Certification of a Director of Community Service
In some counties, the Director of Community Service may also be referred to as the Director of Mental Health Services. When this Director or a designated representative believes that an individual has a mental illness that poses a serious risk of harm to themselves or others and requires immediate inpatient care, they have the authority to arrange for the person’s admission to a hospital. The Director or their designee may also request police or ambulance services to transport the individual.
Before admitting the individual, a physician from the hospital’s staff must verify the necessity for immediate hospitalization. The hospital cannot keep the individual for more than 72 hours without either the individual’s consent for voluntary admission or additional certification from another physician confirming the need for continued involuntary care. Individuals have the right to request a court review of their admission, and the Mental Hygiene Legal Service will represent them at the court hearing.
Emergency Admission
Emergency Admission (9.39 MHL) allows for the immediate admission of individuals who are believed to have a mental illness that could result in serious physical harm to themselves or others. This can be initiated by police officers, the courts, or the Director of Community Services. Within 48 hours of admission, a hospital psychiatrist must evaluate the individual to either release them or confirm that emergency standards for admission are met. Individuals have the right to request a prompt court review, with representation from the Mental Hygiene Legal Service. Emergency admissions are limited to 15 days unless the individual is converted to medical certification or agrees to a voluntary admission.
Inpatient Settings
Informal Admissions (9.15 MHL) represent the least restrictive form of admission. Individuals must request admission themselves and be suitable for this status. No formal application is needed, and informal clients may leave the facility at any time upon request.
Voluntary Admission (9.13 MHL) occurs when an individual applies for admission in writing. For individuals under 16, a parent or authorized agency must apply. Those aged 16 to 18 may apply themselves or have someone else apply on their behalf. The person must recognize the need for inpatient treatment and consent to hospitalization.
Voluntary clients must be released promptly if they request discharge, though a hospital director may seek court authorization to retain them if the director believes involuntary care is necessary. If the director applies to retain the individual within 72 hours of their release request, the individual will remain involuntarily until the court reviews the situation. The Mental Hygiene Legal Service will represent the client during this process.
Involuntary Admission on Medical Certification (9.27 MHL) requires two physicians to certify the need for involuntary care and treatment. Applications for certification can generally be made by family members or individuals with whom the recipient of care resides.
Involuntarily admitted clients can be held in the hospital for up to 60 days. They have the right to request a court review within this period. After 60 days, the hospital director may apply for a court extension, notifying the individual who can object and request a hearing. The Mental Hygiene Legal Service will represent the individual in this hearing.
Outpatient Settings
In New York State, courts may order Assisted Outpatient Treatment (AOT), commonly known as “Kendra’s Law,” for individuals with mental illness who cannot safely live in the community without supervision. The AOT process involves strict criteria and conditions.
Petitions for AOT can be filed by various individuals, including family members, hospital directors, or mental health professionals. Before ordering AOT, the court must determine it is the least restrictive option, ensuring the person cannot survive in the community without supervision due to a history of non-compliance, threats, or risk of relapse.
In Monroe County, AOT is considered only after other options have been exhausted. For more information, individuals can call (585) 753-6634 or (585) 753-5530 in Monroe County, and (585) 243-7250 in Livingston County. Additional details are available at www.omh.ny.gov.
Mental Hygiene Legal Service
The Mental Hygiene Legal Service (MHLS) provides free representation to individuals in mental health, developmental disability, or substance use facilities. MHLS advocates for clients’ wishes, assisting with issues related to their care, treatment, and retention or discharge from facilities. They also represent individuals subject to court-ordered Assisted Outpatient Treatment.
Requests for assistance can be made by telephone, letter, or in person, and MHLS respects client confidentiality. If they cannot provide direct representation, they will refer clients to appropriate agencies. MHLS also provides general information about clients’ rights.
Complaints
If you encounter issues with your care or treatment, the system is in place to address your concerns. Start by discussing the problem with the person most directly involved, such as a caseworker or therapist. If unresolved, escalate the issue to their supervisor or agency administration. Agencies often have grievance processes, and you can also refer to specific groups set up for receiving complaints.
Clearly identify the problem and possible solutions in your complaint. Aim to resolve the issue constructively rather than assigning blame. Initial complaints can be made in person or by phone, with more formal complaints submitted in writing. Always communicate with someone authorized to make necessary changes, set a response deadline, and follow up if needed.
Grievances
Many agencies have committees such as Advisory Councils or Consumer Groups that address grievances and influence agency policy. Clients are encouraged to use the agency’s grievance process before escalating issues externally.
Clients retain civil rights and the right to an individualized service program, medical care, and treatment. They also have the right to object to any care, treatment, or rehabilitation methods with which they disagree.