Metropolitan Police Department Washington D.C.

Subject:

Processing of Suspected Mentally
Disturbed Persons

Series    Number  Change

308      04

Effective Date

August 10, 1987

Revision Date

May 11, 1990

 

 

 

 

 

 

The purpose of this order is to establish the policy and procedures for the treatment, processing and disposition of suspected mentally disturbed persons taken into custody by members of this department. This order consists of the following parts:

 

PART I Responsibilities and Procedures for Members of the Department.

 

A.   Policy.

B.   Hospitalization of Suspected Mentally Disturbed Persons.

C.   Initiating Emergency Hospitalization Procedures.

D.   Medical Treatment of Suspected Mentally Disturbed Persons.

E.   Suspected Mentally Disturbed Persons Charged with a Criminal Offense.

F.   Service of Arrest Warrants on Patients Within a Mental Health Treatment Facility.

G.   Assisting Agents of the Commission on Mental Health Services (OMHS).

H.   Providing Transport Services for Other Law Enforcement Agencies.

I.   Juveniles.

J.   Attempted Suicides.

 

PART II Responsibilities and Procedures for Special Assignment

Personnel.

 

A.   Emergency Response Team (ERT).

 

PART III Responsibilities and Procedures for Supervisory and Command

Personnel.

 

A.   District Officials.

B.   District Watch Commanders.

C.   Emergency Response Team Officials.

D.   Director, Communications Division.

 

PART I

 

A. Policy.

It shall be the policy of the Metropolitan Police Department to treat and process suspected mentally disturbed persons in a manner  reflects a sensitivity to the needs and rights of the persons involved, and to work coopera­tively with all public and private institutitions toward providing citizens of the District of Columbia with a viable and effective mental health services program.

    

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

2 of 13

 

 

 

B.   Hospitalization of Suspected Mentally Disturbed Persons.

 

1.   There are four primary methods by which a suspected mentally dis­turbed person may enter and receive treatment at a hospital or other recognized facility for treatment and care of a mental illness.

 

a.   Voluntary Hospitalization.

Any parson may apply to any public or private hospital in the District of Columbia for admission to such hospital as a voluntary patient for the purposes of observation, diagnosis, care and treatment of a mental illness.

 

          b.   Hospitalization of Non-protesting Persons.

Qualified psychologists as well as psychiatrists may admit or refer a mentally ill person for treatment. A mentally ill person may he admitted without referral from a psychiatrist or qualified psychologist if the need for immediate admission is obvious after preliminary examination.

 

c.   Emergency Hospitalization.

Any duly accredited officer or agent of the Commission on Mental Health Services (OMHS), Department of Human Services; any officer authorized to make arrests in the District of Columbia; any qualified psychologist; or a physician of the person in question who has reason to believe that a parson is mentally Il]. and, because of such illness, is likely to in­jure himself or others if not immediately detained y, with­out a warrant, take such person into custody, transport him / her to a public or private hospital, and make application for admission thereto for purposes of emergency observation and diagnosis. Such application shell reveal the circum­stances under which the parson was taken into custody and the reasons therefore. The administrator of any private hospital may, and the administrator of any public hospital shall, admit and detain for purposes of emergency observation and diagnosis any person with respect to whom such application is made, provided that it is accompanied by a certificate from a psychiatrist, or qualified psychologist, on duty at such hospital stating that he/she has examined the person and is of the opinion that the person is mentally ill and, as result thereof, the person is likely to injure himself herself or others unless immediately hospitalized.

 

 

 

 

 

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

3 of 13

 

 

 

d.   Hospitalization Under Court Orders.

Proceedings for the judicial hospitalization of any person in the District of Columbia may be commended by the filing of a petition with OMHS by a spouse, parent, or legal guardian; by any physician, psychiatrist, or qualified psychologist; by any duly accredited officer or agent of Q4LS; or by any offi­cer authorized to make arrests in the District of Columbia. Such petition shall be accompanied by a certificate of a physician, psychiatrist, or qualified psychologist, stating that he/she has examined the person and is of the opinion that such person is mentally ill, and because of such illness is likely to injure himself/herself or others if allowed to remain at liberty; or by a sworn written statement by the petitioner that the petitioner has good reason to believe that such parson is mentally ill and, because of such ill­ness, is likely to injure himself/herself or others if allowed to remain at liberty, and that such individual has refused to submit to examination by a physician.

 

2.   Members of the force will primarily he concerned with the emer­gency hospitalization method for providing treatment. In this regard, members shall he thoroughly aware of the criteria under which they may take a person into custody t or emergency treatment, or “involuntary admission," at a mental health care facility. Upon coming into contact with a suspected mentally disturbed per­son, members of the force shall have reason to believe that the parson:

 

a.   Is likely to injure himself / herself or other persons if not immediately detained, as manifested by violent acts, or threats of violence, or by placing others in reasonable fear of such harm; or

 

b.   Is likely to injure himself/herself, if not immediately de­tained, as manifested by evidence of attempts at, or threats of, suicide or serious bodily harm, or evidence of an in­ability to provide for his/her basic human needs, including food, clothing, shelter, essential medical care, or personal safety.

 

3.   Members of the force shall take note of the fact that there is a significant distinction between the reason to believe and probable cause stan­dards. Probable cause standard normally requires personal observation on the part of the member, whereas a member may have reason to believe based upon the personal observation of others.

 

 

 

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

4 of 13

 

 

 

4.   Since there is no distinction in the law between public and private property, members of the force may take a suspected mentally disturbed person into custody f or emergency hospitalization on either public or private property, without warrant, affidavit, or certificate.

 

C.   Initiating Emergency Hospitalization Procedures.

 

1.   Upon determining that a person clearly meets the criteria of a suspected mentally disturbed person in need of emergency treatment, as outlined in paragraph B2a or b, members of the force shall prepare a Superior Court Form FO (12) - 826 (Application for Emergency Hospitalization by a Physician, Officer or Agent of D. C. Department of Human Services or an Officer Authorized to Make Arrests). Information entered on the form shall briefly, but clearly, de­scribe the actions of the person, which led the member at the scene to believe that the person presented a danger to himself/herself or others. Statements such as “the person was acting crazy upon my arrival at the scene,” are not acceptable for purposes of emergency evaluation. “Application for Emergency Hospital­ization" form shall be prepared by the member at the scene prior to having the par transported. Members shall not transport anyone for mental observation with out having in their possession a properly prepared application form. Addi­tionally, the member initiating the emergency hospitalization shall prepare a PD Form 251 (Event Report), for a “Sick Person (M.O.) to Hospital.”

 

2.   All persons meeting the criteria of paragraph B2a or b shall be transported to the Intensive Care Unit of the Emergency Psychiatric Response Division (ICU/EPRD) located at the South Community Mental Health Center on the grounds of D.C. General Hospital. If no original offense is involved, the name of the person shall not be entered on the arrest book.

 

3.   All persons being transported to the ICU/EPRD for mental observa­tion, shall be searched prior to being p1aced in a transport vehicle. Weapons, or other items which could be used to inflict injury, shall be removed and prop­erly recorded on the property book at the assigned organizational element of the transporting members. All other personal property of the person being transport­ed shall accompany the person to his/her destination.

 

 

 

 

 

 

 

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

5 of 13

 

 

 

4.   Upon arriving at the ICU/EPRD, the transporting members shall present to the admissions staff a properly prepared “Application for Emergency Hospitalization,” and shall then remain wile a determination is made as to whether the person will be admitted or released. At any time during this period should the hospital admissions personnel require and/or request the assistance of the transporting members in restraining the person being examined, such assis­tance shall immediately be rendered.

 

5.   If a decision is made not to hold or admit the person being observed, the transporting members shall offer the person transportation beck to his/her place of residence when all of the following conditions are met:

 

a.   The vehicle being operated by the members is a scout car equipped to transport persons.

 

b.   The parson’s residence is within the transporting members assigned district, or within a reasonable distance of the direct route to be taken by the members in returning to their assigned district.

 

c.   The person needs and desires such transportation.

 

NOTE:     Should any one of these conditions not be met, members shall not transport persons from the examination loca­tion.

 

6.   Upon obtaining a CCN for the PD Form 251 report, members shall notify the Telecommunication Operations Branch (Teletype) of the person involved.  Additionally, should the person be admitted at the ICU/EPRD for further evalua­tion, the member initiating the action shall make every effort to notify the Hospitalized parson’s spouse, a relative or friend, should one of these persons be aware of the hospitalization.

 

D.   Medical Treatment of Suspected Mentally Disturbed Persons.

 

1.   Should a suspected mentally disturbed person require medical treatment for an injury at the time he/she is taken into custody, the person shall be transported to D.C. General Hospital for treatment.

 

2.   If the person is successfully treated without having to be admitted, he/she shall then he transported from D.C. General to the ICU/EPRD.

 

3.   If, however, the person requires admission at D.C. General, the transporting officers shall deliver the “Application for Emergency Hospitaliza­tion” form to the ICU/EPRD for appropriate follow-up action by that facility.

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

6 of 13

 

 

 

4.  Should a suspected mentally disturbed person be in need of emergency lifesaving care upon being taken into custody, he/she shall be transported(by ambulance if necessary) to the nearest available hospital. Members of the force shall then be guided by the procedures set forth in paragraphs 2 and 3 above, as appropriate.

 

E.   Suspected Mentally Disturbed Persons Charged With a Criminal Offense.

 

1.   When it becomes necessary to charge a suspected mentally disturbed person with a criminal offense, the following procedures shall be complied with:

 

a.   When Court Is In Session.

 

(1)  The a-resting officer shall prepare a ~ Form 251, citing the appropriate offense, and shall have the arrested person booked and possessed at the Central Cellblock (the arrested parson shall then be placed in a cell, prior to presentment at court.

 

(2)  As the court will determine the need for the arrested person to undergo pretrial observation prior to case adju­dication, no Application For Emergency Hospitalization will be required.

 

(3)  Should, However, the arrested person’s mental state be such that continued presence at the ICU/EPRD be required, the procedures outlined under paragraph El b (1) below shall be followed.

 

b.   When Court Is Not In Session.

 

(1)  The arresting officer shall prepare a PD Form 251, citing the appropriate offense, and the fact that the arrested person was transported for mental observation

at the ICU/EPRD. Additionally, the arresting officer shall prepare an Application for Emergency Hospitaliza­tion, and obtain from the Watch Commander at his/her assigned organizational element Form Letter 311 (Notification of Intent to Discharge) (See Attachment “A”). This letter requests that the arresting unit be notified by St. Elizabeth’s Hospital prior to the release of a per­son against whom criminal charges have been placed. This will permit the arresting unit to respond and take custody of the parson if the case has not yet been pre­sented to the court.

 

 

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

7 of 13

 

 

 

(2)  Following booking and processing of the arrested parson at the Central Cellblock, the parson, along with the Superior Court Form FO (12) - 826 and the Form Letter 311 shall be transported to the ICU/EPRD.

 

(3)  Should it be determined by the ICU/EPRD staff that there is no cause to hold the arrested parson for further evaluation, the transporting officers shall return the arrested person to the Central Cellblock for detention and presentment to court

 

(4)  Should the arrested person be held at the ICU/EPRD for further evaluation, the arresting officer shall respond to court on the next court business day and present the case in the same manner as other hospitalized police prisoners. It shall then be the responsibility of the court to determine whether the arrested parson should be detained for the purpose of evaluating mental competency.­

 

2.   If the arrested person requires medical treatment at a hospital for an injury after being taken into custody, the parson shell be transported to D.C. General Hospital, or to the nearest available hospital should lifesaving emergency care be required. A PD Form 313 (Request For Examination) shall be prepared accordingly.

 

3. If the arrested person is treated and returned to the custody of

the transporting members, he/she shall then be taken to the ICU/EPRD for evalua­tion. However, should the arrested person ,require admission to the hospital for medical care, action relating to the posting of guards, processing for identification, and case presentment in court shall be conducted in accordance with ex­isting guidelines for hospitalized police prisoners.

 

F.   Service of Arrest Warrants on Patients Within a Mental Health Treatment Facility.

When it becomes necessary to serve an arrest warrant upon a parson undergoing mental health care as an “in-patient” at a mental health treatment facility, e.g., St. Elizabeth’s Hospital, T).C. General Hospital, the Psychiatric Institute of Washington, etc., the following procedures shall be complied with:

 

a.   Except in cases of emergency requests for police assistance, the service of arrest warrants within these facilities shall be conducted by non-uniformed personnel who have their ser­vice revolvers concealed from view.

 

 

 

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

 8 of 13

 

 

 

b.   Upon arriving at the treatment facility, members shall con­tact the person in charge, or the appropriate medical autho­rity, at the facility, and request assistance in executing the warrant in a manner which would cause the least amount of disruption to the operations of the facility. In this re­gard, members of the force shall adhere to the facility’s procedures, and/or any existing protocols between the facility and this department for conducting activities of this nature, including the securing of service weapons where re­quired, and when the safety of the members is not jeopardized by such adherence.

 

c.   It should be noted that patients in some facilities may be receiving voluntary treatment for not only mental health problems, but also for related drug or alcohol abuse prob­lems. As a consequence, federal Law relating to the privacy of such treatment prohibits a facility from even acknowl­edging that the person named on the arrest warrant is, or has keen, present in the facility, without a special court order which directs the facility to produce the person and re­leases it from the restrictions of the governing law. (See Attachment “B” for a synopsis of the applicable federal law which govern the privacy of such treatment). Therefore, upon applying f an arrest warrant, and prior to executing a pre­viously issued and still outstanding arrest warrant, on a person or suspected, to be receiving voluntary treat­ment in a medical facility other then the ICU/EPRD for a mental illness, drug abuse, or alcohol dependency, members of the force shall aiw request a court order for the compliance and cooperation of the housing facility in executing the war­rant.

 

(1)  Should court be in session at the time the parson is taken into custody, he/she shall be taken directly to court, at which time the circumstances surrounding the arrest shall be made known in order that the court may make an appropriate disposition / referral.

 

(2)  Should court not be in session at the time the parson is taken into custody, he/she shall be taken to the IOJ/ EPRD as an arrested suspected mentally disturbed parson. The medical staff at the ICU/EPRD will, as necessary, contact the facility from which the arrested person was removed for the purposes of determining the exact nature of the person’ s problem(s), and any special treatment that may be required.

 

 

 

 

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

9 of 13

 

 

 

 

(3)  If the person does not require admission at the ICU/EPRD, and is returned to the custody of the transporting members, he/she shall be taken to the Central Cellblock for court presentation.

 

(4)  Should the person require admission at the ICU/EPRD, arresting members shall comply with existing guidelines relating to the hospitalization of police prisoners.

 

All  Patients arrested on a warrant at Saint Elizabeth’ s Hospital shall be taken directly to court, and shall not be processed through, or returned to following court, the ICU/EPRD.

 

G.   Assisting Agents of the Commission    on Mental

Health Services (OMHS).

 

1.   Upon receiving a request from an agent of the Commission on Mental Health Services (OMHS) for police presence at a location to which the agent must and which the agent has reason to believe presents a danger to himself/ herself, the Communications Division shall:

 

a.   Dispatch a patrol wagon or transport car and an official to the location; and

b.   Notify the Emergency Response Team (ERT).

 

2.   Members dispatched to assist the OMHS agents shall remain with the agents until such time as it is determined that:

 

a.   The person being interviewed presents no danger to the agents, at which time the members shall return to service; or

          b.   The  being interviewed requires hospitalization and,

due to his/her violent state, must be transported in a police vehicle.

 

3.   When transport services are provided by this department from a location at which a OMHS agent is present, the agent will be responsible for executing a proper Superior Court Form  FO (12) - 826.

 

4.   Members who transport a mentally ill person at the request of a OMHS agent shall be responsible for notifying the Communications Division, Tele­communications Operations Branch (Teletype), of the person's name and the location from which removed.

 

a.   A PD Form 251, “Sick Person M.O. to Hospital", shall be prepared following delivery of the person to the hospital.

 

Publication

 

Effective Date

Page Number

General Order 308.4

 

August 10, 1987

10 of 13

 

 

 

b.   Any necessary notifications to family members or guardians of the hospitalized parson will be made by agents of OMHS.

 

H.   Providing Transport Services For

Other Law  Enforcement Agencies.

 

1.   Upon request, this department will provide transportation of suspected mentally disturbed persons taken into custody by other law enforcement agencies, e.g., U.S. Secret Service, U.S. Capitol Police, Police, etc., to the ICU/ EPRD. However, the agency member initiating the emergency hospitalization shall provide this department and transporting members with a prepared Superior Court Form P0 (12) - 826. The transporting members shall prepare a TO Form 251, and notify the Telecommunication Operations Branch (Teletype) of the name of the person hospitalized.

 

2.   Juveniles.

 

Juveniles taken into custody as suspected mentally disturbed persons shall be processed in the same manner as adults, with the exception that copies of TO Forms 251 and 379 shall be prepared end forwarded to the Youth Division.

 

3.   Attempted Suicides.

 

Members responding to the scene of an attempted suicide, or investig­ating a case of this nature, shall search for and take possession of medicine bottles, containers, etc., the contents of which ware taken internally by the patient. These items shall be forwarded to the hospital where treatment is to be administered, via the member who accompanies the patient. It is important to the attending physician to )cow the ingredients of the poison or agent taken; this be ascertained from the label or, in case of a prescription, by contacting the drugstore that filled the prescription. It shall be the responsibility of the transporting and/or accompanying member to retain possession of the evidence and turn it over to either a member of the Homicide Branch responding to the hospital or to the member handling the case.

 

 

 

 

IF:RJB:ABK:ilp                                                    General Order No. 308.4

Attachment "A" to General Order No. 308.4

 

GOVERNMENT OF THE DISTRICT OF COLUMBIA

METROPOLITAN POLICE DEPARTMENT

WASHINGTON, D. C. 20001-2188

 

 

 

 

Superintendent

Saint Elizabeth’s Hospital

Washington, D. C. 20032

 

Dr Superintendent:

 

I am hereby requesting notification of release to the community by Saint Elizabeth's Hospital to this department of any hospital plan to discharge

 

or otherwise release                             . who was admitted to

Saint Elizabeth’s Hospital after being criminally charged by the Metropolitan Police Department.

 

I am also requesting the disclosure of information regarding whether the patient's mental condition would permit him to be brought to court for a hearing. The dis­closure of this information is necessary for law enforcement purposes, under (b)(7) of the Privacy Act. 5 U.S.C.. Section 552a. To assure the continued custody of this person and assure the availability of this person for court appearances.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

42 USC 117S Sec. 408.

Confidentiality of Patient Records

 

(a) Records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any drug abuse prevention function conducted, regulated or directly or indirectly assisted by any department or agency of the United States shall, except as provided in a subsection (c), be confidential and be disclosed only for the. purposes and under the circumstances expressly authorized under subsection (b) of this section.

 

(b)(1) The content of any record referred to in subsection (a) may be disclosed in accordance with the prior written consent of the patient with respect to whoa such record is maintained, but only to such extent, under such circumstances, and for such purposes as may be allowed under regulations prescribed pursuant to subsection (g).(2)     Whether or not the patient, with respect to whom any given record referred to in subsection (a) of this section is maintained, gives his written consent, the content of such record may be disclosed as follows:(A)To medical personnel to the extent necessary to meet a bona fide medical emergency.(B)To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or -program evaluation, but such personnel may not identify, directly or indirectly, any individual patient in any report of such research, audit, or evaluation, or otherwise disclose patient identities in any manner.(C)  If authorized by an appropriate order of a court of competent jurisdiction granted after application showing good cause therefore. In assessing good cause the court shall weigh the public interest and the need for disclosure against the injury to the patient, to the physician-patient relationship, and to the treatment services. Upon the granting of such order, the court, in determining the extent to which any disclosure of all or any part of any record is necessary, shall impose appropriate safeguards against unauthorized disclosures.

 

(c)Except as authorized by a court order granted under subsection(b) (2) (C) of this section, no record referred to in subsection (a) may be used to initiate or substantiate any criminal :charges against a patient or to conduct any investigation of patient.

 

(d)The prohibitions of this section continue to apply to records concerning any individual who has been a patient, irrespective of whether or when he ceases to be a patient.

 

(e)  The prohibitions of this section do not apply to any interchange of records -­(1)  within the Armed Forces or within those components of the Veterans’ Administration furnishing health care to veterans, or

(2)between such components and the Armed Forces.

 

(f)         Any person who violates any provisions of this section or any regulation issued pursuant to this section shall be fined not sore than $500 in the case of a first offense, and not more than $5,000 in the case of each subsequent offense.

 

 

(g)         The Director of the Special Action Office for Drug Abuse Prevention, after consultation with the Administrator of Veterans’ Affairs and the heads of other Federal departments and agencies substantially affected thereby, shall prescribe regulations to carry out the purposes of this section. These regulations may contain such definitions, and may provide for such safeguards and procedures, including procedures and criteria for the issuance and SCC of orders under subsection (b) (2) (C), as in the Judgment of the Director are necessary or proper to effectuate the purposes of this section, to prevent circumvention or evasion thereof, or to facilitate compliance therewith.

 

42 CFR 2.65

Investigation and Prosecution of Patients--Rules

(a)    Applicability . This section applies to any application by an investigative, law enforcement, or prosecutorial agency for an order to permit disclosure of patient records for the purpose of conducting an investigation or prosecution of an individual who is, or who is believed to be, a present or former patient in a program.

 

(b)    Notice. Except where an order under $2.66 is sought in conjunction with an order under this section, any program with respect to whose records an order is sought under this section shall be notified of the application and afforded an opportunity to appear and be heard thereon.

 

(c)    Criteria. A court may authorize disclosure of records pertaining to a patient for the purpose of conducting an investigation of or a prosecution for a crime of which the patient is suspected only if the court finds that all of the following criteria are met;

 

(1)         The crime was extremely serious, such as one involving kidnapping, homicide, assault with a deadly weapon, armed robbery, rape or other acts causing or directly threatening lose of life or serious bodily injury, or was believed to have been committed on the premises of the program or against personnel of the program.

(2)      There is a reasonable likelihood that the records in question will disclose material information or evidence of substantial value in connection with the investigation or prosecution.

(3) There is no other practicable way of obtaining the information or evidence.

 

(d)    Scope. Both disclosure and dissemination of any information from the records in question shall be limited under the terms of the order to assure that no information will be unnecessarily disclosed and that dissemination will be no wider than necessary. Under no circumstances may an order under this section authorize a program to turn over patient records in general, pursuant to a subpoena or otherwise, to a grand jury or a law enforcement, investigative, or prosecutorial agency.

 

(e)    Counsel. Any application to which this section applies shall be denied unless the court makes an explicit finding to the effect that the program has been afforded the opportunity to be represented by counsel independent of counsel for the applicant, and in the case of any program operated by any department or agency of Federal, State, or local Government, is in fact so represented.