Involuntary commitment in Pennsylvania

What are the procedures for an involuntary commitment for mental health reasons in Pennsylvania? Can an out-of-state sibling instigate one?

I believe that anyone can initiate the process by contacting whoever is the designated official for the state. I don’t know Pennsylvania law, but a call to a hospital (triage nurse or psychiatric unit) or police would tell you what the steps are for a person to express concern, and also to clarify the grounds for an involuntary hold for evaluation (which varies state by state). Best of luck.

Why do you ask, if you don’t mind me asking?

My wife actually does this sort of thing, but she’s out of the room. I’ll try to offer my recollections of her stories from work. We are in Texas, but perhaps I can help. Maybe things are similar in Pennsylvania. Honestly, Pennsylvania is probably better.

I am assuming that the person in mental distress is an adult. I am also assuming that you are not present in the same place as the distressed person.

The (potentially) ill person must be an imminent threat to himself or others. People are allowed to be strange or to do strange things. However, if the person indicates a -cide (homicide or suicide), that gets attention.

This threat to the health or safety must be witnessed by an independent person. So, if your sibling is threatening his spouse, roommate, or others, have that person call the police. I cannot stress how important that is, though I also recognize how difficult that is. Calling the cops on someone you love can be extremely difficult. However, for an involuntary commitment, the law is going to get involved. Once the police show up, the officers will witness the dangerous behavior and act accordingly. Yes, someone may be arrested, but he will be safe. Don’t underestimate how important that is.

After arrest (or detainment), the ill person will be brought to the mental health department. In our county, that would be my wife. She will visit with the person and determine his/her mental state. Sometimes, she visits with people in the ER or at the county jail. You know those episodes of ER or other medical dramas where they hold someone for a “psych consult”? That’s what my wife does.

Once she is involved, several things can happen. She can convince the person to agree to hospitalization. She can set up follow-up care with the doctor and/or counselor in her office (my wife is a case-worker, not a doctor or LPC). If, in my wife’s opinion, the person is a threat to safety, she can initiate an involuntary commitment. She contacts the state hospital that serves our area (usually the Austin State Hospital, though sometimes it is MUCH farther away) and makes sure they have a bed available. She draws up the paperwork and presents it to a magistrate. The judge signs off on it and the person is placed into the custody of a police officer or deputy who then transports the person to the hospital. My wife only recommends the commitment – an actual judge orders it. If the judge refuses (very rare), she documents that the judge refused commitment and attempts to secure other treatment.

So, I guess the best advice that I have for you is to get someone actually present with your sibling to alert the authorities when the mentally ill behavior is present. Many major cities have police officers who are trained in mental health issues.

Good luck. Besides my wife’s professional experience with this issue, our family is currently going through a similar problem as yours. Both we and the mentally ill family member are in Texas, but we are not in the same town. We too are trying to get her help. It’s not easy.

This link should answer your questions:

If you have further questions, directing them to the MHMR department of the County where the afflicted soul resides would be a good start.

I know that Colorado isn’t Pennsylvania, but it’s not uncommon for a mental health hold call to start out as a welfare check called into the police by a third party.

St. Urho

In short, an non-functioning alcoholic drug-addicted sister who is getting closer and closer to the deep end mentally. She has been coming up with some very worrisome and dangerous ideas lately. Her history has been that she is just talk, but, well, you never know.

During the course of a round-robin of phone calls today, I discovered that she has a court appearance on Thursday (which of course she never mentioned) for some alcohol related and inspired offenses. The assigned judge has seen her before (at least twice) under similar circumstances. Both her estranged husband and her lawyer feel confident that she will be committed. So, I’m just going to hang loose and see what happens. Unless she calls with any immediate reason for me to call the cops there.

Thanks, all, for your input.

Placing an incompetent person in a locked setting temporarily may prevent them from immediately harming themselves or others if they are in a frame of mind to do so deliberately or directly. Short of that, I am uninclined to think forced treatment is likely to do more good than harm no matter how messed-up the person.

OTOH you didn’t ask for opinions. 'Nuff from me.

Well, part of what’s driving me crazy about this is that I don’t really disagree with you. We’re at our wit’s end. None of us can go out there and babysit her.

If she in any shape way fashion or form considers herself to have a problem in need of solution, possibly there is a self-help group she’d be amendable to checking out? In addition to the tried-n-true classic AA experience there are lots of alternatives nowadays, some focused tightly on alcohol as The Problem, others more towards noting it as one symptom among many possible symptoms of underlying Life Problems etc.

Have you checked with the local chapter of NAMI that is closest to her about what programs might be available in her area that could provide some kind of halfway point between full commitment, and letting her go on as she is? Whether one agrees with all the positions that NAMI espouses on the national level, my experience is that the local offices are very good at pointing people towards resources that are available locally, but not well known.

I don’t know that they’ll be able to help you, but they might have some information you could use.

The reason we’re considering involuntary is that over the past few years she has signed up for a number of rehab and/or psych counseling places, some of them live-in, including one of very good repute and expense which accepted her pro bono, so to speak. She has, without fail, left each one within three days.

My hope - my family’s hopes - would be that if she didn’t have a choice it would jolt her out of her rut. I’m aware that it might not help, that it probably won’t help in the long run, but it might, and we’re down to last gasp efforts here. We’re not yet prepared to write her off.

OtakuLoki, there is a branch of NAMI that’s local to her. I’ll send her the info.

You know, I really don’t think an involuntary commitment will get her the length of stay that you seem to feel would be helpful.
I know this isn’t MPSIMS, but if you go the normal involuntary commit route she’ll probably just get another of those 3-day stints of forced boredom that failed to help her the first time.
If she wants to change she has a shot. My best wishes to all parties afflicted.