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Involuntary Commitment – State Mental Health Act (1.2.2)

Involuntary Commitment – State Mental Health Act (1.2.2) - Policies, Clinical, UW Health Clinical, Administrative, Legally Driven Care


Policy Title: Involuntary Commitment – State Mental Health Act
Policy Number: 1.2.2
Category: UW Health
Type: Inpatient
Effective Date: May 7, 2015


To inform staff of the legal requirements for the involuntary commitment of adult patients.


Involuntary commitment is a legal procedure in w hich an individual w ho meets certain statutory criteria may
be involuntarily committed for treatment, protectively placed or given protective services due to mental
illness, drug dependency or developmental disability. The decision to involuntarily commit a person is made
by a judge at a hearing based upon testimony from w itnesses, typically including physicians, other hospital
personnel, police off icers or family. Involuntary commitment requires a court determination that the individual
is mentally ill, drug dependent or developmentally disabled and a proper subject for treatment; meets the
legal standard for dangerousness or imminent harm to him or herself or others (according to specif ic
statutory criteria); and that no less restrictive alternative care or treatment is available in the community. The
dangerousness or imminent harm must be show n by recent acts or omissions.


A. The f iling of a Statement of Emergency Detention by a law enforcement off icer or by the treatment director,
or designee (See UW Health clinical policy 1.2.1, Emergency Detention – State Mental Health Act) w ill
automatically lead to the initiation of the involuntary commitment procedure except in the follow ing
i. The patient is released by the treatment director or by the court w ithin the 72 hour period; or
ii. The patient agrees to voluntary hospitalization prior to the end of the 72 hours.
B. When the emergency detention process is not used, the County Corporation Counsel (CCC) initiates the
involuntary commitment procedure by f iling a Petition for Examination for Involuntary Commitment. Note that
only the CCC can f ile such a petition.


A. The court procedure leading to a determination regarding involuntary commitment, or other less restrictive
treatment such as protective placement or services consists generally of the follow ing basic steps:
i. The f iling of a Statement of Emergency Detention under s. 51.15, Wis. Stats. by a law enforcement
off icer or by the treatment director, or designee, or a Petition for Involuntary Commitment under s.
51.20 f iled by the CCC.
ii. Appointment of legal counsel to represent the individual in commitment proceedings. The interests
of the public are represented by a CCC.
iii. A probable cause hearing to be conducted by the court w ithin 72 hours (Saturdays, Sundays, and
holidays excluded) from w hen the individual w as emergently detained.
iv. If probable cause is found, w ithin 14 days from the date of detention, a court ordered examination
of the individual by tw o court-appointed physicians or a physician and a psychologist is conducted.
B. Probable Cause Court Hearing
i. The probable cause hearing is usually held in the UWHC Inpatient Psychiatric Unit w hen the
patient is a Dane County resident. Residents of other counties are transported to the hearing by
law enforcement from the responsible county. Attendance of the petitioners for involuntary
commitment and the physician (or other health care staff w ith direct know ledge of the patient’s
behavior and condition) is required. Testimony often may be given by speaker phone upon request
(and if approved by the court).
ii. At the probable cause hearing, if the court f inds there is probable cause to believe the individual is
not competent to refuse psychotropic medication and that such medication w ill have therapeutic
value and w ill not unreasonably impair the individual's ability to prepare for and participate in the
legal proceedings, the court may order psychotropic medication as a temporary protective service.
iii. Counsel for the patient may have full access to the patient's medical record, w ith access granted by
Health Information Management. Reasonable questions relating to observed behavior and
professional assessments may be informally answ ered as time and conditions permit. If the

Policy Title: Involuntary Commitment – State Mental Health Act
Policy Number: 1.2.2

medical record is needed at the hearing, it must be subpoenaed by counsel or requested by the
judge. All requests for copies of medical records should go through the UWHC Health Information
Management department and/or the UWMF Health Information/Medical Records department.
iv. Further proceedings for long-term commitment, guardianship or protective services are initiated by
the court or other interested parties.
v. A f inal court hearing w ill take place. At the f inal hearing, the court may order the individual to be
released, to receive protective placement or protective services, or to be committed to the care and
custody of the county s. 51.42 board or ordered for inpatient treatment at an appropriate institution.
A f irst order of commitment usually cannot exceed six months.
vi. A committed patient can refuse medications under s. 51.61(1)(g) unless the court has ordered that
medications can be given involuntarily or unless medications are necessary to prevent serious
harm to the patient or others.

Author(s): Nurse Manager, Inpatient Psychiatry
Senior Management Sponsor: SVP, Patient Care Services and Chief Nursing Officer
Review ers: Director, Hospital Psychiatry Services; Medical Directors, Inpatient Psychiatry; Legal Services
Approval committees: UW Health Clinical Policy Committee
UW Health Clinical Policy Committee Approval: February 16, 2015

UW Health is a cohesive, united and integrated academic medical enterprise comprised of several entities.
This policy applies to facilities and programs operated by the University of Wisconsin Hospital and Clinics
and the University of Wisconsin Medical Foundation, Inc., and to clinical facilities and programs
administered by the University of Wisconsin School of Medicine and Public Health. Each entity is
responsible for enforcement of this policy in relation to the facilities and programs that it operates.


Ronald Sliw inski
UWHC President and CEO

J. Scott McMurray, MD
Chair, UW Health Clinical Policy Committee


Wisconsin Statutes s. 51.15, s. 51.20, s. 51.42, s. 51.61(1)(g) and(h).
UW Health clinical policy 1.2.1, Emergency Detention.

Version: Revision
Next Revision Due: May 7, 2018
Formerly Know n as: Hospital Administrative policy #10.17