Florida Mental Health Act

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The Florida Mental Health Act of 1971 (Florida Statute 394.451-394.47891[1] (2009 rev.)), commonly known as the "Baker Act," allows the involuntary institutionalization and examination of an individual.

The Baker Act allows for involuntary examination (what some call emergency or involuntary commitment). It can be initiated by judges, law enforcement officials, physicians, or mental health professionals. There must be evidence that the person:

• possibly has a mental illness (as defined in the Baker Act).
• is a harm to self, harm to others, or self neglectful (as defined in the Baker Act).

Examinations may last up to 72 hours after a person is deemed medically stable and occur in over 100 Florida Department of Children and Families-designated receiving facilities statewide.

There are many possible outcomes following examination of the patient. This includes the release of the individual to the community (or other community placement), a petition for involuntary inpatient placement (what some call civil commitment), involuntary outpatient placement (what some call outpatient commitment or assisted treatment orders), or voluntary treatment (if the person is competent to consent to voluntary treatment and consents to voluntary treatment). The involuntary outpatient placement language in the Baker Act took effect as part of the Baker Act reform in 2005.

The act was named for a Florida state representative from Miami, Maxine Baker,[2] who had a strong interest in mental health issues, served as chair of a House Committee on Mental Health, and was the sponsor of the bill.

The nickname of the legislation has led to the term "Baker Act" as a transitive verb, and "Baker Acted" as a passive-voice verb, for invoking the Act to force an individual's commitment. Although the Baker Act is a statute only for the state of Florida, use of "Baker Acting" as a verb has become prevalent as a slang term for involuntary commitment in other regions of the United States.[3][not in citation given]

 

Contents

  [hide] 

• 1Clarification of Baker Act criteria
• 2Reception
• 3See also
• 4References

 

Clarification of Baker Act criteria[edit]

Specific criteria must be met in order to initiate involuntary examination. Among those criteria are the following elements, that by themselves, do not qualify an individual as having met or meeting the criteria:

Reason to believe that the person has a mental illness; refusal of voluntary examination; the person is unable to determine whether examination is necessary. Criteria are not met simply because a person has mental illness, appears to have mental problems, takes psychiatric medication, or has an emotional outburst. Criteria are not met simply because a person refuses voluntary examination. Criteria are not met if there are family members or friends that will help prevent any potential and present threat of substantial harm.

The criteria, as stated in the statute, mentions a substantial likelihood that without care or treatment the person will cause serious bodily harm in the near future. ("Substantial" means ample, considerable, firm or strong.)

To further clarify this point of substantial likelihood, there must be evidence of recent behavior to justify the substantial likelihood of serious bodily harm in the near future. Moments in the past, when an individual may have considered harming themselves or another, do not qualify the individual as meeting the criteria. ("Near" means close, short, or draws near.)[4]

Reception[edit]

An editorial in the Tampa Bay Times wrote that the Act is currently only a bandaid solution and should be reformed to allow public defenders to have access to the patient's medical records and ongoing counseling and outpatient mental health treatment should be provided to the patient.[5]

See also[edit]

• 5150 (involuntary psychiatric hold), a section of the California Welfare and Institutions Code
• Laura's Law
• Kendra's Law

References[edit]

1. Jump up ^ https://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0300-0399/0394/0394ContentsIndex.html&StatuteYear=2013&Title=%2D%3E2013%2D%3EChapter%20394
2. Jump up ^ https://www.dcf.state.fl.us/programs/samh/MentalHealth/laws/histba.pdf
3. Jump up ^ North Port police scandal spreading to more officers?; by Bobeth Yates, 2 April 2014, WWSB
4. Jump up ^ 
5. Jump up ^ 

• Text of the Baker Act
• Baker Act Reporting Center
• Florida Department of Children and Families - Baker Act info - including the Baker Act, Administrative Rule 65.E.5, Forms, FAQ's etc.

Florida’s Baker Act: 2013 Fact Sheet Department of Children and Families

What is the Baker Act and What Does It Do?

• ?  The Baker Act is Chapter 394, Part I, Florida Statutes, also known as the Florida Mental Health Act.

• ?  The Baker Act provides legal procedures for mental health examination and treatment, including:

o Voluntary admission
o Involuntary examination
o Involuntary inpatient placement (IIP)
o Involuntary outpatient placement (IOP)

? The Baker Act regulates:
o Crisis stabilization units (CSUs)
o Short‐term residential treatment facilities (SRTs)

? The Baker Act protects the rights of all individuals examined or treated for mental illness in Florida.

What Is Involuntary Examination and How Is It Conducted?

• ?  An involuntary exam is a psychiatric exam conducted without a person’s consent, often called “getting Baker Acted.”

• ?  Involuntary exams are initiated by:

o Law enforcement officers (49%)
o Mental health professionals and physicians (49%) o Circuit courts (2%)

? Criteria for involuntary exam are that the individual:

o Appears to have a mental illness;

o Presents a danger to self or others; and

o Refuses voluntary exam or is unable to understand need for exam

? Involuntary exams are provided only by DCF‐designated Baker Act receiving facilities:

o Hospitals

o Crisis stabilization units (CSUs)

• ?  Services focus on stabilizing the immediate crisis.

• ?  Within 72 hours of arrival, facility must release the individual or file a petition for involuntary placement.

• ?  Average length of stay is 4.5 days.

• ?  Release must be approved by a psychiatrist or a clinical psychologist.

Key Statistics: Involuntary Exams

In 2011, there were:

• ?  150,000 involuntary exams

• ?  111,000 individuals examined

• ?  93,000 adults examined

• ?  18,000 children examined

  Over ten years (2002‐11), there were increases of:

• ?  50% in involuntary exams

• ?  46% in individuals examined

• ?  49% in adults examined

• ?  35% in children examined

Involuntary Exams

200,000 150,000 100,000

50,000

0
2002 2011

Hearing w/o Admission to State Hospital 9.70%

Petition w/o Hearing 13.70%

Outcome of Involuntary Exams

Admission to State Hospital 0.70%

Exam w/o Petition 76%

Key Statistics: Funding & Bed Capacity

Department Budget for Baker Act Beds FY 12‐13:

Adult Beds Child Beds Total

$63.4 million $14.0 million $77.4 million

Baker Act Receiving Facilities:

CSUs (All Public) 54 Public Hospitals 13 Private Hospitals 59 Total 126

Baker Act Bed Capacity:

Adult ‐ CSU 903 Adult ‐ Public Hospital 659 Adult – Private Hospital 2,632* Total Adult Beds 4,194

Child – CSU 196 Child – Public Hospital 209 Child – Private Hospital 329* Total Child Beds 734

*Private hospital beds are not intended to serve indigent individuals, although they are sometimes used for that purpose.

Funding Sources For Baker Act Beds

DCF 621 13%

Non‐ DCF 4,307 87%

What Is Involuntary Inpatient Placement (IIP)?

• ?  Involuntary inpatient placement (IIP) is the Baker Act’s term for civil commitment.

• ?  IIP allows an individual to be admitted for mental health treatment (beyond stabilization of the immediate crisis) without their consent.

• ?  IIP requires:

o Meeting criteria very similar to those for involuntary

examination.
o A petition filed by the receiving facility within the 72 hour

involuntary exam period.
o Supporting opinions of a psychiatrist and either a second

psychiatrist or a clinical psychologist.
o A court order based on a hearing where at least one of the

professionals testifies.
? An individual ordered to IIP may receive services in:

o A state mental health treatment facility (SMHTF) (“state hospital”) (avg. length of stay = 1.7 years)

o A short‐term residential treatment facility (SRT).
o IIP may be ordered for up to 6 months, and may be

extended with additional hearings.

What Is Involuntary Outpatient Placement (IOP)?

• ?  Involuntary outpatient placement (IOP) is a form of commitment that allows individuals to be mandated by the court to receive mental health treatment on an outpatient basis.

• ?  Criteria for IOP are more difficult to meet than criteria for involuntary inpatient placement. For IOP, the individual must:

o Have a history of noncompliance with treatment and be unlikely to survive safely in the community without supervision.

o Have, within the last 36 months:

• ?  Received at least two Baker Act involuntary exams;

  OR

• ?  Received mental health services in a forensic or correctional facility; OR

• ?  Engaged in serious violent behavior or attempts at self‐harm

? IOP has been used infrequently and provider participation varies. It is currently available in Escambia, Santa Rosa, Leon, Volusia, Manatee, Sarasota, Seminole, and DeSoto Counties.