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An act of assistance

In 1971, former Rep. Maxine Baker of Miami sponsored a legislative action. Baker’s role as the House Committee chairwoman of Mental Health allowed her to defend people with mental illnesses who were deprived of certain liberties while in mental health facilities.

The act, commonly referred to as the Baker Act, became effective the following year and brought about major changes to Florida’s 97-year-old mental health laws.

Paul Stiles, psychologist and associate professor in the department of mental health law and policy of the Louis de la Parte Florida Mental Health Institute, said laws to help the mentally ill date back to the late 1800s, almost one hundred years prior to the Baker Act.

Stiles said there have always been mental health hearings in Florida, especially in the late ’60s and ’70s.

“The Civil Rights movement push in the 1970s helped the mentally ill,” he said. “It made the process become more objective.”

Prior to the act, the mentally ill were treated more clinically, Stiles said, because only two psychologists were allowed to review the person. Baker wanted to have a judicial review and strengthen the due process and civil rights of patients in mental health facilities.

Since 1972, the Baker Act, has received a number of legislative amendments. The most substantial were in 1996. The reforms sought greater protections for people seeking voluntary admission and those being discharged from a state treatment facility. The amendments also strengthened the informed consent and guardian advocacy provisions, expanded notice requirements. It also provided for suspension and withdrawal of receiving and treatment facility designations.

Stiles, who is also a lawyer, said these revisions put in place three ways a person can initiate a petition for involuntary admission into a facility — to be “Baker Acted.”

“A professional, such as a doctor or counsel, a law enforcement officer or a judge could initiate the process by filing a petition requesting the person be brought to the nearest receiving facility for care,” he said.

A person can also voluntarily admit himself or herself to a facility. In order to do so, a person must show evidence of a mental illness, must be competent to provide consent and be suitable for treatment.

The Baker Act also states that the three parties must have determined the following criteria to involuntarily admit a person: The person refused voluntary examination or is unable to determine whether examination is necessary, reason to believe that without care or treatment the person is likely to suffer from neglect resulting in a real and present threat that can’t be avoided by others, or the person, without treatment or care, could cause serious harm to himself or herself or to others.

“If any of these are determined, the person is taken to a receiving facility,” Stiles said.

A receiving facility is a center that holds the person in question for no longer than 72 hours. During those 72 hours the person would receive a professional exam to determine if the criteria reported are met. The criteria includes proof they have a mental illness and that they are a danger to not only themselves but to others.

“At the end of the 72 hours, the facility could petition the court for the person to stay longer, shift the person’s stay to voluntary status or release the person,” Stiles said.

If the facility petitions the court for a longer stay, Stiles said, the court must hear the case in five days. Stiles said the judge would decide and/or grant the petition to be “Baker Acted” to the person. The judge, when “Baker Acting” someone, gives a placement order for a stay at a receiving facility for at least six months. After those six months are up, the facility can again petition the court requesting a longer treatment, Stiles said.

“During the placement order period, the person is receiving care they need for their illness,” he said. “Some need intensive treatment.”

There are more than 130 receiving facilities in the state of Florida.

Stiles studies the Baker Act at FMHI. He and associates collect the initiated petitions for the 72-hour emergency observation period and enter them in a database to study the demographics of who is “Baker Acted.”

“We have entered in over 100,000 forms (total),” he said.

The summary for the Baker Act Annual Report for 2001 states that the median age for those that have been “Baker Acted” is 37 years old, and out of the 85,133 forms submitted in 2001, 19 percent of those involuntarily admitted were age 17 or younger.

Stiles said the number of younger people getting “Baker Acted” is not so much a growing trend, but it is the age that most mental illnesses start to show symptoms.

“For serious disorders such as schizophrenia, it is not surprising that people in their late-20s experience an involuntary crisis,” he said. “It becomes more of a reality.”

Stiles said the majority of all the Baker Act cases helped save patients’ lives.

“The Baker Act allows professionals to evaluate the situation and protects (the patients’) rights when in a mental health facility,” he said.

Those who need immediate attention for a mental illness can call the Crisis Hotline at (813) 234-1234 or go to the Northside Community Center off Bruce B. Downs, located next to the Veterans Administration Hospital for emergencies.

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