By John Hawkins
There’s a lot of talk about government efficiency these days. Whether it’s in Washington, D.C., at the Texas Capitol or on your television, right now there’s no missing it. Much of it centers on financial concerns: whether our tax dollars are being used in a lean and worthwhile manner. But other times, realizing efficiency might be simpler than that; for example, it might be just a matter of making sure everyone has the same understanding of existing law so government can work as intended.
In an era in which mental health care is at the forefront of our minds, Texas law needs one of those clarifications for a person experiencing a mental health crisis. That’s why, during this session of the Texas Legislature, THA is once again pushing for a change that will clarify the process by which hospitals obtain an order of protective custody (OPC) for a patient who is a danger to themselves or others. Doing so is an important component of our broad strategy to improve behavioral health in Texas – and it checks the efficiency box from the standpoints of both care and cost.
Obtaining an OPC from a judge often precedes committing a person to inpatient mental health treatment. The judge issues such an order upon finding that a patient is at substantial risk of serious harm to either themselves or to someone else and in need of inpatient mental health care. After the issuance of an OPC, the patient can receive more intensive and specialized mental health treatment.
But under current law, a facility can only request an OPC in a county where the patient lives, is “found” or is receiving court-ordered mental health treatment. That’s important because a person in the throes of a mental health crisis may be apprehended by law enforcement in one county, then transported to a hospital in a neighboring county – leading to confusion on the meaning of “found.”
Most jurisdictions in Texas interpret the law to allow the issuing of an OPC where the patient is located when the application is filed. But sometimes the law is misunderstood to be narrower than that, leading to OPC application rejections in that situation. When that happens, representatives from the hospital are forced to the travel to the county where the patient was apprehended to obtain an OPC from a judge there – who may even disagree that “found” means where the patient was apprehended, creating further confusion. That slows down the time it takes for the patient to receive those specialized, time-sensitive mental health services – and adds both cost and administrative burden for facilities that could have been providing that care much faster. It also may make it impossible to obtain an OPC if both counties disagree on where an order can be filed.
THA is supporting House Bill 3163 by Rep. Jeff Leach (R-Plano) and its companion, Senate Bill 643 by Sen. Nathan Johnson (D-Dallas). This bipartisan measure would make it clear that a treating hospital may request an OPC in the county where the hospital and the patient are located. It’s simple, common-sense and removes the last hurdle a hospital may have to quickly get a troubling situation under control.
Mental health care isn’t a topic that often presents easy answers. But allowing these orders to be issued in the same county as the requesting hospital is as straightforward a step as we could hope for in the behavioral health realm. Giving hospitals that quicker route to action could be the difference between a serious incident and a life redirected onto a stable and sustainable path.