Mental health crisis: temporary detention and involuntary commitment

The Mental Health Act applies to anyone who needs, requests, receives or has received mental health services, including disorders related to substance abuse, dependence and substance-induced disorders. It covers adults 18 or older and minors 17 or younger. For adults, the most common remedies requested from the court are five: the petition for 24-hour temporary detention; the one for involuntary commitment for a maximum of 15 days; the one for change of status from voluntary to involuntary admission, also for a maximum of 15 days; the one for compulsory treatment; and the petition to subject an adult to electroconvulsive therapy. The statute starts from a premise worth keeping in mind: the person subject to these remedies is presumed mentally capable and their recovery possible, and judicial determinations must focus on that person’s best interest, not that of their relatives or the service provider.

The temporary detention petition can be filed by any person over 18 who observes that another person over 18 poses a danger to themselves, others or property and refuses treatment or psychiatric evaluation voluntarily. That includes, without limitation, relatives, friends, neighbours, law enforcement officers and agency staff. The involuntary commitment petition can be filed by the same person who arranged the temporary detention, a representative authorized by the hospital, or any person over 18 who has in hand the hospital’s certification recommending that level of care. For minors under 18 the rule differs: the consent of a parent with parental authority, the legal custodian or the legal guardian suffices to take the minor to an institution, and in that case no court intervention is needed because it counts as voluntary treatment, even if the minor disagrees.

• For temporary detention: having reasonable basis to believe a person 18 or older requires immediate mental health treatment to protect them from causing physical harm to themselves, others or property, and that they do not wish to receive medical care voluntarily.Verified against the official source
• Filing the sworn request as soon as possible after the psychiatric emergency occurs, and never later than 24 hours after the episode.Verified against the official source
• Being over 18. You need not be a relative.Verified against the official source
• For involuntary commitment: having the hospital-issued certification signed by the psychiatrist recommending that level of care, and requesting it within 24 hours of its issuance.Verified against the official source

• The sworn request, filed through the Electronic Court’s interactive form.
• For involuntary commitment: the hospital certification, signed by the psychiatrist.
• For compulsory treatment: the medical recommendation that must accompany the petition.

1. 1

   Step 1: If it is now and it is dangerous

   If there is immediate danger, call 9-1-1. For the court order: if you are within the hours these requests are handled — Monday to Friday 8:30 am to 10:00 pm, Saturdays, Sundays and holidays 1:00 pm to 10:00 pm — file it through the Electronic Court. If the psychiatric emergency occurs outside those hours, go to the nearest police station: from there the on-duty judge system is activated and the matter can be handled at the station. Do not wait for the court to open.

2. 2

   Step 2: This is not an arrest

   It is the doubt that keeps many families from calling. Proceedings under the Mental Health Act are civil, not criminal. Police involvement in the transfer does not make the order an arrest and does not affect the person’s record.

3. 3

   Step 3: File within 24 hours of the episode

   The request is sworn and must be filed as soon as possible after the emergency, and never later than 24 hours after the episode. The court holds an ex parte hearing — only the petitioner is present —, the judge evaluates the request’s content, interviews the petitioner and, if warranted, issues the temporary detention order for the person to be evaluated by a psychiatrist.

4. 4

   Step 4: The order lasts 72 hours: move

   The temporary detention order is valid for 72 hours — three calendar days — from issuance, and lapses automatically if it is not served, that is, if it is not delivered to the person against whom it was issued. The detention itself is for a maximum of 24 hours, so the person can be evaluated and the level of care and treatment determined.

5. 5

   Step 5: You coordinate the transfer

   This surprises people and is worth knowing beforehand: whoever requested the order arranges the ambulance through the health plan of the person subject to detention, and coordinates with the nearest police station so an officer, along with first responders, assists in serving it. If it is a psychiatric emergency or the person has no health plan, arrangements can be made through 9-1-1 or medical emergencies. On arrival, deliver the order immediately at the hospital.

6. 6

   Step 6: If the hospital recommends commitment: 15 days and a hearing in five

   Once the person is evaluated, the professional team can certify that it recommends involuntary commitment. That petition is requested within 24 hours of the hospital issuing the certification, signed by the psychiatrist. Initial involuntary commitment is for a term no longer than 15 days, which can be shorter or longer depending on symptom progress and the team’s recommendations. Once authorized, the court sets a follow-up hearing within the next five business days to evaluate whether it continues or discharge is warranted.

7. 7

   Step 7: Alternative without hospitalization: compulsory treatment

   If your concern is that the person does not commit to their treatment, there is compulsory treatment, which the court itself describes as an alternative to avoid psychiatric hospitalization. The petition must be accompanied by a medical recommendation. The duration depends on progress: the court orders follow-up hearings at least every three months, and the professionals file reports on adherence to treatment. The case is closed when the person shows they pose no danger, when the professionals so recommend, or when it is shown they are in charge of their recovery.

Through the Electronic Court, remotely or using the equipment available at the nearest courthouse during working hours. Outside the hours these requests are handled, at the nearest police station, from which the on-duty judge is contacted.

• Not calling because you believe it is an arrest: these are civil proceedings and do not affect the person’s record.
• Waiting for the court to open when the emergency is in the middle of the night, instead of going to the nearest police station.
• Letting more than 24 hours pass from the episode before filing the request.
• Obtaining the order and not serving it within 72 hours: it lapses automatically.
• Assuming the court or the police arrange the ambulance: whoever requested the order arranges it.
• Believing you must be a relative to request it: any person over 18 who observed the situation can.

These are the government pages this guide is based on.

• Poder Judicial de Puerto Rico

  Poder Judicial

  poderjudicial.pr

• Electronic Court urgent requests

  Poder Judicial

  poderjudicial.pr

• Electronic Court — interactive form

  Poder Judicial

  tribunalelectronico.poderjudicial.pr