Civil Commitment in Minnesota: a brief overview

The meeting  opened at  6:15 PM, 16 attenders.  

This month’s topic was Civil Commitment in Minnesota, an overview.   Our presenter was Asst. Hennepin County Attorney Annsara Lovejoy Elasky who is currently working in the Adult Services Division of H.C.A.O. 

A recording of the meeting is posted here: https://youtu.be/nxXxdxKNLcg

Starting with the basics:

Definition of Commitment:   This is a court order for treatment of  any of the following alone or in any combination:

• Mental illness
• Chemical dependency
• Developmental  disability 

Persons who may be judged needing commitment may:

• Suffer from mental illness, OR excessive and habitual use of drugs or alcohol, OR a developmental disability (identified before age 22)
• Are likely to harm themselves or others by failing to provide a major necessity OR be threatening to attempt harm to themselves or others, OR  have recently displayed serious physical problems (chemical dependency, only)
• There is no “less restrictive” treatment option available
• Can be any age – juveniles (rare) and adults can be committed

Civil Commitment is a series of  orderly steps:  

• The Hold: getting to be evaluated
• The Petition
• Pre-petition screening
• Court hearings
• Court order

The Hold:  There are two types of initial holds

• 1) Peace/Health Office (the transport hold)     This gets a person who is in crisis out of the community and into a hospital (which may be a treatment facility, a state-operated treatment program, or a community-based treatment program.    This is an information-based hold.   Specially trained social workers can obtain this hold as can police officers who can document need with written witness testimony from a reliable witness.
• 2) Emergency hold (the 72-hour hold)  This must have detailed  information supporting the hold.   The 72-hour hold is used to keep a person in a facility for further evaluation and/or treatment.   The 72-hour hold is an option the “examiner” at the hospital can use.

The Petition  – Four requirements:

• Petitioner – the entity seeking the commitment. In Hennepin County, this is likely to be a treatment professional (who may have taken evidentiary information from family, friends or by-standers)
• Doctor, physician’s assistant or mental health professional has to recommend commitment (aka the Examiner’s Statement) 
• There must be a detailed statement on why commitment is appropriate (this is where the gathered, documented testimony is recorded)
• The Petitioner then contacts “Prepetition Screening”

Prepetition Screening:  Program of Hennepin County that collects information on the patient while at the hospital and makes a recommendation to support or not support a petition.  They forward their findings onto the County Attorney’s Office.

The County Attorney reviews, signs, and files the Petition (The C.A. is the lawyer for the petitioner)

The Court appoints an attorney for the patient (Respondent).  

Court Hearings:

• The Court issues a “Court Hold”, which extends the 72-hour hold until the Preliminary Hearing
• An Examination and preliminary hearing is held 3 days after the filing.     
• Within 3 days of the Preliminary Hearing (in Hennepin)  a trial is held. 

An exception:  When a defendant in Criminal Court is incompetent to participate in the trial, the Rule of 20 is key.   See the expanded statement at the bottom of this report, marked **

At Court:  In Hennepin County, the defendant will make appearances on 2 days.

• Day 1:  Examination and Preliminary Hearing:

• Examination:  The court-appointed psychologist/psychiatrist reviews the records and interviews the patient.   They write a report to the Court with their opinion about commitment.
• Preliminary hearing: The respondent can agree to stay in the hospital or ask for a hearing where the Court will decide if the hold should continue.   A concern is the risk of serious physical harm if a person is released before the trial

• Day 2: Trial

• Many cases achieve a settlement without a trial for something less than commitment, but the Court remains involved.   Roughly 70% go to a Stay of Commitment where the person agrees to take prescribed medication and to stay in contact with their court-ordered contact, if at any point during the stay period the terms are violated, the respondent is then placed on Commitment.
• If there is no settlement, trial proceedings offer each party a chance to offer evidence.   The Court will ask for testimony from the Examiner.   The Court takes the matter “under advisement” and issues a written decision later (in Hennepin County).   In H.C., the average case that does not settle, will take about 2 weeks between the initial intake to the issued decision.

The Court Order: The Court issues a written order which details the terms of the “stay agreement” (i.e. the Commitment) to requesting entity or entities, OR Dismisses the case.

• If  the outcome is a Commitment, an order is issued for 6 months.   This order does not mean being in a hospital for 6 months, it is an order for treatment.  The Court can name more than professional treatment center to control treatment and often does. 
• The patient’s participation is NOT voluntary.
• The entity which controls treatment has the authority to determine that treatment.   The court has conferred authority to continue treating a person against that person’s will.

WHERE DO THE PATIENTS GO?

• Most patients are treated at community hospitals or privately run chemical dependency treatment programs.
• Some patients, whose illness is severe, go to hospitals or programs run by the state (e.g. Anoka Metro Regional Treatment Center, Community Behavioral Health Hospitals, CARE programs).   St. Peter is for people who might be dangerous to others.   Juvenile placement was difficult as it only had three beds at one point.

MEDICATIONS. 

• Court authority is needed to force neuroleptic medications.   These are  antipsychotic medications, which are used to treat many psychiatric disorders.   This does not include other medications like sleep aids or antidepressants that might be helpful
• The Court Authority is filed as a separate petition (called Jarvis Order) by a medical professionals.  This petition must show that the patient is not competent to decide whether to accept medications and they are refusing to take them.
• Many petitions for MI also have a Jarvis petition for neuroleptic tagging along during the commitment process

CASE MANAGER

• After a patient leaves the hospital, they are assigned a County Case Manager to monitor progress and compliance.  
• This person works with the hospital for a discharge plan covering the living environment, managing appointments, and so on.   There are different levels of contact depending on needs, but a standard is 1 meeting in person  a month and 2 phone meetings.  
• The Case manager can revoke the release and bring the patient back to the hospital  or treatment program if things are not going well.  
• The Case manager can also ask the court to extend the Commitment Order.  

HOW CAN I HELP?   Collect [and document with date, dime, place, names] as much information as you can under the circumstances.

Make sure the information you have (about specific behaviors, symptoms, and danger to self or others) is communicated accurately to the treatment facility. 

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**Rule 20.01 states

• the defendant may not waive counsel in the proceedings.   
• The defendant must be able to rationally consult with their counsel OR understand the proceedings, OR participate in the defense. “Competency” is the ability to participate in the proceedings

Rule 20.02 Defense of mental illness.   The M’Naghten Defense is that a person, because of mental illness or cognitive impairment, at the time of  committing the criminal act, had a mental defect to the extent that they did not understand the nature of the act or that it was wrong. 

[EQ: For more detail, see Rule of 20.01 and 20.02  here:  https://www.revisor.mn.gov/court_rules/cr/id/20/] 

IF the defendant is incompetent to participate in Criminal Court, the criminal court judge refers the case for civil commitment.     Misdemeanor charges are dismissed.   Gross misdemeanors and felonies are suspended for later review (every six months).   If the defendant is committed and in jail, the Commissioner of Human Services has 48 hours to get them to a DHS facility for competency restoration (this was/is challenging during Covid-19 pandemic).  

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Questions and Answers

QQ  How can someone consult an attorney before they are charged and have a court-appointed attorney?   What about family members?

AA:  The Hennepin County Board has a Defense Panel.   People can talk to an attorney for advice, explanation of how the proceedings go forward and related topics.   When someone is appointed to be the defendant for that client, then that attorney should be the contact.    It helps that if, as sometimes happens, people show up for the same complaints repeatedly over the years, that first contact will be that person’s attorney which makes continuity.  

QQ: Do some reports or complaints carry more weight than other people’s?  

AA: The Petitioner must have an “Examiner’s statement” and that person must be a licensed medical professional.Information gathered by police officers (including the testimony of others), information gathered by family members are all weighed on that Examiner’s statement.  COPE is a really good resource for people who are not medical professionals but who are worried about a family member.   After the client has been hospitalized, family members should contact the hospital.

QQ: Is your office training the social workers?

AA: HC conducted a number of workshops for officers and others, on a variety of related topics, so, yes!

There is a division of cases:   Hennepin County Atty. Office handles more of the criminal cases while Minneapolis A.O. is in charge of the misdemeanors.   Atty Okronkwo handles many of the “gap cases” which are the repeaters.  It’s notable that Hennepin County has a Court Intake Social Worker, who reaches out to people who are often in the gap-case group and asks if they are interested in participating in a treatment program on a voluntary basis.   She does get some into treatment. 

QQ: Do 911 operators have any way of knowing a bit of information they can pass along to officers that would make the job easier?

AA:  There was a database about previous bases being built before Covid interrupted that.   BCA Information is accessible to all officers, and that would be the data source.  It is possible they’re still working out who would have access to information.
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STATE OF THE PRECINCT

Viewing the crime reports for the period 8/2-8/8 in the 2nd Precinct
Violent Crimes:  5 Robberies, 6 Agg. Assault, 2 Domestic Ag. Assault.
Property Crime:  4  Burglaries, 50 Larcenies (larceny is items NOT taken by force, violence or fraud),   23  theft from motor vehicles, 9 auto thefts
The Second Precinct reports 11.22%  of violent crimes in the city.    That remains the lowest reporting precinct in MPD.
CPS Juarez pointed to the Larceny numbers and reminded us that that number could be cut way down if people will remember to take all their stuff out of their cars when they leave.   Clear the car; lock the car and, if you have  a garage, put the car in the garage.   It’s especially important to remove all weapons from your car, every time.  

CPS Juarez reported that a man was held up at the Mobile station on University Avenue, but got a good look at the robbers.   Officers arrested two people whom the man identified as his assailants!

QQ:  Robbery and assault seem to be tied to bar closings:  Can’t we shut down the streets like other cities do?

AA: We have the budget to pay officers for the overtime we’d need for that, but people are not signing up for it.   Perhaps that will change now that U of M students are returning.  

CPS Ali was happy to report that Minneapolis had a very successful NNO.   There were 36 events in the Second Precinct alone and they were well attended. 

A final note:  CPS Nick Juarez reported that he is leaving the Second Precinct as of August 13.   The good part of the announcement is that UMPD promptly recruited him, and so he won’t be moving far.  He speculated that UMPD had not had a rep at 2-PAC since Officer Nystrom retired, so maybe he’ll be back as the U of M representative.