Maryland's emergency petition (EP) statute was broadened
by the legislature this session. Maryland's EP statute permits lay persons,
the police or physicians to initiate an emergency psychiatric evaluation.
Lay persons, but not police or physicians, must have the petition request
approved by a judge who issues a custody order authorizing a law enforcement
officer to transport the person to the nearest psychiatric facility
for a psychiatric evaluation. The patient is then examined by the emergency
room physician who determines if the patient requires further psychiatric
or medical services.
Under the new statute, EPs allow the police to bring a
citizen to the nearest emergency room if there is reason to believe
the citizen has a mental disorder and the individual presents a danger
to the life or safety of the individual or of others. This is a change
from the prior statute, which required the petitioner to prove imminent
dangerousness.
The definition of dangerousness in the new statute is
the same definition of dangerousness that has been used in Maryland's
civil commitment statute for many years. That definition has been broadly
interpreted by administrative law judges and includes threats of violence,
inability to care for self or maintain activities of daily living. Proving
dangerousness under this definition does not require that overt acts
of dangerousness be observed or alleged.
Under the EP statute physicians have always had the ability
to endorse an EP and give it to a police officer without court involvement.
To do so, physicians must have examined the patient. There is no time
frame specified in the law for this examination in relation to the physician's
initiation of the EP. Physicians may base their decision to initiate
an EP on data collected during the examination. The new statute now
also allows physicians to base their decision on "other information
obtained that is pertinent to the factors giving rise to the petition"
as well.
The new legislation, which was supported by a coalition
of groups including the Maryland Psychiatric Society and NAMI, will
go into effect October 1, 2003.
Jeffrey S. Janofsky, M.D.
