ANNUAL REPORT OF BAKER ACT DATA Summary of 2013 Data

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1 ANNUAL REPORT OF BAKER ACT DATA Summary of 2013 Data Prepared for the Agency for Health Care Administration by Released: May 2014 Annette Christy, Ph.D. Associate Professor Department of Mental Health Law & Policy de la Parte Florida Mental Health Institute College of Behavioral and Community Sciences University of South Florida

2 INTRODUCTION In 1971, the Florida Legislature enacted the Florida Mental Health Act, a comprehensive revision of the state s mental health commitment laws. The law is widely referred to as the Baker Act in honor of Maxine Baker, the former state representative who sponsored the Act. Since the Baker Act became effective in 1972, multiple legislative amendments have been enacted to protect individuals civil and due process rights. There are several data reporting requirements in the Baker Act. Specific to the data used for analyses included in this report, as of 1996 all receiving facilities have been required to send a copy of every involuntary examination initiation form (i.e., reports from law enforcement officers, certificates of mental health professionals and court issued ex-parte orders) to the Florida Agency for Health Care Administration (AHCA) on the next working day after the person arrives at the facility (Section F.S.). Section F.S. also requires AHCA to submit an annual report to the Department of Children and Families, the President of the Florida Senate, the Speaker of the House of Representatives, and the minority leaders of the Senate and House of Representatives. This is the sixteenth Annual Report under the revised provisions. TECHNICAL NOTES Understanding what the data are not is as important as understanding what they are when considering related policy decisions. The Baker Act data analyzed for this report are from initiation forms received. However, some individuals for whom forms were received were never admitted to the receiving facility because an examination by a physician or psychologist performed prior to admission determined they did not meet criteria. The data also do not include information on what occurred after the initial examination. The data do not reveal how long individuals stayed at the facility and whether they remained on an involuntary or voluntary basis. Finally, there is anecdotal evidence suggesting some people spend most or all of their 72-hour involuntary examination period at emergency rooms of non-receiving facilities subsequent to being medically cleared. This reportedly occurs despite the legal requirement to transfer such persons to a designated receiving facility within 12 hours of medical clearance. Involuntary examination forms for people who never reach a receiving facility are not received by the Baker Act Reporting Center, so are not included in the data used for analyses in this report. Questions about this report may be addressed to Annette Christy at the Baker Act Reporting Center , also see Page 1

3 Templates of the forms submitted by Baker Act Receiving Facilities, as well as the full text of the Baker Act and companion Administrative Rule 65E-5 may be found at the Florida Department of Children and Families Crisis Services - Baker Act Manual webpage Receiving facility staff are encouraged to go to the Baker Act Reporting Center website for updates on data reporting issues ( Information about Baker Act related training is available at This includes information about face-to-face trainings, as well as free, online training. Online modules available as of 2013 are as follows: Suicide Prevention Introduction to the Baker Act Emergency Medical Conditions and the Baker Act Individual Rights and the Baker Act Law Enforcement and the Baker Act Long Term Care and the Baker Act Minors and the Baker Act Trauma Series Why People Die by Suicide Online versions of web events are also available at on the following topics. Why People Die by Suicide (Speaker: Thomas Joiner, Ph.D., Florida State University) Trauma Series (Speakers: Norin Dollard, Ph.D., & Vicki Hummer, MSW, LCSW, University of South Florida) Co-Occurring Disorders (Speaker: Holly Hills, Ph.D. University of South Florida) Baker Act & Marchman Act Comparison (Martha Lenderman, MSW, Lenderman & Associates) Copies of the most recent Baker Act training manual may be purchased. Information about where to purchase manuals may be found on the main Baker Act Reporting Center website, under the training link (see The main web page of the Florida Department of Children and Families provides many useful links, including to the statute, administrative rules, training manuals, and frequently asked questions. Suggested Citation: Christy, A. (2014). Report of 2013 Baker Act Data. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute. Page 2

4 2013 Involuntary Examination Data There were 171,744 involuntary examinations initiated in calendar year Counts of involuntary exam initiations for the last twelve years are reported in Table 1. The percentage increase from each year to 2013 is also reported. For example, the number of involuntary exam initiations increased 72.14% from 2002 to The increase from 2012 to 2013 was 9.15%. Table 1: increases in Involuntary Exam from Each Year to 2013 Year Involuntary Exam Percent Increase to , , % , % , % , % , % , % , % , % , % , % , % These increases in the numbers of involuntary exam initiations is greater than Florida population increases during this time. For example, census estimates from Florida Charts 1 show that from 2012 to 2013 the Florida population for people five and older increased less than one percent (0.93%), while the number of involuntary exam initiations increased by 9.15%. While the population of people five and older increased by 15.25% from 2002 to 2013, the number of involuntary exam initiations increased 72.14%. 1 Page 3

5 Initiator Type and Evidence Type: As shown in Table 2, almost half (49.65%) of the involuntary exam initiations in 2013 were initiated by law enforcement, with close to half initiated by mental health professionals (48.39%), with the remaining (1.96%) initiated via ex-parte order of a judge. The most common evidence type upon which involuntary exam initiations were based was harm only (63.58%), with other exams initiated based on harm and self neglect (24.00%), self neglect only (9.77%), with evidence type not reported for 2.65% of forms. Over half of involuntary examinations (54.15%) were based on harm to self only, with 20.40% based on evidence of harm to self and others, and 6.13% harm to others only. Table 2: Initiator Type, Evidence Type and Harm Type for Involuntary Examinations Variable Involuntary Exam Figures Type of Initiator # % Mental Health Professional 83, % MH Professionals Law Enforcement 85, % Judges 3, % Law Enforcement Judges Evidence Type # % Harm only 109, % Harm and Self Neglect 41, % Self Neglect only 16, % Not Reported 4, % Harm Type # % To self only 92, % To self and others 35, % To others only 10, % Not reported 16, % Self Neglect Only (does not apply) 16, % Harm Only Harm & Self Neglect Self Neglect Only Not Reported Self Only Self & Others Others Only Not Reported Neglect Only (Does Not Apply) Counts of involuntary examinations based on the county of residence as reported on the Cover Sheet submitted with each form are presented in Table 3. It is important to understand that there are many reasons why some counties have higher numbers of involuntary exam initiations than would be expected based on the population and those that are low based on the population. Only about half of counties have a Baker Act receiving facility, which is one reason accounting for disproportionate geographic distribution of involuntary examinations. Page 4

6 Table 3: Involuntary Exam by County of Residence Calendar Year 2013 County Involuntary Exam County Involuntary Exam County Involuntary Exam Alachua 1,844 Hardee 157 Okeechobee 346 Baker 105 Hendry 176 Orange 10,612 Bay 1,364 Hernando 1,485 Osceola 2,404 Bradford 212 Highlands 981 Palm Beach 9,337 Brevard 5,415 Hillsborough 12,394 Pasco 4,878 Broward 13,019 Holmes 149 Pinellas 10,286 Calhoun 96 Indian River 985 Polk 6,264 Charlotte 1,268 Jackson 232 Putnam 403 Citrus 1,171 Jefferson 92 Saint Johns 871 Clay 933 Lafayette * Saint Lucie 2,867 Collier 1,447 Lake 2,152 Santa Rosa 1,053 Columbia 382 Lee 4,582 Sarasota 2,980 DeSoto 173 Leon 1,545 Seminole 3,118 Dixie 112 Levy 223 Sumter 397 Duval 7,277 Liberty 36 Suwannee 171 Escambia 4,316 Madison 227 Taylor 75 Flagler 460 Manatee 2,044 Union 71 Franklin 54 Marion 2,806 Volusia 3,816 Gadsden 286 Martin 806 Wakulla 120 Gilchrist 62 Miami-Dade 22,150 Walton 347 Glades 52 Monroe 484 Washington 184 Gulf 101 Nassau 226 Hamilton 44 Okaloosa 1,561 * Counties with counts of 20 or less have been redacted in order to achieve de-identification in accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Page 5

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