N.Y. Mental Hygiene Law § 9.39: Emergency admissions for immediate observation, care, and treatment

§ 9.39 Emergency admissions for immediate observation, care, and

treatment.

(a) The director of any hospital maintaining adequate staff and

facilities for the observation, examination, care, and treatment of

persons alleged to be mentally ill and approved by the commissioner to

receive and retain patients pursuant to this section may receive and

retain therein as a patient for a period of fifteen days any person

alleged to have 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 themself or others. "Likelihood to result in serious

harm" as used in this section shall mean:

1. substantial risk of physical harm to themself as manifested by

threats of or attempts at suicide or serious bodily harm or other

conduct demonstrating that they are dangerous to themself, 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, or

3. a substantial risk of physical harm to the person due to an

inability or refusal, as a result of their mental illness, to provide

for their own essential needs such as food, clothing, necessary medical

care, personal safety, or shelter.

The director shall cause to be entered upon the hospital records the

name of the person or persons, if any, who have brought such person to

the hospital and the details of the circumstances leading to the

hospitalization of such person. The director shall, in accordance with

section 33.13 of this chapter, upon admission of a person under this

section, ensure that reasonable efforts are made to identify and

promptly notify any community provider of mental health services that

maintains such person on its caseload that such person has been received

for examination under this section.

The director shall admit such person pursuant to the provisions of

this section only if a staff physician of the hospital upon examination

of such person finds that such person qualifies under the requirements

of this section. Such person shall not be retained for a period of more

than forty-eight hours unless within such period such finding is

confirmed after examination by another physician who shall be a member

of the psychiatric staff of the hospital. Such person shall be served,

at the time of admission, with written notice of their status and rights

as a patient under this section. Such notice shall contain the patient's

name. At the same time, such notice shall also be given to the mental

hygiene legal service and personally or by mail to such person or

persons, not to exceed three in number, as may be designated in writing

to receive such notice by the person alleged to be mentally ill. If at

any time after admission, the patient, any relative, friend, or the

mental hygiene legal service gives notice to the director in writing of

request for court hearing on the question of need for immediate

observation, care, and treatment, a hearing shall be held as herein

provided as soon as practicable but in any event not more than five days

after such request is received, except that the commencement of such

hearing may be adjourned at the request of the patient. It shall be the

duty of the director upon receiving notice of such request for hearing

to forward forthwith a copy of such notice with a record of the patient

to the supreme court or county court in the county where such hospital

is located. A copy of such notice and record shall also be given to the

mental hygiene legal service. The court which receives such notice shall

fix the date of such hearing and cause the patient or other person

requesting the hearing, the director, the mental hygiene legal service

and such other persons as the court may determine to be advised of such

date. Upon such date, or upon such other date to which the proceeding

may be adjourned, the court shall hear testimony and examine the person

alleged to be mentally ill, if it be deemed advisable in or out of

court, and shall render a decision in writing that there is reasonable

cause to believe that the patient has a mental illness for which

immediate inpatient care and treatment in a hospital is appropriate and

which is likely to result in serious harm to themself or others. If it

be determined that there is such reasonable cause, the court shall

forthwith issue an order authorizing the retention of such patient for

any such purpose or purposes in the hospital for a period not to exceed

fifteen days from the date of admission. Any such order entered by the

court shall not be deemed to be an adjudication that the patient is

mentally ill, but only a determination that there is reasonable cause to

retain the patient for the purposes of this section.

(a-1) 1. If a patient admitted under this section is discharged at any

time before such patient has been admitted to a psychiatric center or

inpatient psychiatric service subject to licensure by the office of

mental health, the facility shall:

(i) advise such patient of clinically appropriate follow up services;

and

(ii) for individuals with complex needs, as defined by the regulations

of the office:

(A) for individuals in care management programs, coordinate discharge

planning with such care management program; and

(B) provide referrals, if clinically appropriate and available, for

care management services, community-based services, residential

services, or peerbased programs.

2. Discharges pursuant to this subdivision shall comply with discharge

obligations under article twenty-eight of the public health law and the

regulations of the department of health, as applicable.

(b) Within fifteen days of arrival at the hospital, if a determination

is made that the person is not in need of involuntary care and

treatment, he shall be discharged unless he agrees to remain as a

voluntary or informal patient. If he is in need of involuntary care and

treatment and does not agree to remain as a voluntary or informal

patient, he may be retained beyond such fifteen day period only by

admission to such hospital or another appropriate hospital pursuant to

the provisions governing involuntary admission on application supported

by medical certification and subject to the provisions for notice,

hearing, review, and judicial approval of retention or transfer and

retention governing such admissions, provided that, for the purposes of

such provisions, the date of admission of the patient shall be deemed to

be the date when the patient was first received under this section. If a

hearing has been requested pursuant to the provisions of subdivision

(a), the filing of an application for involuntary admission on medical

certification shall not delay or prevent the holding of the hearing.

(c) If a person is examined and determined to be mentally ill the fact

that such person suffers from alcohol or substance abuse shall not

preclude commitment under this section.