A responsible individual who has credible knowledge of an adult‘s mental illness and the condition or circumstances that have led to the adult’s need for assisted outpatient treatment may file, in the court in the county where the proposed patient resides or is found, a written application that includes:
Assisted outpatient treatment: means involuntary outpatient mental health treatment ordered under Section 26B-5-351. See Utah Code 26B-5-301
Designated examiner: means :
(a)
a licensed physician, preferably a psychiatrist, who is designated by the division as specially qualified by training or experience in the diagnosis of mental or related illness; or
(b)
a licensed mental health professional designated by the division as specially qualified by training and who has at least five years' continual experience in the treatment of mental illness. See Utah Code 26B-5-301
Designee: means a physician who has responsibility for medical functions including admission and discharge, an employee of a local mental health authority, or an employee of a person that has contracted with a local mental health authority to provide mental health services under Section 17-43-304. See Utah Code 26B-5-301
Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
Hearsay: Statements by a witness who did not see or hear the incident in question but heard about it from someone else. Hearsay is usually not admissible as evidence in court.
Informed waiver: means the patient was informed of a right and, after being informed of that right and the patient's right to waive the right, expressly communicated his or her intention to waive that right. See Utah Code 26B-5-301
Local mental health authority: means a county legislative body. See Utah Code 26B-5-101
Mental health officer: means an individual who is designated by a local mental health authority as qualified by training and experience in the recognition and identification of mental illness, to:
(a)
apply for and provide certification for a temporary commitment; or
(b)
assist in the arrangement of transportation to a designated mental health facility. See Utah Code 26B-5-301
Mental health treatment: means convulsive treatment, treatment with psychoactive medication, or admission to and retention in a facility for a period not to exceed 17 days. See Utah Code 26B-5-301
Mental illness: means :
(a)
a psychiatric disorder that substantially impairs an individual's mental, emotional, behavioral, or related functioning; or
(b)
the same as that term is defined in:
(i)
the current edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association; or
(ii)
the current edition of the International Statistical Classification of Diseases and Related Health Problems. See Utah Code 26B-5-301
Patient: means an individual who is:
(a)
under commitment to the custody or to the treatment services of a local mental health authority; or
Process: means a writ or summons issued in the course of a judicial proceeding. See Utah Code 68-3-12.5
State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
Substantial danger: means that due to mental illness, an individual is at serious risk of:
(a)
suicide;
(b)
serious bodily self-injury;
(c)
serious bodily injury because the individual is incapable of providing the basic necessities of life, including food, clothing, or shelter;
(d)
causing or attempting to cause serious bodily injury to another individual;
(e)
engaging in harmful sexual conduct; or
(f)
if not treated, suffering severe and abnormal mental, emotional, or physical distress that:
(i)
is associated with significant impairment of judgment, reason, or behavior; and
(ii)
causes a substantial deterioration of the individual's previous ability to function independently. See Utah Code 26B-5-301
Testimony: Evidence presented orally by witnesses during trials or before grand juries.
Treatment: means psychotherapy, medication, including the administration of psychotropic medication, or other medical treatments that are generally accepted medical or psychosocial interventions for the purpose of restoring the patient to an optimal level of functioning in the least restrictive environment. See Utah Code 26B-5-301
unless the court finds that the information is not reasonably available, the proposed patient’s:
(i)
name;
(ii)
date of birth; and
(iii)
social security number; and
(b)
(i)
a certificate of a licensed physician or a designated examiner stating that within the seven-day period immediately preceding the certification, the physician or designated examiner examined the proposed patient and is of the opinion that the proposed patient has a mental illness and should be involuntarily committed; or
(ii)
a written statement by the applicant that:
(A)
the proposed patient has been requested to, but has refused to, submit to an examination of mental condition by a licensed physician or designated examiner;
(B)
is sworn to under oath; and
(C)
states the facts upon which the application is based.
(2)
(a)
Subject to Subsection (2)(b), before issuing a judicial order, the court may require the applicant to consult with the appropriate local mental health authority, and the court may direct a mental health professional from that local mental health authority to interview the applicant and the proposed patient to determine the existing facts and report them to the court.
(b)
The consultation described in Subsection (2)(a):
(i)
may take place at or before the hearing; and
(ii)
is required if the local mental health authority appears at the hearing.
(3)
If the proposed patient refuses to submit to an interview described in Subsection (2)(a) or an examination described in Subsection (8), the court may issue an order, directed to a mental health officer or peace officer, to immediately place the proposed patient into the custody of a local mental health authority or in a temporary emergency facility, as provided in Section 26B-5-334, to be detained for the purpose of examination.
(4)
Notice of commencement of proceedings for assisted outpatient treatment, setting forth the allegations of the application and any reported facts, together with a copy of any official order of detention, shall:
(a)
be provided by the court to a proposed patient before, or upon, placement into the custody of a local mental health authority or, with respect to any proposed patient presently in the custody of a local mental health authority;
(b)
be maintained at the proposed patient’s place of detention, if any;
(c)
be provided by the court as soon as practicable to the applicant, any legal guardian, any immediate adult family members, legal counsel for the parties involved, the local mental health authority or its designee, and any other person whom the proposed patient or the court shall designate; and
(d)
advise that a hearing may be held within the time provided by law.
(5)
The court may, in its discretion, transfer the case to any other court within this state, provided that the transfer will not be adverse to the interest of the proposed patient.
(6)
Within 24 hours, excluding Saturdays, Sundays, and legal holidays, of the issuance of a judicial order, or after commitment of a proposed patient to a local mental health authority or its designee under court order for detention in order to complete an examination, the court shall appoint two designated examiners:
(a)
who did not sign the assisted outpatient treatment application nor the certification described in Subsection (1);
(b)
one of whom is a licensed physician; and
(c)
one of whom may be designated by the proposed patient or the proposed patient’s counsel, if that designated examiner is reasonably available.
(7)
The court shall schedule a hearing to be held within 10 calendar days of the day on which the designated examiners are appointed.
(8)
The designated examiners shall:
(a)
conduct their examinations separately;
(b)
conduct the examinations at the home of the proposed patient, at a hospital or other medical facility, or at any other suitable place that is not likely to have a harmful effect on the proposed patient’s health;
(c)
inform the proposed patient, if not represented by an attorney:
(i)
that the proposed patient does not have to say anything;
(ii)
of the nature and reasons for the examination;
(iii)
that the examination was ordered by the court;
(iv)
that any information volunteered could form part of the basis for the proposed patient to be ordered to receive assisted outpatient treatment; and
(v)
that findings resulting from the examination will be made available to the court; and
(d)
within 24 hours of examining the proposed patient, report to the court, orally or in writing, whether the proposed patient is mentally ill. If the designated examiner reports orally, the designated examiner shall immediately send a written report to the clerk of the court.
(9)
If a designated examiner is unable to complete an examination on the first attempt because the proposed patient refuses to submit to the examination, the court shall fix a reasonable compensation to be paid to the examiner.
(10)
If the local mental health authority, its designee, or a medical examiner determines before the court hearing that the conditions justifying the findings leading to an assisted outpatient treatment hearing no longer exist, the local mental health authority, its designee, or the medical examiner shall immediately report that determination to the court.
(11)
The court may terminate the proceedings and dismiss the application at any time, including prior to the hearing, if the designated examiners or the local mental health authority or its designee informs the court that the proposed patient does not meet the criteria in Subsection (14).
(12)
Before the hearing, an opportunity to be represented by counsel shall be afforded to the proposed patient, and if neither the proposed patient nor others provide counsel, the court shall appoint counsel and allow counsel sufficient time to consult with the proposed patient before the hearing. In the case of an indigent proposed patient, the payment of reasonable attorney fees for counsel, as determined by the court, shall be made by the county in which the proposed patient resides or is found.
(13)
(a)
All persons to whom notice is required to be given shall be afforded an opportunity to appear at the hearing, to testify, and to present and cross-examine witnesses. The court may, in its discretion, receive the testimony of any other individual. The court may allow a waiver of the proposed patient’s right to appear for good cause, which cause shall be set forth in the record, or an informed waiver by the patient, which shall be included in the record.
(b)
The court is authorized to exclude all individuals not necessary for the conduct of the proceedings and may, upon motion of counsel, require the testimony of each examiner to be given out of the presence of any other examiners.
(c)
The hearing shall be conducted in as informal a manner as may be consistent with orderly procedure, and in a physical setting that is not likely to have a harmful effect on the mental health of the proposed patient.
(d)
The court shall consider all relevant historical and material information that is offered, subject to the rules of evidence, including reliable hearsay under Rule 1102, Utah Rules of Evidence.
(e)
(i)
A local mental health authority or its designee, or the physician in charge of the proposed patient’s care shall, at the time of the hearing, provide the court with the following information:
(A)
the detention order, if any;
(B)
admission notes, if any;
(C)
the diagnosis, if any;
(D)
doctor’s orders, if any;
(E)
progress notes, if any;
(F)
nursing notes, if any; and
(G)
medication records, if any.
(ii)
The information described in Subsection (13)(e)(i) shall also be provided to the proposed patient’s counsel:
(A)
at the time of the hearing; and
(B)
at any time prior to the hearing, upon request.
(14)
The court shall order a proposed patient to assisted outpatient treatment if, upon completion of the hearing and consideration of the information presented, the court finds by clear and convincing evidence that:
(a)
the proposed patient has a mental illness;
(b)
there is no appropriate less-restrictive alternative to a court order for assisted outpatient treatment; and
(c)
(i)
the proposed patient lacks the ability to engage in a rational decision-making process regarding the acceptance of mental health treatment, as demonstrated by evidence of inability to weigh the possible risks of accepting or rejecting treatment; or
(ii)
the proposed patient needs assisted outpatient treatment in order to prevent relapse or deterioration that is likely to result in the proposed patient posing a substantial danger to self or others.
(15)
The court may order the applicant or a close relative of the patient to be the patient’s personal representative, as described in 45 C.F.R. § 164.502(g), for purposes of the patient’s mental health treatment.
(16)
In the absence of the findings described in Subsection (14), the court, after the hearing, shall dismiss the proceedings.
(17)
(a)
The assisted outpatient treatment order shall designate the period for which the patient shall be treated, which may not exceed 12 months without a review hearing.
(b)
At a review hearing, the court may extend the duration of an assisted outpatient treatment order by up to 12 months, if:
(i)
the court finds by clear and convincing evidence that the patient meets the conditions described in Subsection (14); or
(ii)
(A)
the patient does not appear at the review hearing;
(B)
notice of the review hearing was provided to the patient’s last known address by the applicant described in Subsection (1) or by a local mental health authority; and
(C)
the patient has appeared in court or signed an informed waiver within the previous 18 months.
(c)
The court shall maintain a current list of all patients under its order of assisted outpatient treatment.
(d)
At least two weeks prior to the expiration of the designated period of any assisted outpatient treatment order still in effect, the court that entered the original order shall inform the appropriate local mental health authority or its designee.
(18)
Costs of all proceedings under this section shall be paid by the county in which the proposed patient resides or is found.
(19)
A court may not hold an individual in contempt for failure to comply with an assisted outpatient treatment order.
(20)
As provided in Section 31A-22-651, a health insurance provider may not deny an insured the benefits of the insured’s policy solely because the health care that the insured receives is provided under a court order for assisted outpatient treatment.
Renumbered and Amended by Chapter 308, 2023 General Session
