IL allows voluntary and involuntary care for mental health treatment. Many barriers remain
Mental health disorders affect millions of Americans on a yearly basis, and the National Alliance on Mental Illness says 1 in 20 American adults experience serious mental illness each year.
A University of California Los Angeles study published in 2020 found the use of involuntary psychiatric commitments spiked from 2010 to 2020. The research showed the number of involuntary admissions outpaced population growth 3:1 over the studied decade.
Illinois law has provisions for involuntary inpatient psychiatric treatment, as well as an outpatient version, but involuntary outpatient care is less common.
The News-Democrat spoke with Mark Heyrman, general counsel to Mental Health America and chair of public policy for Mental Health America of Illinois, about involuntary inpatient commitment and its alternatives.
Here’s what to know about Illinois law on involuntary inpatient commitment and alternative treatment procedures.
How does involuntary inpatient commitment work in Illinois?
In Illinois, a person can be involuntarily admitted to an inpatient mental health facility when certain conditions are met, including that “immediate hospitalization is necessary for the protection of such person or others from physical harm.”
“Typically, it’s used fairly sparingly. The vast majority of people who have serious mental illnesses are never hospitalized and many of them, if they are hospitalized, are hospitalized voluntarily,” Heyrman said.
Another adult must file a petition detailing the signs and symptoms of a mental illness and any threats or patterns of behavior supporting the claim that immediate hospitalization is necessary.
The petition must also include information such as the petitioner’s relationship with the respondent and the names and addresses of the respondent’s relatives, if possible.
Additionally, the petitioner must provide a statement as to whether they have a legal or financial interest in the respondent’s potential admittance, or if they are involved in any legal dispute with the respondent.
According to the statute, knowingly making a material false statement in the petition is a Class A misdemeanor.
“Within 24 hours, the hospital has to complete two certificates to support the petition. If they can’t get two mental health professionals to agree that you need to be committed, then you must be discharged,” Heyrman said.
A doctor must sign one certificate, while a psychologist, social worker or other mental health professional can complete the other.
If the certificate is unavailable, a person can be detained for examination in a mental health facility for up to 24 hours while the petitioner attempts to secure the certificate. The 24-hour limit applies to cases solely based on petitions.
What about involuntary outpatient commitment?
In Illinois, involuntary outpatient treatment is sometimes used as an alternative to inpatient hospitalization. A judge can order involuntary outpatient treatment if they deem it sufficient and safe to carry out.
“We don’t do that very often. We perhaps should do it more often, both as a way not to put you in the hospital if we don’t need to but also to keep people safe so they don’t get worse and end up in the hospital,” Heyrman said.
There are many barriers to accessing outpatient treatment, however, and it can be more complicated to implement than inpatient commitment.
“The logistics of it are daunting,” Heyrman said.
To avoid inpatient commitment through outpatient treatment, a patient needs a community treatment facility that’s willing to accept them and report to the court. This process involves lots of requirements that can be expensive.
“We have this well-worn path of inpatient commitment, and outpatient commitment, although it’s been around for decades, it’s a less well-known option and in most of the state it’s not used,” Heyrman said.
Involuntary outpatient commitment is sometimes used in Cook County and infrequently in other Illinois regions, Heyrman said it’s uncommon due to the logistic challenges.
Whether it’s through court order or a patient is seeking care for themselves, hospital bed availability, financing and rural access to care can also be barriers to people receiving mental health care.
More information about involuntary commitment is available from Illinois’ legislation database.
What alternative types of mental health admissions are there in Illinois?
Voluntary admissions may be the first alternative to involuntary commitment that comes to mind. But Heyrman said even with voluntary mental health admissions, a patient can be kept beyond their will.
“If you sign yourself in and then you change your mind, they can keep you for basically a week after you’ve changed your mind while they evaluate whether you need to be committed or whether you can be released,” Heyrman said.
There is a way to seek mental health care informally where it’s less likely a hospital will be able to keep a patient against their will.
“We overuse this kind and underuse a much less burdensome alternative called informal admission,” Heyrman said.
Informal admission is being admitted to a non-psychiatric hospital for a medical condition, Heyrman said.
Those who seek medical care in a non-psychiatric setting can typically leave at will, Heyrman said.
More information about mental health advocates’ positions on involuntary admissions can be found at Mental Health America.
