Mental Hygiene Law - Admissions Process

MHL Admission StandardWho Applies for/Initiates Request for Hospital EvaluationWho examines at Time of ApplicationAvailable TransportWho Evaluates at Hospital Prior to AdmissionWho ConfirmsDuration of Hospital StayVoluntary (§9.13) Standard: person has a mental illness for which care and treatment in a mental hospital is appropriate; person is suitable for admission on a voluntary basisPatient makes application. (For patients under 18, see reverse #1)[Form OMH 472](See " Who Evaluates at Hospital Prior to Admission")Peace/police officers/ambulance service may transport at patient's request. [No form]Staff MD of any hospital* must confirm that the person meets the Voluntary Standard.[Form OMH 472]— — —Indefinite.Patient to notify hospital in writing prior to leaving. If director objects, he or she must apply within 72 hours for a court order of retention. (MHL §9.13 (b))Informal (§9.15)Standard: person has a mental illness for which care & treatment in a mental hospital is appropriate; person is suitable for admission on an informal basis and does not pose a substantial threat of harm to self or others.Patient makes oral request - no written application. (Patient is served with written notice of status and rights upon admission.)(No application)Peace/police officers/ambulance service may transport at patient's request. [No form]Staff MD of any hospital* (See reverse #2) should confirm that the person meets the Informal Standard.[No form]— — —Indefinite.Patient must be permitted to leave at any time while on informal status.Involuntary - Two Physician Certificate (§9.27)Standard: person has a mental illness for which care & treatment in a mental hospital is essential to his/her welfare; person's judgment is too impaired for him/her to understand the need for such care and treatment; as a result of his/her mental illness, the person poses a substantial threat of harm to self or others. (See reverse #3)Any of eleven parties may make application. (See reverse #4)[Form OMH 471]Two MDs using InvoluntaryStandard[Form OMH 471A]Peace/police officers/ambulanceservice may transport at examining MD's request[Form OMH 471B]Staff psychiatrist of any hospital,* other than one of the two original certifying MDs, must examine and confirm that the person meets the involuntary standard.[Form OMH 471]— — —Up to 60 days.** Patient may be held involuntarily beyond 60 days if the hospital applies for a court order of retention and the court is satisfied the patient continues to meet the Involuntary Standard. (MHL §9.33)Involuntary - Director of Community Services (DCS) or Designee (§9.37)Standard: same as Emergency StandardDCS or Designee makes application.[Form OMH 475]DCS or Designee using Emergency Standard. (See reverse #5)[Form OMH 475A/475B]Peace/police officers must transport at DCS or Designee's request.Ambulance service is authorized to transport.[Form OMH 475]Staff MD of any hospital* must confirm that the person meets the Emergency Standard.[Form OMH 475C]Staff psychiatrist must, within 72 hours after admission, (excluding Sundays and Holidays) examine and certify that the patient meets the involuntary §9.27 Standard. [Form OMH 475D]Up to 60 days.** Patient may be held involuntarily beyond 60 days if the hospital applies for a court order of retention and the court is satisfied the patient continues to meet the Involuntary Standard. (MHL §9.33)Emergency (§9.39)Standard: reasonable cause to believe that the person has a mental illness for which immediate observation, care and treatment in a hospital is appropriate and which is likely to result in serious harm to him/ herself or others. "Likelihood of serious harm" means:
  1. a substantial risk of physical harm to the person as manifested by threats of or attempts at suicide or serious bodily harm or other conduct demonstrating that the person is dangerous to him/herself (See reverse #6). or
  2. a substantial risk of physical harm to other persons as manifested by homicidal or other violent behavior by which others are placed in reasonable fear of serious physical harm.
In accordance with each appropriate section of the MHL the following parties may initiate (no application):
  1. §9.39 Not specified
  2. §9.41 Peace or police officers. (See reverse #7)
  3. §9.43 Court (through Civil Order).
  4. §9.45DCS or Designee. (See reverse #8)
  5. §9.55 Qualified psychiatrist supervising or providing treatment in an OMH licensed or operated facility without a psychiatric inpatient unit. (See reverse #9)
  6. §9.57 Director of a general hospital without a psychiatric inpatient unit, upon the recommendation of an Emergency Room MD; or, director of a C.P.E.P., upon the recommendation of a C.P.E.P.MD. (See reverse #9)
  7. §9.58 Mobile Crisis Outreach Team physician or qualified mental
  8. health professional. (See reverse #10)
(No application)Peace/police officers must transport at initiator's request. Ambulance service is authorized to transport.[A-F: Form OMH 474A/476A][G: Form OMH 482]Staff MD of §9.39 hospital must examine and determine that the person meets the Emergency Standard.[Form OMH 474]Staff psychiatrist must, within 48 hours after admission, examine the patient and confirm the first MD's finding that the patient meets the Emergency Standard.[Form OMH 474]Up to 15 days.** Patient may be held involuntarily beyond 15 days if he/she meets the Involuntary Standard and is converted to a §9.27 involuntary admission, in accordance with the process described above.*** (MHL §9.39 (b))C.P.E.P.**** Emergency (§9.40)Standard: person may have a mental illness for which immediate observation, care and treatment in a C.P.E.P. is appropriate and which is likely to result in serious harm to him/herself or others. "Likelihood of serious harm" means:
  1. a substantial risk of physical harm to the person as manifested by threats of or attempts at suicide or serious bodily harm or other conduct demonstrating that the person is dangerous to him/herself (See reverse #6). or
  2. a substantial risk of physical harm to other persons as manifested by homicidal or other violent behavior by which others are placed in reasonable fear of serious physical harm.
In accordance with each appropriate section of the MHL the following parties may initiate (no application):
  1. §9.40 Not specified
  2. §9.41
  3. §9.43
  4. §9.45
  5. §9.55
  6. §9.57
  7. §9.58{A-G are the Same as for Emergency (§9.39) Admission}
(No application)Peace/police officers must transport at initiator's request Ambulance service is authorized to transport.[A-F: Form OMH 474A/476A][G: Form OMH 482]Staff MD of C.P.E.P. must, within 6 hours after the person is received in the C.P.E.P. emergency room examine and determine that he/ she meets the C.P.E.P. Emergency Standard.[Form OMH 476]Staff psychiatrist must, within 24 hours after the patient is received in the C.P.E.P. emergency room, examine the patient and confirm the first MD's finding that the patient meets the C.P.E.P. Emergency Standard (in which case the patient must be moved to an extended observation bed).[Form OMH 476]Up to 72 hours (after which the patient must be discharged from C.P.E.P.). ** Patient may subsequently be held involuntarily if he/she meets the Involuntary Standard (§9.27) or Emergency Standard (§9.39) and is admitted to an appropriate facility in accordance with the processes described above.*****(MHL §9.40 (e) (f))

* As defined in MHL §1.03 (10). Includes any facility operated or certified by OMH which provides inpatient care or treatment of the mentally ill, including a certified ward, wing or unit of a general hospital.

** Note that the patient (or the patient's representative) may, at any time, request a court hearing regarding the patient's commitment, which generally must be held within 5 days after receipt of the request. If the court denies the application for the patient's release, and the patient is on involuntary status under §9.27 or §9.37, he/she may be held for the remainder of the 60-day commitment period or for up to 30 days, after the application for release is denied, whichever is later.

*** Note that such patient's 60-day commitment period will be calculated from the day he/she was first admitted under §9.39.

**** Comprehensive Psychiatric Emergency Program.

***** Note that such patient's 60-day commitment period (pursuant to §9.27) or 15-day commitment period (pursuant to §9.39) will be calculated from the time he/she was initially received in the C.P.E.P. emergency room.

https://www.omh.ny.gov/omhweb/forensic/manual/html/mhl_admissions.htm