WV lawmakers advance bill to let doctors involuntarily commit someone without contacting the courts

The West Virginia Senate is considering two related bills that would change how the state handles mental health emergencies and involuntary commitments. SB 742 would allow hospital doctors to single-handedly place someone on a 72-hour mental health hold. SB 741 would expand an existing pilot program that is evaluating how involuntary commitment cases are handled in certain counties. The bill would allow more counties to participate.

The pilot program brings together hospitals, courts, law enforcement and advocacy groups to improve how cases are reviewed and processed. It looks at things like better transportation options for patients, reviewing past cases to find improvements and setting clear standards for mental health evaluations. It also aims to make sure qualified professionals evaluate people quickly and coordinate with state hospitals to arrange admissions when needed.

Counties included in this program are Cabell, Berkeley and Ohio. Proposed new counties would include Hampshire, Morgan, Wood and Raleigh.

Supporters say expanding the program could make the involuntary commitment process more consistent, improve the quality of evaluations and provide better support for patients and families. The bill also encourages explaining the commitment process and possible treatment options clearly to the person involved. 

Brandon Hatfield, Vice President and General Counsel of the West Virginia Hospital Association, spoke on the bill and explained why the pilot program is limited to specific counties instead of being open statewide. 

“So, the idea with this is, do it in an individual jurisdiction, and then we can take best practices, go back to the legislature and maybe codify that for the state,” Hatfield said.

SB 742 would allow hospital doctors to place someone on a 72-hour mental health hold without first contacting certain court officials, such as a judge or magistrate. 

Right now, hospitals can temporarily hold someone in a mental health crisis. But, they are required to try to contact a circuit judge, magistrate or mental hygiene commissioner—a judge-appointed attorney for commitment cases—before officially starting the involuntary hospitalization process. SB 742 would remove that requirement and let an authorized hospital doctor make the decision based on their medical judgment. 

The doctor would need to believe the person has a mental illness or addiction and could be a danger to themselves or others. The doctor would also have to sign a written statement explaining why the hold is necessary.

Some believe these changes would modernize West Virginia’s mental health laws and make emergency care more responsive to real-world situations. 

“I’m happy to support this legislation,” said Sen. Rollan Roberts, R-Raleigh. “I’ve been caught in the middle of physicians, families, and patients, and we couldn’t do anything. So, to be able to give that 72-hour time slot is fabulous, and I’m glad. And I hope this legislation makes it all the way.”

However, some legal experts and advocacy groups say that giving doctors more authority over involuntary commitment without immediate court involvement can reduce oversight and possibly lead to misuse. 

The National Alliance on Mental Illness (NAMI) has stated that “involuntary civil commitment does not produce positive results for everyone, and NAMI recognizes that discussions about involuntary civil commitment and its use can be challenging and emotionally charged for both peers and family members.”

Black people are significantly more likely to be committed to psychiatric hospitals against their will, according to a study led by Harvard Medical School. 

Research suggests that’s partly because Black communities have less consistent access to preventative care, like therapy or psychiatric medication. They’re also more likely to experience stressors like poverty, food insecurity and gun violence. However, psychiatrists, particularly white ones, also have measurable, implicit biases about Black patients, according to a study from the Yale University School of Medicine. 

Doctors tend to see Black patients as less compliant and more aggressive. They’re more likely to misdiagnose their depression or mood disorders as schizophrenia. And they’re more likely to prescribe them high doses of older-generation antipsychotics that can have significant negative side effects. Black patients are also more likely to be restrained, locked in seclusion rooms and given sedatives against their wills, per reporting from Pittsburgh’s Public Source.

SB 741, the pilot program bill, still has to pass the Senate Finance Committee. SB 742, which would allow doctors to single-handedly involuntarily commit someone, will likely be up for a Senate Floor vote next Monday.