Alabama Attorney General Opinion 1979-0101

• OFFICE OF THE ATTORNEY GENERAL : • CHARLES A. GRADDICK ATTORNEY GENERAL STATE OF ALABAMA qat ll2 rig-0010i LEE L. KALE DEPUTY ATTORNEY GENERAL WILLIAM M. SENIORS, JR. EXECUTIVE. ASSISTANT WALTER S. TURNER CHIEF ASSISTANT ATTORNEY GENERAL . JANIE NOBLES February 21, 1979 ADMINI IVE BUILDING 64 NORTH UNION MONTGOMERY. AREA (205).134-51110 ADMINI VE ASSI Mr. Thomas A. Salter Director North Central Alabama Mental Health Center P. 0. Box 637 -Decatur, Alabama 35602 MENTAL HEALTH - A voluntary admission into an inpatient psychiatric hospital must be based on a knowing, intelligent and informed decision by the individual seeking admission. Dear Mr. Salter: This will acknowledge receipt of your letter dated December 13, 1978, in which you requested an opinion from this office regarding the admission of patients into psychiatric hospitals serving certain clients of the North Central Alabama Mental Health Center. In your letter, you stated that your Center contracts for in-patient psychiatric services through a local psychia- tric hospital. Your questions concern persons admitted to said hospital by the North Central Alabama Mental Health Center who are not sufficiently dangerous to require involuntary civil commitment, but whose compe- tency to choose voluntary admission is tenuous. Your specific questions in that regard are as follows: "May they be voluntarily admitted? May the person's family authorize such admission?" In answering your questions, it is necessary to discuss what requirements must be mete in order for a person Mr. Thomas A. Salter February 21, 1979 Page 2 to voluntarily admit himself into a psychiatric hospital for treatment. For such an admission to be in fact a voluntary one, it must be knowingly and intelligently consented. See Lynch v. Baxley, 386 F. Supp. 378. In other words, there must be an informed consent which requires that the person have sufficient knowledge to be able to make an intelligent decision. Necessary information, if not already known, must be supplied to the individual so that a consent can be an informed one. Additionally, the consent should be more than a merely passive assent and should indicate that the person clearly understands the ramifications of his decision. Another prerequisite is that the person is not under any coercion and is making the decision on his own. It is strongly recommended that a statement be signed by the indiVidual that evidences that he has been given sufficient information regarding the hospital and the proposed treat- ment to form a judgment, that he does in fact consent to admission and treatment and, further, that his signature be witnessed by persons present at such discussion. In deciding about the ability of an individual to consent to admission and treatment, the appropriate mental health professionals must make a decision as to whether the patient is making a voluntary, knowing and intelligent consent. In light of this, some judgment has to be made as to whether they consider the patient competent to make such a decision. This does not mean that the individual must be competent in all regards, but rather is limited to his competency to understand and make this particular decision. To answer your specific questions, if a person is not able to make a voluntary, knowing and intelligent decision consenting to admission and treatment, he should not be admitted to a local psychiatric hospital in the absence of some court order authorizing said admission. Secondly, the individual's family may not authorize such admission. I point out for your information that Code of Alabama 1975, §22-8-1, authorizes mental health and medical services without consent where the patient is unable to give consent, where there are no known relatives, and where attempts to secure consent would Mr. Thomas A. Salter February 21, 1979 Page 3 result in delay of treatment which would increase the risk to the person's life or health. I also point out that Code of Alabama 1975, SS22-52-1 through 22-52-17, establish the involuntary civil commitment procedures in Alabama. These sections provide for the commitment of persons into public facilities other than the Depart- ment of Mental Health. It might be appropriate in some cases to seek a commitment to the local psychiatric hospital for in-patient services rather than hospital- ization at a state institution. I hope this will sufficiently answer your questions concerning this matter. If we can be of further assistance, please advise. . Sincerely, CHARLES A. GRADDICK ATTORNEY GENERAL By- PK en-vh. t ec s :13 R. EMMETT POUNDSTONE, III ASSISTANT ATTORNEY GENERAL REP:sb