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Dr. Mark, Doctor (MD)
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In Massachusetts, how long is a section 12 valid

Resolved Question:

In Massachusetts, how long is a section 12 valid? In an emergency room setting and a patient is section 12, does a phyiscian have to sign a section 12 every 24 hours while the patient is in the ED waiting placement? After 72 hours a psychiatrist must come in and evaluate the patient and write a section 12, and how long is the section signed by the psychiatrist good for?
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Mark replied 8 years ago.
4 day hold in Massachusetts.

Here is the statute:

Section 12. (a) Any physician who is licensed pursuant to section two of chapter one hundred and twelve or qualified psychiatric nurse mental health clinical specialist authorized to practice as such under regulations promulgated pursuant to the provisions of section eighty B of said chapter one hundred and twelve or a qualified psychologist licensed pursuant to sections one hundred and eighteen to one hundred and twenty-nine, inclusive of said chapter one hundred and twelve, who after examining a person has reason to believe that failure to hospitalize such person would create a likelihood of serious harm by reason of mental illness may restrain or authorize the restraint of such person and apply for the hospitalization of such person for a four day period at a public facility or at a private facility authorized for such purposes by the department. If an examination is not possible because of the emergency nature of the case and because of the refusal of the person to consent to such examination, the physician, qualified psychologist or qualified psychiatric nurse mental health clinical specialist on the basis of the facts and circumstances may determine that hospitalization is necessary and may apply therefore. In an emergency situation, if a physician, qualified psychologist or qualified psychiatric nurse mental health clinical specialist is not available, a police officer, who believes that failure to hospitalize a person would create a likelihood of serious harm by reason of mental illness may restrain such person and apply for the hospitalization of such person for a four day period at a public facility or a private facility authorized for such purpose by the department. An application for hospitalization shall state the reasons for the restraint of such person and any other relevant information which may assist the admitting physician or physicians. Whenever practicable, prior to transporting such person, the applicant shall telephone or otherwise communicate with a facility to describe the circumstances and known clinical history and to determine whether the facility is the proper facility to receive such person and also to give notice of any restraint to be used and to determine whether such restraint is necessary.

Then:

(d) A person shall be discharged at the end of the four day period unless the superintendent applies for a commitment under the provisions of sections seven and eight of this chapter or the person remains on a voluntary status.



http://www.treatmentadvocacycenter.org/LegalResources/StateLaws/Massachusettsstatute.htm
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Customer: replied 8 years ago.
So, is it my understanding that once a section 12 is signed to hold a patient in the ED, it is valid for 4 days and if no placement is made then the patient is free to walk? What happens if no bed is found and a psychiatrist comes in and states the patient is not safe to leave and has already been held in the ED for 3 days?
Expert:  Dr. Mark replied 8 years ago.
According to the law in Massachusetts, at the end of 4 days, one of two things has to happen:

1) The patient voluntarily decides he/she wants to be admitted for psychiatric treatment

or

2) The court must have a hearing determining that the patient is mentally ill and that discharge from the facility would create a likelihood of serious harm.

This is from section 7:

Section 7. (a) The superintendent of a facility may petition the district court or the division of the juvenile court department in whose jurisdiction the facility is located for the commitment to said facility and retention of any patient at said facility whom said superintendent determines that the failure to hospitalize would create a likelihood of serious harm by reason of mental illness.

And then section 8:

Section 8. (a) After a hearing, unless such hearing is waived in writing, the district court or the division of the juvenile court department shall not order the commitment of a person at a facility or shall not renew such order unless it finds after a hearing that (1) such person is mentally ill, and (2) the discharge of such person from a facility would create a likelihood of serious harm.
Customer: replied 8 years ago.
So in the ED setting, not a mental health facility, once a section 12 is signed it is valid for 4 days and does not have to be renewed every 24 hours. Once the 4 days is up then the above process has to be started?
Expert:  Dr. Mark replied 8 years ago.
According to the law, that appears to be correct.

Each hospital may have their own policies in addition to the law, but the law states the minimum requirement.
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