CHAPTER 57-HOSPITALIZATION OF MENTALLY ILL

Sec.

1631. Definitions.

1632. Authority to receive patients.

1633. Emergency hospitalization.

1634. Newly-admitted patients.

1635. Right to discharge on application; emergency detention.

1636. Petition for judicial determination.

1637. Hospitalization upon court order; judicial procedure; not adjudication of

legal incompetency.

1638. Detention under special circumstances.

1639. Habeas corpus.

1640. Transportation.

1641. Notice of hospitalization or discharge.

1642. Right to humane care and treatment.

1643. Mechanical restraints.

1644. Right to communicate and receive visitors; exercise of civil rights.

1645. Transfer of patients generally.

1646. Release on convalescent status.

1647. Readmission.

1648. Disclosure of information; penalties.

1649. Discharge upon medical review.

1650. Discharge other than upon medical review.

1651. Discharge of prisoners.

1652. Payment of charges.

1653. Receiving members of Armed Forces and Public Health Service beneficiaries.

1654. Additional powers of health director.

1655. Powers of magistrates in absence of district judge.

1656. Unwarranted commitments; penalties.

§ 1631. Definitions

As used in this chapter:

"designated examiner" means a licensed physician registered by the Health Bureau as specially qualified, under standards established by it, in the diagnosis of mental or related illness;

"Health Bureau" means the Health Bureau of the Canal Zone Government, under the supervision of the health director;

"health director" means the director of the Health Bureau of the Canal Zone Government;

"hospital" means a Canal Zone Government hospital or institution, or part thereof, equipped to provide in-patient care and treatment for the mentally ill;

"interested party" means an interested responsible adult including but not limited to the legal guardian, spouse, parent, adult child, or next of kin of an allegedly mentally ill individual or patient;

"licensed physician" means an individual licensed under the laws of the Canal Zone to practice medicine and a medical officer of the Government of the United States while in the Canal Zone in the performance of his official duties;

"mentally ill individual" means an individual having a psychiatric or other disease which substantially impairs his mental health; and "patient" means an individual under observation, care and treatment in a hospital pursuant to this chapter.

§ 1632. Authority to receive patients

The head of a hospital may receive therein for observation, diagnosis, care, and treatment any individual eligible for treatment at Canal Zone medical facilities whose admission is applied for by one of the following means:

(1) Any individual, including a minor with consent of parent or guardian, may be admitted upon application by the individual. (2) Any individual may be admitted upon written application by an interested party, by the health director, or by the head of any

institution in which the individual may be, if the application is accompanied by a certificate of a licensed physician stating that on a basis of an examination held not more than 15 days prior to the individual's admission, the individual is in his opinion mentally ill, or has symptoms of mental illness, and because of his illness either:

(A) is likely to injure himself or others if allowed to remain at liberty, or

(B) is in need of care or treatment in a hospital.

§ 1633. Emergency hospitalization

(a) If the certificate by a licensed physician under section 1632 (2) of this title states a belief that the individual (A) is likely to injure himself or others if allowed to remain at liberty, or (B) is in need of immediate hospitalization, any interested party or peace officer may, upon indorsement of the certificate for that purpose by the health director or by the judge of the district court or a magistrate in the Canal Zone, take the individual into custody, apply to a hospital for his admission, and transport him thereto.

(b) Any interested party or peace officer who has good and valid reason to believe that an individual is mentally ill, and because of his illness is likely to injure himself or others if not immediately restrained, pending examination or certification by a licensed physician or pending indorsement of the certification as provided in subsection (a) of this section, may take the individual into custody, apply to a hospital for his admission, and transport him thereto. The application for admission shall state the circumstances under which the individual was taken into custody and the reason for the applicant's belief concerning the individual's mental condition.

§ 1634. Newly-admitted patients

(a) The head of the hospital shall cause to be held a preliminary examination by a designated examiner, within a period not to exceed 48 hours after the close of the day of admission of every patient, to determine if there is a reasonable necessity existing for his continued hospitalization and immediate medical care.

(b) At the end of the 48-hour period, a patient so admitted pursuant to section 1632 (2) or 1633 of this title shall, without need of application therefor, be discharged if a preliminary examination has not been held or if, upon examination, the designated examiner refuses or fails to certify to the head of the hospital that in his opinion the patient is mentally ill and either is likely to injure himself or others if allowed at liberty, or is in need of care or treatment in a hospital and because of his illness lacks sufficient insight or capacity to make a responsible decision concerning his hospitalization. In the case of such a discharge, notice thereof shall be given to the person who applied for the patient's admission and, if the indorsement procedures of section 1633 of this title were utilized, to the appropriate indorsing official or court.

(c) A patient admitted pursuant to section 1632 (2) or 1633 of this title may remain for treatment on a voluntary basis under the same conditions prescribed for patients admitted pursuant to section 1632 (1) of this title, with the provisions of section 1635 of this title applying with respect to discharge. If a patient admitted pursuant to section 1632 (2) or 1633 of this title elects to remain for treatment on a voluntary basis, the head of the hospital shall certify that the patient has at the time sufficient insight or capacity to make responsible application for his own hospitalization. In these instances, notice shall be given of the patient's decision to remain on a voluntary basis to the health director and to the person who applied for the patient's admission and, where the indorsement procedures of section 1633 of this title were utilized, to the appropriate indorsing official or court.

§ 1635. Right to discharge on application; emergency detention

(a) An individual after 30 days following admission to a hospital pursuant to section 1632 (1) of this title, or an individual admitted to a hospital pursuant to section 1632 (2) or 1633 of this title, shall be forthwith discharged therefrom upon his request or upon the request in writing of an interested party or peace officer, and notice of discharge shall be given as prescribed in section 1649 of this title, except that:

(1) if admitted pursuant to section 1632 (1) of this title, his discharge may be conditioned upon his agreement;

(2) if under 21 years of age and admitted pursuant to section 1632(1) of this title, his discharge prior to becoming 21 years of age may be conditioned upon the consent of his parent or guardian;

(3) if the head of the hospital, within 48 hours from the receipt of the request, files with a judge of the district court a certification that in his opinion the discharge of the patient would be unsafe to the patient or others, the discharge may be postponed for a period not to exceed 5 days for the commencement of commitment proceedings pursuant to section 1637 of this title; and if the judge of the district court finds that, because of existing circumstances, proceedings for judicial hospitalization cannot reasonably be instituted in such time, the discharge may be postponed for a period not to exceed 15 days.

(b) The head of the hospital shall provide reasonable means and arrangements for informing patients of their right to discharge, as provided by this section and other sections of this chapter, and for assisting them in making and presenting requests for discharge. § 1636. Petition for judicial determination

A patient hospitalized pursuant to section 1632, 1633, or 1637 of this title may have the need for his continued hospitalization determined or redetermined on his own petition or that of an interested party to the judge of the district court. Upon receipt of the petition, the court shall conduct proceedings in accordance with section 1637 of this title, except that the proceedings need not be conducted if the petition is filed sooner than:

(1) 6 months after the issuance of an order of hospitalization pursuant to section 1637 of this title; or

(2) 1 year after the filing of a previous petition under this section; or

(3) 30 days after the voluntary application and admission of a patient.

§ 1637. Hospitalization upon court order; judicial procedure; not adjudication of legal incompetency

(a) An interested party, a licensed physician, a peace officer, the head of an institution in which the individual may be hospitalized, or the health director may, by filing an application with a judge of the district court, commence proceedings for the hospitalization of an individual by judicial commitment.

(b) Upon receipt of an application, the judge of the district court shall give notice thereof to the proposed patient, to his legal guardian, if any, and to one or more of the other interested parties, if any.

(c) As soon as practicable after notice of the commencement of proceedings is given, the court shall appoint two designated examiners to examine the proposed patient and to report to the court their findings as to the mental condition of the patient and his need for care or treatment in a hospital. The court may consider the choice of the patient in appointing the examiners. If the designated examiners report that the

proposed patient refuses to submit to an examination, the court shall give notice to the proposed patient and order him to submit to the examination. The order may direct that the proposed patient be taken into custody and detained pending a hearing.

(d) The examination shall be held at a hospital or other medical facility, at the home of the proposed patient, or at another suitable place not likely to have a harmful effect on his health.

(e) If the report of the designated examiners states that the proposed patient is not mentally ill, the court shall, without taking any further action, terminate the proceedings and dismiss the application. Otherwise, the court shall forthwith fix a date for, and give notice of, a hearing to be held not more than 15 days from receipt of the report of the designated examiners.

(f) The proposed patient, the applicant, the legal guardian and other interested parties, as determined by the court, shall be given notice and afforded an opportunity to appear at the hearing to testify, and to present and cross-examine witnesses, and the court may, in its discretion, receive the testimony of any other person. The proposed patient need not be present, and the court may exclude all persons not necessary for the conduct of the proceedings. The hearings shall be conducted as informally as may be consistent with orderly procedure and in a physical setting not likely to have a harmful effect on the mental health of the proposed patient. The entire proceeding may be recorded stenographically or with the use of mechanical recording devices as the court may approve. The court shall, in any event, prepare and maintain a summary record of all relevant and material evidence which may be offered concerning the mental condition of the proposed patient and may relax the rules of evidence to the extent of receiving affidavits, certificates of licensed physicians and other writings of similar apparent authenticity and reliability. An opportunity to be represented by counsel shall be afforded to every proposed patient, and if neither he nor others provide counsel the court shall appoint counsel.

(g) If, upon completion of the hearing and consideration of the record, the court finds the patient is:

(1) mentally ill; and

(2) (A) because of his illness is likely to injure himself or others if allowed to remain at liberty; or (B) is in need of immediate care or treatment in a hospital, and because of his illness, lacks sufficient insight or capacity to make a responsible decision concerning his hospitalization,

the court shall order his hospitalization for an indeterminate period; otherwise, the court shall terminate the proceedings and dismiss the application. If the court orders the hospitalization of the proposed patient, a copy of the summary of proceedings shall accompany the patient to the hospital.

(h) The order of hospitalization shall be directed to the Health Bureau and it is the responsibility of the health director to assure the carrying out of the order.

(i) Notwithstanding any other provision of this chapter, commitment proceedings under this section may not be commenced with respect to a patient admitted pursuant to section 1632 (1) of this title unless release of the patient has been requested pursuant to section 1635 of this title.

(j) An order for hospitalization pursuant to this section does not constitute a judicial determination of legal incompetency. Proceedings for a determination of legal competency of, and the appointment of a guardian for, a patient who has been ordered hospitalized may be instituted prior to, concurrently with, or following the completion of proceedings under this section.

§ 1638. Detention under special circumstances

(a) Pending his removal to a hospital, a patient taken into custody pursuant to section 1633 or 1637 of this title, or ordered to be hospitalized pursuant to section 1637 of this title, may be detained in a medical facility, his home, or any other suitable facility under such reasonable conditions as the health director may fix, but he may not, except because of and during an extreme emergency, be detained in a nonmedical facility used for the detention of individuals charged with or convicted of penal offenses. The health director shall take such reasonable measures, including provision for medical care, as may be necessary to assure proper care of an individual temporarily detained pursuant to this section.

(b) Notwithstanding any other provision of this chapter, a patient may not be released or discharged from custody during the pendency of proceedings for judicial hospitalization if, in the opinion of the head of the hospital, it would be unsafe to the patient or others, unless the court, upon the application of the patient or of an interested party, determines justifiable reason exists for release or discharge. § 1639. Habeas corpus

An individual detained pursuant to this chapter is entitled to the writ of habeas corpus upon proper petition by himself or an interested party to any court in the Canal Zone generally empowered to issue the writ of habeas corpus.

§ 1640. Transportation

When an individual is about to be hospitalized under the provisions of this chapter, the Health Bureau shall, upon the request of a person having a proper interest in the individual's hospitalization, arrange for the individual's transportation to the hospital with suitable medical or nursing attendants and by such means as may be suitable for his medical condition. When practicable, the individual to be hospitalized shall be permitted to be accompanied by one or more of his friends or relatives.

§ 1641. Notice of hospitalization or discharge

(a) When a patient has been admitted to a hospital pursuant to this chapter other than upon his own application, the head of the hospital shall notify immediately the patient's legal guardian, parent or parents, spouse, or next of kin, if known.

(b) The head of the hospital admitting an individual under any provision of this chapter, or discharging an individual so admitted, shall forthwith make a report thereof to the health director, and, if the patient was hospitalized under section 1637 of this title, to the district court.

§ 1642. Right to humane care and treatment

The Health Bureau shall be guided by the principles of humane care and treatment, and, to the extent that facilities, equipment and personnel are available, shall provide medical care or treatment in accordance with the highest standards of accepted medical practice. § 1643. Mechanical restraints

Mechanical restraints may not be applied to a patient unless determined by the head of the hospital to be required by the medical needs of the patient. Every use of a mechanical restraint and reasons therefor shall be made a part of the clinical record of the patient over the signature of the head of the hospital.