Bill Could Protect Mental Health Patients, Others

Summary of Testimony in Support of Senate Bill 359 on behalf of the Texas Medical Association, Texas Hospital Association, Texas College of Emergency Physicians, and Federation of Texas Psychiatry 

  • Currently, if an individual voluntarily seeks services at a hospital then decides to leave before being treated, but a physician believes that the patient is mentally ill and a danger to self or others, neither the hospital nor the physician can detain that person legally. Thus, hospitals and physicians are put in the unenviable position of having to choose between illegally detaining a mentally ill person who a physician believes is a danger to self or others and letting that patient leave.  

  • Physicians currently cannot initiate an emergency detention. Only law enforcement can initiate a detention, and only a court can issue an order of protective custody. This can be problematic, especially in a hospital when no peace officer is available and the physician has no choice but to let the patient leave. 

  • In Texas, a peace officer can initiate an emergency detention without seeing the patient, relying solely on the word of a physician, and the physician determines whether the patient continues to meet the detention criteria. It seems counterintuitive that a physician is the expert needed to determine the extent of danger to self or others and to release a mental health hold, but that the physician cannot initiate a hold.

  • Permitting physicians to initiate a four-hour hold could alleviate burdens on law enforcement and the judiciary and could result in fewer patients being committed because the individual may be stabilized during the detention period.

  • Psychiatric emergencies occur 24/7/365. These cases are most often managed in emergency departments throughout Texas by emergency physicians. The additional burden of requiring a peace officer or judge to become involved before any action can be taken prevents timely treatment of these potentially dangerous patients and complicates the patient interaction.

  • Senate Bill 359 applies only to a small group of patients: individuals who have sought services at a hospital or freestanding emergency medical center voluntarily then want to leave, but the physician at the hospital believes these patients are a danger to self or others. It does not apply to any patient who is brought in on an emergency detention initiated by a peace officer or is under an order of protective custody issued by a court.


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