LEGAL RIGHTS OF AN ADULT RECIPIENT OF MENTAL HEALTH SERVICES IN NEW MEXICO

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1 LEGAL RIGHTS OF AN ADULT RECIPIENT OF MENTAL HEALTH SERVICES IN NEW MEXICO June 2001 This handbk is a publicatin f Disability Rights New Mexic, 1720 Luisiana Blvd. NE, Albuquerque, NM Develpment and reprductin f this handbk is ne f many activities supprted thrugh a federal grant frm the U.S. Department f Health and Human Services (#SMX B), pursuant t the prvisins f the Prtectin and Advcacy fr Individuals with Mental Illness Act. The views expressed in this handbk are thse f Disability Rights New Mexic and d nt necessarily reflect the views f the U.S. Department f Health and Human Services. Permissin is granted t reprduce this handbk fr training and educatinal purpses prvided credit is given t the Disability Rights New Mexic. LEGAL RIGHTS OF AN ADULT RECIPIENT OF MENTAL HEALTH SERVICES IN NEW MEXICO Prduced by Channel One, Inc. and the New Mexic Patients Rights Advcacy Calitin with a grant frm The New Mexic Cmmunity Supprt Prgram Revisins by Disability Rights New Mexic

2 TABLE OF CONTENTS Nte: The wrds and phrases in italic thrughut this bklet are defined in the Glssary. INTRODUCTION When yu receive mental health services n an in-patient r ut-patient basis, yu have the same rights under the United States Cnstitutin as any ther citizen. In additinal t yur cnstitutinal rights, New Mexic law guarantees the rights described in this bklet. Sme f these rights can be limited r taken away, but nly when it is believed t be in the interests f effective treatment. Due prcess f law must be fllwed befre any f yur rights can be limited, unless there is a clear emergency. Thrughut this bklet we have attempted t explain what yur rights are in New Mexic, which rights can be limited r taken away, and the prcedures that must be fllwed by thse wh wish t limit r take away a right because they believe it is in yur best interests. It is ur hpe that this infrmatin will prvide yu with the knwledge yu need t prtect yur rights, preserve yur dignity, and advcate n yur wn behalf. It is imprtant t nte that the infrmatin cntained in this bklet refers t yur rights as a vluntary r invluntary patient, but sme d nt apply t thse with criminal charges. While many f these rights als apply t treatment in criminal settings, the prcedures utlined here are part f ur civil (nn-criminal) cde. RIGHTS PROTECTION AND ADVOCACY SERVICES In May f 1986, Cngress passed legislatin requiring each state t prvide prtectin and advcacy services t persns receiving mental health services in residential facilities. In New Mexic, these services are prvided by the Disability Rights New Mexic in Albuquerque. The DRNM is an independent, nn-prfit agency that has been prviding advcacy services t persns in New Mexic with disabilities since Mental health advcates at DRNM investigate cmplaints regarding incidents f abuse r neglect f persns receiving mental health services in hspitals, cmmunity residential prgrams, nursing hmes, barding hmes and jails, prisns and frensic settings, r within three mnths f discharge frm such a facility. In additin t physical abuse, mental cruelty, r failure t prvide a safe and humane envirnment, cmplaints regarding inapprpriate r inadequate treatment services can als be reviewed and/r investigated. DRNM staff can assist with issues such as the right t refuse treatment r the exercise f persnal rights within a residential treatment prgram. As an advcacy agency, DRNM is cmmitted t prtecting the rights f recipients f mental health services, and fllwing their wishes wherever reasnable and pssible. While it is P & A s plicy t use infrmal methds f negtiatin and prblem slving first, the agency has the authrity t take legal actin n behalf f clients.

3 T request assistance r btain mre infrmatin abut the legal rights f persns with disabilities, yu can cntact the DISABILITY RIGHTS NEW MEXICO AT (ALBUQUERQUE) r (STATEWIDE TOLL-FREE). Prtectin and Advcacy als has a satellite ffice in Las Vegas, New Mexic. The number in Las Vegas is Right t DUE PROCESS OF LAW IN-PATIENT RIGHTS Yu have the right t knw yur rights and t participate in the legal prcess any time yu believe yur rights have been taken away r limited either illegally r withut gd cause. Yu have the right t speak t a lawyer at any time and t be represented by a lawyer at all curt prceedings. If yu cannt affrd a lawyer ne will be appinted fr yu by the curt, free f charge. Yu may als cntact the Disability Rights New Mexic at (Albuquerque) f (Las Vegas) r (statewide tll-free) whenever yu have a questin abut yur rights. B. Right t A SAFE AND HUMANE ENVIRONMENT Whether yu are a vluntary r invluntary patient, yu have the right t be free frm harm, abuse and neglect and t be treated with respect and dignity. In ther wrds, yu have the right t a safe and humane envirnment. This includes: a cmfrtable bed, adequate changes f linen, and reasnable strage space fr yur persnal items; reasnable privacy while sleeping, bathing, dressing and taking care f persnal hygiene. (Yur physician can limit this right fr yur wn safety r if it is a necessary part f yur therapy. The reasn fr the limitatin must be written in yur case recrd); The right t reasnable pprtunities fr indr and utdr physical exercise, with reasnable access t recreatinal areas and equipment every day, and nurishing, wellbalanced, varied and appetizing fd. Right t COMMUNICATE Yu have the right t cmmunicate with anyne yu chse while an in-patient in any mental health treatment prgram. This includes: private cnversatins with a lawyer, physician, scial wrker, psychlgist, r member f the clergy, f yur chsing, at any reasnable time;

4 the right t see ther visitrs daily during visiting hurs; reasnable access t writing materials and stamps and a reasnable amunt f help in writing, addressing, and mailing letters (Yur mail must be sent ut unpened. Any mail addressed t yu cannt be pened r read by anyne but yu); reasnable access t a telephne in private, t make and receive lcal calls (In the case f a persnal emergency, yu have the right t make reasnable lng distance calls); and writing materials, pstage, r telephne calls free f charge, if yu cannt affrd t pay fr them. Yur physician can place limitatins n yur cmmunicatin rights fr gd cause related t yur therapy. Yur right t visit with yur lawyer, physician, psychlgist, clergy r scial wrker can never be taken away frm yu. The reasns fr any limitatins must be written in yur case recrd. The right t call yur attrney cannt be limited at any time. a Right t RECEIVE HUMANE AND APPROPRIATE TREATMENT Yu have the right t receive prmpt and humane treatment fr any physical r psychlgical prblems yu may have regardless f yur ability t pay. The treatment must be the least drastic means available, and the verall gal f yur treatment shuld be t help yu functin independently. Yur treatment rights include: a cmplete physical examinatin when yu are admitted t a treatment prgram (unless yu have had ne within the last tw days) and nce every 12 mnths frm then n; a treatment plan develped within 14 days f admissin, designed t meet yur special needs; the right t help design and update yur treatment plan which must include the fllwing: a descriptin f yur prblems and needs; a descriptin f the least restrictive envirnment in which yur needs can be met; treatment gals and hw lng it might take t meet each gal; a descriptin f hw yur treatment plan will help yu achieve yur gals; assignment f staff members t help yu achieve yur gals and what else will d t help yu; and what yu have t d r accmplish befre yu can be sent t a less restrictive envirnment r be discharged and hw lng that might take. treatment r habilitatin plans shall als include the fllwing assessments: mental status exam, intellectual functin, psychlgical functin, vcatinal, scial, medicatin and physical assessments.

5 YOU ALSO HAVE THE RIGHT t be free frm unnecessary r unusually large amunts f medicatin; t be free frm the use f medicatin as punishment, fr the cnvenience f the staff, as a substitutin fr a treatment plan, r in amunts that interfere with achieving the gals in yur treatment plan; and t be free frm seclusin r restraint except when is it necessary t prevent injury t yurself r thers, r substantial interference with the relate t preventin, nt t past acts. While in seclusin r restraint yu must be checked every 15 minutes and allwed the use f a tilet when needed. Yu must be allwed t eat and bather at regular times. Yur physician must write in yur case recrd the reasns why restraint r seclusin is necessary. 1. The Right t REFUSE OR CONSENT TO TREATMENT Unless yu have been fund incmpetent by a curt f law r yu have been fund incapable f infrmed cnsent and have had a treatment guardian appinted, yu have the right t refuse r cnsent t treatment. Yu have this right even if yu have been cmmitted and are an invluntary patient. Yu have the right t be fully infrmed abut any suggested treatment r therapy befre giving yur cnsent. (This includes the use f medicatin.) T be fully infrmed, yu must be tld rally r in writing: the prblem fr which treatment r therapy is prpsed; what the treatment r therapy is and hw it wrks; the risks and cnsequences f the treatment r therapy; the likelihd that the treatment r therapy will be successful; the pssible alternatives; and the cnsequences f nt receiving the treatment r therapy. Fr yur cnsent t be valid, yu must be able t understand all the infrmatin given t yu abut the treatment r therapy. Yur cnsent must be vluntary, and nt btained by frcing yu r threatening yu in any way. Yu have the right t change yur mind and withdraw yur cnsent fr any treatment r therapy at any time. Yur infrmed and written cnsent is required fr the fllwing treatments r therapies:

6 psychsurgery; cnvulsive therapy experimental treatment; r behavir mdificatin prgrams using averse stimuli. Hwever, if a licensed physician believes that giving yu psychtrpic medicatin is necessary t prtect yu frm serius harm, it can be given t yu n an emergency basis withut yur cnsent. If this is dne, the physician must write a reprt in yur case recrd that explains the emergency and the reasn that giving yu psychtrpic medicatin withut yur cnsent was the least drastic means f prtecting yu frm serius harm. Psychtrpic medicatin can be given withut cnsent under emergency cnditins fr nly 3 wrking days. Then yu have the right t a curt prceeding which will determine if yu are legally cmpetent t refuse r cnsent t treatment. If it is determined by the curt that yu are nt cmpetent t make yur wn treatment decisins, a treatment guardian will be appinted t make a decisin n yur behalf. 1. Right t CONFIDENTIALITY It is yur right t have all infrmatin that is shared with staff r written in yur case recrd held in strictest cnfidence, including the fact that yu are receiving r have ever received mental health services. This cnfidential infrmatin cannt be shared with any ther individual, facility, r agency withut yur written permissin, except under the fllwing circumstances: request fr the infrmatin is made by a mental health prfessinal r trainee wh needs the infrmatin t prvide services n yur behalf; the infrmatin is needed t prtect against the clear risk that yu will seriusly hurt yurself r smene else in the very near future (cnfidential infrmatin can be used against yu in curt); the infrmatin is demanded by yur insurance cmpany befre they will pay fr treatment; when the disclsure f infrmatin is t yur primary caregiver and the infrmatin disclsed is fr the cntinuity f yur treatment. Right t ACCESS YOUR RECORDS Yu have the right t read yur case recrd, treatment plan, r any infrmatin the facility r agency has abut yu and t make cpies f that infrmatin. Yu may als add infrmatin t yur recrds in rder t clarify r crrect anything yu feel is inaccurate. Yur crrectins and clarificatins must be included any time yur recrd is sent t anther persn, facility, r agency. Yur request t read yur recrds may be denied because yur physician r ther mental health prfessinal believes, and has nted in yur recrd, that reading them

7 wuld be harmful t yu. If yu are denied access t yur recrds, yu have the right t petitin the curt fr an rder allwing yu t read the entire recrd. 2. Right t EXERCISE YOUR CIVIL RIGHTS Civil rights are basic rights granted t every citizen in ur sciety. Yu cannt be denied any f yur civil rights just because yu are being treated in a mental health treatment prgram. Yu are cnsidered t be legally cmpetent t make yu wn decisins and t manage yur wn affairs unless yu have been fund incmpetent by a curt f law. Yur civil rights include: the right t practice the religin f yur chice and t receive a reasnable amunt f help in getting t nearby religius services; the right t nt fllw r participate in the practice f religin; the right, as a vluntary patient r client, t discharge yurself frm a mental health treatment prgram at any time. (Smetimes discharging yurself against medical advice can result in a refusal by yur insurance cmpany t pay yur bill. Yu shuld check first with yur insurance cmpany.); the right t vte and t register t vte; the right t receive, buy, sell, hld r give away yur prperty; the right t marry, make a will, r enter int any legal cntract; the right t express yur pinins; the right nt t be discriminated against in any manner because f yur race, clr, sex, religin, natinal rigin, age, handicap, degree f disability, r ability t pay. OUT-PATIENT RIGHTS If yu are receiving mental health services as an ut-patient frm a cmmunity mental health center, yu have the fllwing rights: 1. t receive a written descriptin f yur rights in English r Spanish when requesting services; 2. t receive apprpriate treatment r therapy fr yur emtinal r psychlgical prblem; 3. t be fully infrmed abut any prpsed treatment r therapy, including its risks and cnsequences; 4. t a treatment plan t meet yur special needs, within 30 days f the date yu begin receiving services;

8 5. t participate in designing and updating yur treatment plan; 6. the right t have all infrmatin that is shared with staff r is written in yur case recrd held in strictest cnfidence, including the fact that yu are receiving r have ever received mental health services. This cnfidential infrmatin cannt be shared with any ther individual, facility, r agency withut yur written permissin except under the fllwing circumstances: request fr the infrmatin is made by a mental health prfessinal r trainee wh needs the infrmatin t prvide services n yur behalf; the infrmatin is needed t prtect against the clear risk that yu will seriusly hurt yurself r smene else in the very near future (cnfidential infrmatin can be used against yu in curt); the infrmatin is demanded by yur insurance cmpany befre they will pay fr treatment; when the disclsure f infrmatin is t yur primary caregiver and the infrmatin disclsed is fr the cntinuity f yur treatment. 1. the right t access yur recrds. Yu have the right t read yur case recrd, treatment plan r any infrmatin the facility r agency has abut yu and t make cpies f that infrmatin. Yu may als add infrmatin t yur recrds in rder t clarify r crrect anything yu feel is inaccurate. Yur crrectins and clarificatins must be included any time yur recrd is sent t anther persn, facility, r agency. Yur request t read yur recrds my be denied if yur physician r ther mental health prfessinal believes, and has nted in yur recrd, that reading them wuld be harmful t yu. Yu have the right t petitin the curt fr an rder allwing yu t read the entire recrd if access is limited. CIVIL COMMITMENT Civil cmmitment is a curt prceeding t determine if it is necessary t send a persn invluntarily t a mental health treatment prgram because he r she is believed t have a mental disrder that makes him r her a danger t self r thers, and will benefit frm treatment. The curt may rder that a persn believed t be mentally disrdered receive a mental health evaluatin and treatment in a mental health treatment prgram. 1. Emergency Invluntary Evaluatin and Treatment A persn can be held invluntarily fr mental health evaluatin and treatment fr up t 7 days befre a civil cmmitment hearing is held, if it is an emergency. Fr a persn t be held invluntarily n an emergency basis, a licensed physician must determine that: the persn has a mental disrder; and the persn will likely inflict bdily harm t self and thers in the near future; and

9 hlding the persn invluntarily is necessary t prevent that harm. A plice ffice may als hld a persn n an emergency basis if: the persn culd therwise be arrested; r the persn has just attempted suicide; r the fficer has gd reasn t believe that the persn, because f a mental disrder, will inflict serius bdily harm t self r thers, and that hlding the persn invluntarily is necessary t prevent that harm. If yu are held in a jail by the plice because they believe yu have a mental disrder, and yu have nt been charged with a crime, yu have the right: t be taken t an evaluatin facility as sn as pssible and n later than 24 hurs frm the time yu are taken t jail; t be separated frm ther inmates; t nt be identified n recrds used nly t recrd custdy f prisners; t be prtected frm cmmitting suicide; and t be treated with the respect and dignity that every citizen wh is neither accused nt cnvicted f a crime deserves. If yu have been held fr emergency mental health examinatin and treatment, the physician, the State f New Mexic, r the evaluatin facility has 5 days t petitin the curt fr a civil cmmitment hearing if they believe yu meet thse standards. (Yu have the right t apply t be a vluntary patient at any time, but yur applicatin may be denied.) While at the evaluatin facility, yu have the right t be tld immediately rally r in writing: the reasn yu are there; what will happen if yu are cmmitted; wh is asking the curt t cmmit yu and why; that yu have the right t a hearing withing7 days; that yu have the right t a lawyer; that yu have the right t be in tuch with a lawyer and an independent mental health prfessinal f yur chsing; and that yu have the right t receive necessary and apprpriate treatment.

10 Nn-Emergency Invluntary Evaluatin and Treatment When there is n emergency but it is believed that an adult has a mental disrder and is likely t inflict serius bdily harm t self r thers, any interested persn can request the district attrney t investigate and determine if there is gd cause t cmmit that persn fr a 30-day perid. If the district attrney determines that gd cause exists, a civil cmmitment hearing is requested. The curt may then issue a summns t the persn believed t be mentally disrdered t appear at a hearing n less than 5 days frm the date f petitin. The persn is required t have a mental health evaluatin befre cming t the hearing. Anyne wh des nt shw up fr this civil cmmitment hearing r wh did nt have a mental health evaluatin befre cming t the hearing, can be held invluntarily at an evaluatin facility fr up tp 7 days befre anther hearing is held. Change Frm Vluntary Patient T Invluntary Patient A vluntary patient f client in a mental health treatment prgram wh decides t leave the prgram can be held invluntarily at the facility if the directr f the prgram r a physician believes that the persn is a danger t self r thers. On the first business day fllwing the persn s request t be discharged, the directr r physician must submit a request t the district attrney t begin civil cmmitment prceedings. A civil cmmitment hearing must be held within 5 days frm the date f the persn s request fr discharge. 30-Day Cmmitment Once a petitin fr civil cmmitment has been filed with the curt, yu and yur lawyer must receive a cpy. Yu can make the decisin t waive yur right t a hearing after talking t yur lawyer. (If yu chse t waive yur right t a hearing, yu can be invluntarily cmmitted fr up t 30 days.) At the civil cmmitment hearing yu have the right: t be represented by a lawyer; t have yur side f the stry tld; t have an independent mental health prfessinal testify n yur behalf; t crss-examine witnesses testifying in favr f the cmmitment; and t be present at any and all hearings, if yu chse, At this first hearing the curt may rder cmmitment fr up t 30 days if it is fund by clear and cnvincing evidence: that the persn, because f mental disrder, is likely t inflict serius bdily harm t self r thers (Serius bdily harm t self can include grave passive neglect which may be defined as nt taking prper care f neself, such as nt eating, nt having prper shelter, r nt taking necessary medicatin);

11 that the persn is likely t benefit frm treatment; and cmmitment will prvide the persn with the treatment they need and is the least drastic means available. Extended Cmmitment Within 21 days f the beginning f the 30 days cmmitment perid, a physician, the State f New Mexic, r the evaluatin facility may petitin the curt fr an extended cmmitment. An extended cmmitment prceeding must be held befre the end f the 30-day cmmitment unless yu chse t waive yur right t a curt prceeding. (If yu give up yur right t a curt prceeding, yu can be invluntarily cmmitted fr the extended perid.) Yu have the same rights at this prceeding as yu d at a 30-day cmmitment hearing, plus yu have the right: t request a jury trial; and t appeal the decisin t a higher curt. After the extended cmmitment hearing the curt can rder cmmitment fr up t 6 mnths unless yu have been cmmitted twice in a rw; cmmitment can then be fr up t ne year. When the cmmitment perid ends, yu can be held invluntarily nly after a new curt prceeding. While yu are serving a civil cmmitment perid, yu have all the rights described in this bklet and the same rights as any citizen, except the right t chse where yu live and t cme and g as yu please. Yu als have the right: t request the curt t re-examine yur cmmitment rder at any time. The curt must hear yur request if at least 60 days have passed since the curt last cnsidered yur cmmitment. (A friend r relative can d this fr yu.); t apply fr vluntary patient status; r t petitin fr a writ f habeas crpus. (A writ f habeas crpus tests the legality f the riginal cmmitment prcess. It can be used t declare yur riginal cmmitment invalid if any f the prcedures fr civil cmmitment were imprper. A friend r relative can petitin fr yu.) 1. Cnvalescent Status If the directr f the facility where yu have been cmmitted believes that yu have imprved and that it is n lnger in yur best interests t stay at the facility, yu can be released n cnvalescent status. The directr can rder that yu return t the facility any time it is believed that yu require in-patient treatment again, until the end f yur cmmitment perid. If yu d nt return t the facility vluntarily when such an rder is made the facility may ask the curt t hld a hearing and rder the plice t take yu back. Once yur cmmitment perid ends, yu cannt be rdered t return t the facility withut a new civil cmmitment hearing.

12 The directr can als fficially discharge yu frm the facility while yu are released n cnvalescent status. If that is dne yu cannt be rdered t return even if yur cmmitment perid has nt ended. GUARDIANSHIP AND CONSERVATORSHIP The fact that a persn is receiving mental health services, r ever has, des nt mean that he r she is incmpetent r incapacitated, nr des being invluntarily cmmitted t a treatment prgram mean that a persn is incmpetent r incapacitated. T be fund legally incmpetent r incapacitated requires a curt prceeding in which the persn wh believes smene is incmpetent r incapacitated must prve that because f a disability the persn is unable t manage his/her affairs, prperty r financial affairs r bth. If a persn is unable t manage his/her prperty and affairs effectively and there is prperty which will require prtectin, a cnservatr may be appinted by a prbate curt t manage the prperty fr the persn. If a persn is fund by the curt t be incapacitated and unable t make persnal decisins, the curt may appint a guardian t make sme r all decisins fr the incapacitated persn. During any guardianship, cnservatrship r cmpetency prceeding in curt, yu have the fllwing rights: t be represented by a lawyer; t have yur side f the stry tld; t have yur wn independent mental health prfessinal testify n yur behalf; t crss-examine witnesses; t have a private hearing, if yu chse; and t be present at the prceeding. A guardian r cnservatr may be appinted by the curt fr a specified perid f time r fr an indefinite perid. A request fr this kind f rder may be made by infrmal letter t the judge.

13 A persn can be fund incapacitated r unable t functin in limited areas. A guardian r cnservatr is then appinted t make decisins fr the persn nly in the specific areas listed in the curt rder. If it is believed that a persn is nt capable r making his/her wn treatment decisins, and interested persn can petitin the curt fr appintment f a treatment guardian. The treatment guardian has the legal authrity t make decisins abut the kind f treatment the persn will receive. Once a petitin has been filed, there must be a hearing within 3 wrking days. A treatment guardian can be appinted fr a limited amunt f time, nt t exceed ne year. At the end f that appintment a new hearing must be held befre the guardian can cntinue t have the legal authrity the make treatment decisins. Yu, yur lawyer, yur relatives, r yur guardian have the right t petitin the curt at any time t end the treatment guardianship. Befre making decisins, the treatment guardian is required t cnsult with yu and cnsider yur pinins and any previus decisins yu have made under similar circumstances. Yur, yur physician, r mental health prfessinal have 3 days after hearing the treatment guardian s decisin, t appeal t the curt. Yu have the right t be represented by a lawyer during the appeal. The curt may verrule the treatment guardian s decisin if it believes that it is nt in yur best interests. GLOSSARY Advcate: T speak ut in supprt f a psitin r cause; a persn wh speaks ut in supprt f a psitin r cause. Appeal: T challenge a curt decisin in a higher curt. Aversive Stimuli: Anything which, because it is believed t be unreasnable, unpleasant, uncmfrtable r distasteful, is used t cause a behavir t ccur less ften (des nt include talk therapies, physical restrictins t prevent harm t self r thers, r psychtrpic medicatins which are nt used as punishment). Behavir mdificatin prgrams: Prgrams designed t change a persn s behavir, usually by rewarding sme types f behavir and punishing r ignring ther types f behavir. Case recrd: The written recrd cntaining a persn s past and current treatment, therapy, behavir, persnal and family histry, evaluatins, and/r treatment plan.

14 Civil cmmitment: A curt rder requiring a persn t receive mental health evaluatin and treatment as an in-patient r ut-patient. Civil cmmitment hearing: A curt prcedure where it is decided if a persn shuld be sent invluntarily t a mental health treatment prgram because it is believed he r she has a mental disrder that makes him/her a danger t self r thers. Clear and cnvincing evidence: Prf sufficient t persuade a reasnably minded persn. Cmpetency: A persn s ability t understand the nature and effect f his/her actins and t make ratinal decisins. Cmpetent: Having cmpetency. Cnsent: Oral r written permissin. In rder fr cnsent fr treatment t be sufficient under the law, yu must be fully infrmed as t the prblem fr which the treatment is prpsed, a descriptin f the treatment and hw it wrks, the risks and cnsequences f the treatment, the likelihd that the treatment will be successful, the pssible alternatives, and the cnsequences f receiving n treatment. Cnservatr: A persn appinted by the curt t manage the mney and/r prperty fr smene wh has been fund incmpetent r incapacitated. Cnvalescent status: When a persn wh has been cmmitted as an in-patient in a treatment prgram is given permissin t leave by the directr f the prgram befre the cmmitment perid has ended. Cnvulsive therapy: Electric shck r insulin cma shck treatments. Curt rder: A judge s ruling, usually in written frm. Crss-examine: T questin a witness in curt wh has testified fr the ther side. District attrney: A lawyer elected r appinted t serve the peple within a certain gegraphical area as prsecutr fr the state. Due prcess f law: A general principle f law which guarantees that certain prcedures must be fllwed befre a persn s rights r prperty can be taken away. Evaluatin: The bservatin, testing, and diagnsis f persns believed t have a mental disrder by a mental health prfessinal; and/r the written reprt f such findings. Evaluatin facility: A cmmunity mental health prgram, a medical facility having psychiatric services available, the Las Vegas Medical Center, r if nne f these is reasnably available r apprpriate, the ffice f a licensed physician.

15 Experimental treatment: Any mental health treatment which may present significant risk f physical harm (des nt include accepted treatment used in cmpetent practice f medicine and psychlgy and supprted by scientifically acceptable studies.) Extended cmmitment prceeding: A curt hearing r jury trial where extended cmmitment is decided. Facility: The place that serves t huse a treatment prgram. Grave passive neglect: Nt taking prper care f yurself t the extent that yur life is in sme danger. Guardian: A persn appinted by the curt t make decisins as t care, custdy, and cntrl f a persn wh has been fund t be incapacitated (r is a minr). Incapacitated: T be unable, because f a disability, t make and cmmunicate decisins. Incmpetent: Lacking the ability t understand the nature and effect f ne s actins and t make ratinal decisins. Independent mental health prfessinal: A mental health prfessinal wh is nt assciated with the persn, party, prgram r agency that is bringing curt actin against a persn. In-patient: a persn receiving mental health services while living in a hspital, nursing hme, r cmmunity residential prgram such as a halfway huse r transitinal hme. Invluntary patient r client: A persn wh is rdered by the curt t receive mental health services either as an in-patient r ut-patient. Jury: A grup f impartial peple assigned at a trial r hearing t make the final decisin based n the facts that have been presented in the case. Least drastic means: The legal requirement that a persn s treatment be nr mre harsh, hazardus r intrusive than is necessary t prtect the persn frm harm; the least restrictin f a persn s physical mvements (care shuld be prvided as clse as pssible t a persn s hme). Least restrictive envirnment: The setting r place that causes the least change t a persn s nrmal pattern f living and wrking which is at the same time effective in meeting that persn s needs (It shuld be as clse as pssible t the persn s hme). Medicatin: Medicine; drugs. Mental disrder: A substantial disrder f a persn s emtinal prcesses, thught, r ability t learn which seriusly impairs judgment, behavir, r capacity t recgnize reality.

16 Mental health prfessinal: A physician r ther prfessinal wh by training r experience is qualified t prvide mental health services. Out-patient: A persn receiving mental health services frm a cmmunity mental health center, a private psychiatrist, r any ther mental health prfessinal while living independently, with friends r relatives, r in a barding hme. Petitin: A written dcument submitted t the curt asking that the curt take a specific actin. Physician: A medical dctr, including a psychiatrist. Psychlgical: Invlving the mind r emtins. Psychsurgery: Surgery n the brain t cntrl r change thughts, emtins, and/r behavir. Restraint: A device r means f limiting r restricting a persn s mvement r behavir. Seclusin: Separatin frm thers; islatin. Summns: An fficial rder t appear in curt. Testify: T make an fficial statement in curt after swearing t tell the truth. Therapy: Treatment f illness, disability, r psychlgical prblems. Treatment guardian: A persn appinted by the curt t make treatment decisins fr smene fund by the curt incapable f making r expressing infrmed treatment decisins. Treatment plan: The specific curse f actin t be taken t help a persn achieve treatment gals, mve t the least restrictive envirnment pssible, and imprve the quality f his/her life. Treatment prgram: A place r design fr prviding mental health services t a persn as an in-patient r ut-patient. Trial: The frmal examinatin f the facts f a case by a curt f law. Vluntary patient r client: A persn wh freely chses t receive mental health services, either as an in-patient r ut-patient. Waive: T give up a right vluntarily. Witness: A persn asked t testify in curt. Writ f habeas crpus: An rder by a curt t release a persn wh is cnfined, after examinatin f the legality f the persn s cnfinement.

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