California law allows a mentally ill person to be placed in care involuntarily for a maximum of 72 hours if a designated officer finds that the person is a danger to him- or herself, a danger to others, or gravely disabled and unable to perform self-care. Once this 72-hour period is completed, a hearing must be held to determine if the person should remain in involuntary care for a longer period of time. This hearing consists of a hearing officer, someone handling inpatient care, and a patient’s rights representative. However, in the past, the hearing itself had only the statements of these persons, and the patient him- or herself to use in making the determination.
A recent revision to the law allows information about the person and the history or progress of their illness to be collected from family members, intimate partners, or “consumer identified natural resource systems”. While health care providers may not disclose information about a patient without their consent, they may take account of information provided by a family member intended to give context to the immediate mental health crisis. A form for this purpose is not available online for use in California.
The form, available from county mental health offices or treatment facilities, allows family members to give information about the history and present context of the person’s illness, and treatment options. Using this form, caregivers and others may provide valuable input to deliberations about the care needed by their family member
Experience has shown that a mentally ill person may be able to make statements in a hearing about their intent to manage self-care, obtain shelter and food, and follow medical instructions, without, however actually having the ability to carry out these intentions. The testimony of family members about past incidents and the ability of the patient to follow instructions and carry through on commitments can be of great help to the hearing officers. This contextual information may show a pattern of re-hospitalization, when the patient has been released before they have recovered enough to care for themselves and function in the world.
Families of people with mental illness often struggle to find effective ways to support them, and may feel that little guidance is available. The form offers a structured way for family members to give input while still respecting the rights of patients to consent to care.