When a Loved One Needs Help Now, Know Your Options

Involuntary Commitment for Addiction in Florida

A person can be taken to a receiving facility for an examination period of up to 72 hours, starting when the person arrives. This page explains how the hold starts, what happens during it, and what rights the person keeps.

What Is an Involuntary Examination Hold?

Under Florida Statute § 394.455, an “involuntary examination” means an examination performed under s. 394.463, s. 397.6772, s. 397.679, s. 397.6798, or s. 397.6957 to determine whether a person qualifies for involuntary services. The statute lets a person be taken to a receiving facility for that exam if there is reason to believe that the person has a mental illness and because of his or her mental illness meets the listed criteria.

A receiving facility is a public or private facility or hospital designated by the department to receive and hold or refer, as appropriate, involuntary patients under emergency conditions for mental health or substance abuse evaluation (§ 394.455). Section 394.463 refers to the designated receiving system under § 394.462. Florida’s definitions describe this term in detail. The facility then decides whether the person needs further care or should be released.

The goal of a hold is evaluation, not automatic treatment. Staff must find out whether the person meets the law’s criteria for further involuntary services. A hold and a later court-ordered service plan are two different steps.

How Does an Involuntary Examination Hold Begin?

Under Florida Statute § 394.463, an involuntary examination may be initiated by any one of the following means: A court order, a law enforcement officer, or a professional’s certificate can each start the examination.

• Court order. A circuit or county court may issue an ex parte order (an order signed without the other side present). It must rest on sworn testimony with specific facts. If no time limit is written, the order is valid for 7 days after the date it was signed, but only until the person is delivered to the facility.
• Law enforcement officer. An officer may take a person into custody when the person appears to meet the criteria. The officer must restrain the person in the least restrictive way available. The officer must also write a report.
• A physician, a physician assistant, a clinical psychologist, a psychiatric nurse, an advanced practice registered nurse registered under s. 464.0123, a mental health counselor, a marriage and family therapist, or a clinical social worker who examined the person within the preceding 48 hours can execute a certificate. If less restrictive options are not available, an officer takes the person into custody.

Under a court’s ex parte order, if other less restrictive means are not available, such as voluntary appearance for outpatient evaluation, a law enforcement officer or other designated agent of the court must take the person into custody, and the order must be made part of the patient’s clinical record. That is why a hold can begin on a street or at home.

When Does an Involuntary Examination Hold Apply?

A hold applies when a person appears to have a mental illness. The word “appears” matters here.

It does not depend on a later finding about what was true.

Under Florida Statute § 394.463, a person may be taken to a receiving facility for involuntary examination if there is reason to believe that the person has a mental illness and because of his or her mental illness meets the listed criteria. That impairment must substantially interfere with the person’s ability to meet the ordinary demands of living. The definition leaves out intoxication and conditions shown only by substance abuse, as well as developmental disabilities and conditions shown only by dementia, traumatic brain injury or antisocial behavior.

What Happens During the 72-Hour Hold?

A person held for examination must be examined by a physician or clinical psychologist without unnecessary delay. The examination period must be for up to 72 hours and begins when a patient arrives at the receiving facility; for a minor, the examination must be initiated within 12 hours after arrival (§ 394.463).

Several rules apply during the hold:

• A person who stays more than 12 hours gets a physical exam within 24 hours of arrival, under § 394.459.
• The facility must give prompt notice of the person’s whereabouts to a guardian, attorney, or other listed contact. This happens within 24 hours, under § 394.4599.

Two details are worth tracking from the first hours. One is whether the examination has happened. The other is whether the family has been notified.

What Are Your Rights During a Hold?

Under Florida Statute § 394.459, a person who is receiving treatment for mental illness shall not be deprived of any constitutional rights, but if such a person is adjudicated incapacitated, his or her rights may be limited to the same extent the rights of any incapacitated person are limited by law. The statute says a person receiving treatment for mental illness ‘shall not be deprived of any constitutional rights’, but if such a person is adjudicated incapacitated, his or her rights may be limited to the same extent the rights of any incapacitated person are limited by law (§ 394.459).

• Dignity. The person’s dignity must be respected at all times. This includes any time the person is taken into custody or moved. A person with mental illness who is not charged with a crime cannot be jailed.
• The facility must also provide a telephone for free local calls.
• Information. Before consenting to treatment, the person or guardian must receive a plain-language explanation. That includes the reason for admission, the proposed treatment, its risks, alternatives, and the expected length of care.
• Notices. Notices must be given both orally and in writing. They must use language the person can understand. An interpreter must be provided if needed, under § 394.4599.

What Happens After the Hold Ends?

A patient under a court order for involuntary services must be discharged when the order expires or at any time they no longer meet the criteria for involuntary services, unless they have transferred to voluntary status. That rule appears in § 394.469, which requires action at any time a patient is found to no longer meet the criteria for involuntary placement, not only at the end of the examination period. Fla. Stat. § 394.469 reads: “(1) POWER TO DISCHARGE.—At any time a patient is found to no longer meet the criteria for involuntary placement, the administrator shall: (a) Discharge the patient, unless the patient is under a criminal charge, in which case the patient shall be transferred to the custody of the appropriate law enforcement officer.”

A court may instead order involuntary inpatient placement or involuntary outpatient services. The court must find the criteria met by clear and convincing evidence. Involuntary services can last up to 6 months, under § 394.467.

If the court finds a patient incompetent to consent to treatment and the patient has not been adjudicated incapacitated and has no guardian with the authority to consent to mental health treatment already appointed, it must appoint a guardian advocate under § 394.4598. Under Fla. Stat. § 394.4598, in lieu of the training required of guardians appointed under chapter 744, a guardian advocate must, at a minimum, participate in a court-approved 4-hour training course before exercising his or her authority, and the court, deciding on a case-by-case basis, may waive some or all of the training requirements or impose additional requirements. The court can review the guardian advocate’s decisions upon petition of the patient’s attorney, the patient’s family, or the facility administrator, according to § 394.4598.

Your Next Step

An involuntary examination hold can arrive without warning. You may be trying to understand the process, protect a family member’s rights, and decide what comes next, all at once.

Richard J. Casey III, Esq. is responsible for this page.