:

1. The person is mentally ill

2. Because of that mental illness there is a substantial risk of serious harm to the person or to others unless the person is immediately restrained

3. There is not sufficient time to obtain a warrant before taking the person into custody

How can a substantial risk of harm to the person or others be demonstrated?

The person's behavior, evidence of severe emotional distress and deterioration in the person's mental condition to the extent that the person cannot remain at liberty

How may an officer form the belief that the person meets the criteria for apprehension?

From a representation of a credible person or on the basis of the conduct of the apprehended person or the circumstances under which the apprehended person is found

What shall a peace officer inform the subject of during an EDO?

The reason for the detention, that a staff member of the facility will inform the person of the person's rights within 24 hours after the time the person is admitted to a facility

Can a peace officer seize a firearm found in the possession of a person during an EDO?

Yes

Shall a peace officer provide the person a written copy of the receipt for the firearm and a written notice of the procedure for the return of a firearm during an EDO?

Yes

Shall arrangements be made to transport a person who is entitled to release?

Yes

Where can a person be transported to after release?

1. The location of the person's apprehension

2. The person's residence in this state

3. Another suitable location

Where shall a peace officer transport an apprehended person to when taken into custody without a warrant?

1. The nearest appropriate inpatient mental health facility

2. A mental health facility deemed suitable by the LMHA, if an appropriate inpatient mental health facility is not available

3. Transfer the apprehended person to emergency medical services personnel of an emergency medical services provider

Is a jail or similar detention facility suitable for an EDO?

Not unless an extreme emergency

Where should a person be kept if they are in a jail or similar detention facility for an EDO?

Separate from any person who is charged with or convicted of a crime

Where is the nearest appropriate inpatient mental health facility?

Baptist behavioral center

What are the local mental health facilities deemed suitable by the LMHA?

Baptist hospital - Beaumont

St Elizabeth hospital - Beaumont

Med Center - Port Arthur

What shall the notification of detention contain?

1. A statement that the officer has reason to believe and does believe that the person evidences mental illness

2. A statement that the officer has reason to believe and does believe that the person evidences a substantial risk of serious harm to the person or others

3. A specific description of the risk of harm

4. A statement that the officer has reason to believe and does believe that the risk of harm is imminent unless the person is immediately restrained

5. A statement that the officer's beliefs are derived from specific recent behavior, overt acts, attempts, or threats that were observed by or reliably reported to the officer

6. A detailed description of the specific behavior, acts, attempts, or threats

7. The name and relationship to the apprehended person of any person who reported or observed the behavior, acts, attempts, or threats

What happens when the person gets to the hospital?

A preliminary examination at the facility

When must the preliminary examination occur?

Within 12 hours after the person is apprehended

How many hours does the facility have to order protective custody?

48 hours from the time of the person's arrival

Where does the hospital campus start?

The entire main hospital campus including the parking lot, sidewalks, and driveway or hospital departments, including any buildings owned by the hospital that are within 250 yards of the hospital

What does EMTALA require hospitals to do?

Follow detailed standards and requirements for transfers of patients, including the use of medical vehicles staffed with medical personnel and equipment with proper life-saving capabilities, document all elements of compliance carefully, and report suspected possible violations of the EMTALA by other institutions that result in a patient presenting at the reporting facility

If the hospital operates an emergency room, they must admit a patient with an EMC and either ________.

1. Stabilize them

2. Transfer them to an appropriate facility once they are stabilized enough as to not jeopardize their safety

Can a hospital refuse patients a routine MSE screening?

No

What patients and conditions are covered in EMTALA?

1. Symptoms of substance abuse (including alcohol intoxication)

2. Symptoms of psychiatric disturbance (including suicide gestures, attempts, etc.)

Is LE required to stay at the facility after transporting the person for emergency detention once the required documentation has been completed?

No

What are some symptoms related to PTSD?

Re-experiencing, avoiding, negative cognitions or mood, arousal

What are some protective factors for preventing suicide?

Support system, not using drugs or alcohol, faith, employment, financial stability

What's the initial three point assessment?

Comprehension, behavior, emotion

What are some symptoms of cognitive disorders?

Loss of contact with reality, interference with ability to meet life's demands, alteration of mood