A Guide to Involuntary Holds in Vermont: What You Need To Know
When a loved one is struggling with their mental health, it can be incredibly difficult to know how to help. Sometimes, the situation becomes serious enough that a psychiatric hold may be necessary to ensure the person’s safety. In Vermont, as in other states, involuntary psychiatric holds are designed to provide urgent care for individuals who are a danger to themselves or others due to severe mental illness. This guide will explain what an involuntary psychiatric hold is, how it works in Vermont, and what patients and their families need to understand about the process.
What is an Involuntary Hold?
An involuntary psychiatric hold (often referred to as a “72-hour hold” in Vermont) is a legal procedure where a person is placed in a mental health facility for evaluation and treatment against their will. This action is taken when a person is believed to be experiencing a mental health crisis that puts their own safety or the safety of others at risk. It is intended to provide immediate care and to determine whether longer-term treatment is necessary.
How are They Initiated?
Emergency Examination: An “interested party” (can be mental health professionals, police officers, family members, etc.) can apply if they believe an individual is in need of treatment.
Physician’s Certificate: This application must be accompanied by a licensed physician’s certificate that outlines the circumstances and symptoms that demonstrate the need for such an examination.
If a qualified mental health professional and a physician agree that the person poses a risk of imminent harm to themself or others, and this individual refuses voluntary treatment, they can be held for up to 72 hours for evaluation. Vermont Statutes Annotated notes that the individual may be detained for up to 24 hours without an application in an urgent crisis.
What Criteria Must Be Met to Place Someone on an Involuntary Hold?
Danger to Self or Others: Can include attempted suicide, threats of violence, or inability to meet basic needs (e.g., feeding or bathing oneself)
Major Mental Illness: The individual must be diagnosed with a major mental illness as defined by Vermont Statute, and it should be the primary cause of the dangerous behavior.
Note: Major mental illness in Vermont may include schizophrenia, major depression, bipolar disorder, and more. This does not include intellectual disability.No Alternatives: Less restrictive options are unavailable or unsuitable for the individual’s condition.
Vermont Laws
In Vermont, the laws governing involuntary psychiatric holds are grounded in the state’s Mental Health Law. Key points include:
72-hour hold: A person can be held for up to 72 hours (3 days) for evaluation in a crisis. During this time, professionals will assess their mental health and determine if further treatment is required.
Court Hearings: If it is determined that a longer hold or further treatment is needed, a court hearing will take place. The individual has a right to a lawyer during this process.
Continuing care: If the person is found to still require care after 72 hours have passed, they may be placed under a long-term hold or involuntary treatment court order. This could last anywhere from several weeks to 90 days or more, depending on the case.
Vermont’s legal framework outlines several different types of psychiatric holds, each serving an important but distinct purpose. The different types include:
Emergency Examination (EE) Hold
Duration: Up to 72 hours, excluding weekends and holidays.
Purpose: For immediate evaluation when someone is a danger to themselves or others.
Extended Involuntary Treatment
Duration: Varies; typically up to 90 days, with possible extensions.
Purpose: Court-ordered treatment following a hearing if the person is found to need ongoing care.
Order of Non-Hospitalization (ONH)
Duration: Set by the court, often up to 90 days, renewable.
Purpose: Allows a person to live in their community under specific treatment conditions rather than being hospitalized.
Potential outcomes
After the 72-hour hold, several outcomes are possible:
Release: If professionals determine the individual no longer poses a risk, they will be released, often with recommendations for ongoing treatments such as therapy.
Involuntary Commitment: If the individual still needs psychiatric care, they may be placed under an extended involuntary commitment order.
Voluntary treatment: If the person agrees to treatment during the hold, they may continue receiving care without the need for longer involuntary treatment. This may come with the possibility of less restrictive outpatient care.
Patient and Family Rights
It’s important to remember that both the individual undergoing the hold and their family have rights during this process, including:
Right to information: The person being held must be informed of the reason for the hold, their rights, and the options available to them.
Right to legal representation: If a court hearing is required or requested, the individual has the right to an attorney.
Family involvement: Family members are generally allowed to be involved in the treatment planning process, though patient privacy and confidentiality must be respected.
Right to appeal: If an individual feels the hold is unjustified, they can challenge it through legal channels.
How You Can Help
As a family member or close friend, it's natural to feel overwhelmed and unsure of how to help during this challenging time. Here are a few ways you can support your loved one:
Stay calm and informed: Understanding the process and what the person will experience can help you stay calm and better support them.
Advocate for their care: If possible, attend meetings or court hearings to ensure the best outcome for your loved one. You may also be able to help connect them to resources that can aid in their recovery.
Offer emotional support: Mental health crises can leave individuals feeling vulnerable. Be patient, listen without judgment, and reassure them that treatment is meant to help.
Seek support for yourself: This process can be stressful for families, too. Reach out to local support groups or a counselor to process your emotions and gain insight into how to cope.
Conclusion
Involuntary psychiatric holds are a vital tool for ensuring individuals experiencing a mental health crisis get the care they need. While the process can be upsetting for patients and their families, understanding the steps involved and knowing your rights can provide much-needed clarity during this difficult time. If you or someone you know is facing an involuntary hold, remember that this step is taken with the intent of protecting the person’s health and safety. Your support, advocacy, and understanding can make all the difference in their recovery journey.
