All admissions for inpatient mental health services require a commitment, whether it is voluntary or involuntary. A brief definition of each type of commitment is as follows:

201 (Voluntary Admission): A person who is 14 years old or older (or the guardian of a child under age 14), signs a 201 commitment for voluntary admission to inpatient mental health services. Under a 201 commitment, the person may sign him/herself out prior to the attending doctor's release, but must give 72 hours written notice of intent to leave. When this written request to withdraw from treatment is received by the staff of the inpatient mental health unit, the person can be held up to 72 hours, at the discretion of the physician. This gives the provider time to further evaluate the person and initiate involuntary commitment, if needed, or finalize a discharge plan.

302 (Involuntary Admission): A 302 commitment is petitioned to a county mental health delegate by someone who has first hand knowledge of a person who is dangerous to him/herself or others. Once the 302 is authorized, the person is subject to an involuntary psychiatric evaluation by a doctor. If the examining physician upholds the petition, the person is admitted to the hospital for up to five days. Within that five days, one of three things can happen: 1) the person is allowed to sign a 201 voluntary commitment; 2) the person is discharged by the attending doctor; or 3) an extended involuntary stay is petitioned to the court and a hearing is held to evaluate the clinical evidence for the petition.

303 (Involuntary Admission): This is an extension of a 302 commitment. A 303 commitment is granted by a mental health hearing officer after hearing testimony from the person that petitioned the 302 commitment, the attending physician, and the person who was involuntarily committed. A 303 commitment is effective for up to 20 days.

304 (Involuntary Admission): This involuntary admission is effective up to 90 days, and is granted by a mental health hearing officer in response to a petition. The types of 304 commitments are as follows:

304A: Commitment from community to state hospital;
304B: Commitment from inpatient mental health to state hospital; and
304C: Commitment to outpatient treatment.

Inpatient mental health is the primary service type in the HealthChoices program for which a person may be involuntarily admitted. A consumer might also be committed involuntarily to outpatient mental health services. In such a case, the commitment type would be a 304C. These commitments are not addressed in this report. Voluntary and involuntary mental health admissions are governed by the Mental Health Act of 1972 and only apply to mental health services. Substance abuse treatment does not apply under this act. A person cannot be involuntarily committed to substance abuse treatment; however, s/he can be sentenced by the criminal justice system to substance abuse treatment


Comparison of Inpatient Mental Health Admissions by Commitment Type for Second Quarter 2000
Type of
Commitment
Number of Inpatient Mental
Health Admissions
Percentage of Inpatient
Mental Health Admissions
201 1,363 81%
302 203 12%
303 86 5%
304 33 2%
TOTAL 1,685 100%
Note: The raw numbers represent adult and children/adolescent admissions