First, before I start this I want to make my admiration of police officers known. They put themselves in the line of danger many times and I am grateful for them. However, I do have to say that I think we require out of our police officers too much. I think that it is hard for them with a week of training to determine if someone has a mental health condition or not and how to respond appropriately. I have thought for many years that a few officers should be more extensively trained or that we have crisis teams available in the state of Florida. This is the subject for another blog. This is simply to inform what law enforcement can do in the state of Florida regarding the Baker Act.
There are six groups of people who can Baker Act in Florida and law enforcement is one of them. Law enforcement is the only one that can use third party observations, everyone else has to go on what they are seeing right now. Emergency room physicians frequently do not understand this as I have seen many Baker Acts based on what the family says. So sometimes, law enforcement gets upset when called into a facility with a mental health worker clearly present who can Baker Act and they will not complete the paperwork. It may be that the third party has to be taken into consideration and the patient is denying what transpired. The other reason law enforcement may be called in is to transport. The Baker Act requires that the police do this if an involuntary Baker Act has been done by a licensed professional. They do not have to transport a voluntary patient however. The only reason that law enforcement does not need to transport if the county has contracted with an emergency medical transport service or a private transport company and law enforcement is not considered necessary. Now the law enforcement officer may determine that EMS is necessary and can call for them but then have to be available if needed in the back of the vehicle.
When law enforcement then arrives with a Baker Act can a receiving facility deny the person. No except in one case, if the person has been arrested on a felony. So if law enforcement arrests someone who has committed a murder, for instance, then they must go to jail first and be processed. If law enforcement brings a voluntary patient, then the facility does not have to admit the patient. Again law enforcement does not even have to transport the patient if he or she is voluntary. If the person has a legal guardian or has a medical condition such as dementia or Alzheimer’s, their legal guardian cannot sign them in if it is an adult patient. I am very inexperienced with minors as our facility does not take them in. If the patient is taken to a hospital first, law enforcement just has to stay if they are acting dangerously until security staff or clinical personnel arrive. They do not have to come back and transport, the ER has to arrange for this transport.
What happens if the person is under the influence of drugs or alcohol? It may be more appropriate to Marchman Act the patient then Baker Act. Even if they threaten to harm themselves you can still Marchman Act the patient. This puts them into a detox facility where they may be more likely to get appropriate treatment. Many Baker Act receiving facilities do not have the means to detox a patient safely. This is not the officers position to figure this out, they just have to transport to the receiving facility. The receiving facility can then arrange transport to another appropriate facility if they feel it is medically necessary. So the receiving facility has to accept but does not have to admit if it is not safe for the patient. For instance, alcohol detox is very dangerous for an individual, the receiving facility may transport to an emergency room to get the person safely detoxed and then take the patient in.
When transporting a patient who has been Baker Acted you cannot use handcuffs or any other restraining device except for the protection of themselves or others. Law enforcement must clearly document this before using any such devices.
The reason for a Baker Act according to the law is (s.394.463) ” A person may be taken to a receiving facility for involuntary examination if there is reason to believe that the person has a mental illness and because of his or her mental illness:
(a) The person has refused voluntary examination after conscientious explanation and disclosure of the purpose of the examination: or
2. The person is unable to determine or himself or herself whether examination is necessary; and
(b) 1. Without care or treatment, the person is likely to suffer from neglect or refuse to care for himself or herself; such neglect or refusal poses a real and present threat of substantial harm to his or her well-being; and it is not apparent that such harm may be avoided through the help of willing family members or friends or the provision of other services; or
2. There is a substantial likelihood that without care or treatment the person will cause serious bodily harm to himself or herself in the near future, as evidenced by recent behavior” ( Chapter 394 Mental Health, 2015).
I hope this is helpful for both law enforcement and citizens alike.
Department of Children and Families (2003) Marchman Act Handbook Retrieved from: www.dcf.state.fl.us
Florida Statutes Chapter 394 Mental Health Retrieved from: http://www.leg.state.fl.us/Statutes
NAMI (2015) Baker Act Essentials Retrieved from: www.namigainesville.org/images
State of Florida (2015) Law Enforcement Retrieved from: www.myflorida.com
About the Author:
Janet received her RN at Maria College and has over 25 years of nursing experience. She has a BSN degree and is working on her Masters. Janet has worked in hospital, intensive care, nursing home / ALS, Rehab and home heath care situations. She has also worked a nurse.in corrections. Her first interest in Psychiatric Nursing came when she was a nurses aid at Albany Meds Psych floor while attending Nursing school. She is currently employed at a Psychiatric hospital in Southwest Florida and also works as a home health nurse providing both medical and psychiatric nursing care.