The Rutherford Report: State's Only In-Hosptial Courtroom at ARMC

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“We need to change the culture on this topic and make it OK to speak about mental health and suicide.”

—Luke Richardson
State's Only In-Hospital Courtroom at ARMC

There’s a courtroom inside Arrowhead Regional Medical Center (ARMC) in Colton.

But don’t try to pay a traffic ticket or show up for jury duty there because this unique courtroom only hears specific types of cases.

This court exclusively handles cases related to the Lanterman-Petris-Short Act and some probate hearings that can give doctors the right to treat patients who lack the mental capacity to make their own health care decisions.

The Lanterman-Petris-Short Act (LPS) governs involuntary commitments of patients suffering from severe mental illness in California.

The facility is located in ARMC’s Behavioral Heath Unit, and it is the only courtroom in California actually located in a hospital.

San Bernardino County decided to locate its mental health courtroom inside the County hospital years ago. Prior to the establishment of ARMC, there was a small courtroom at the former San Bernardino County Medical Center.

State law requires LPS hearings to be held in a location that is least disruptive to patients’ treatment; the courtrooms also must preserve confidentiality of the proceedings.

Hearings are held at the ARMC courtroom two days a week, and the number of cases heard during a day can range from a few patients to 20 or more.

“It’s a really fluid and unpredictable calendar,” San Bernardino Superior Court Mental Health Counselor Wayne Henkelmann said.

Typically, cases involve patients suffering from schizophrenia, bipolar disorders or other serious mental health conditions that cause them to become a danger to themselves or others. The court also handles cases where a patient is deemed gravely disabled, which means they are unable to provide for their basic personal needs such as food, clothing and shelter because of a mental disorder.

Patients often land in a hospital after being picked up by law enforcement and placed on what’s known as a 5150 hold. The name comes from the California Welfare and Institutions Code that allows people to be held involuntary for up to 72 hours for psychiatric evaluations.

There are only six designated hospitals in San Bernardino County that are staffed and equipped to provide involuntary mental health services: ARMC, San Bernardino Community, Redlands Community, Loma Linda Behavioral Medical Center, Canyon Ridge, and the Jerry L Pettis Memorial Veterans Hospital.

After the 72 hours is up, doctors must seek a judge’s approval to hold patients without their consent for an additional 14 days of treatment.

If the patient refuses to take medications, doctors can also petition for a Riese Hearing to allow for the administration of involuntary specified medications to patients during their hospitalization. However, the standards for such treatment and holds are high, and doctors must present “clear and convincing evidence” the patient lacks capacity to make their own decisions.

During proceedings, patients are represented by an attorney from a private law firm that contracts with the County and an attorney from the County Counsel’s office represents the hospital.

“Eventually, if they start taking their meds and starting feeling better and their mental health condition stabilizes, they may be discharged with a discharge plan,” Deputy County Counsel Frank Salazar said.

The Office of the Public Guardian-Conservator, which falls under the auspices of the County Department of Aging and Adult Services Director, seeks conservatorships for patients when there are no viable alternatives to provide care.

Patients under an LPS conservatorship are placed in facilities that can provide the level of care they need. It can range from commitment at Patton State Hospital to being placed at a board and care facility.

Conservatorships can be temporary—normally about 30 days—or permanent. However, even permanent conservatorships must be reestablished annually through the court.

Patients being held involuntarily also have the right to file writs of habeas corpus. When that occurs, the patient is brought before a judge who determines whether the person is still a danger to themselves or others or if they are gravely disabled.

If a judge determines there’s no legal reason to hold the patient, the patient must be discharged.
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