Baker Act fails kids, families

Recently, and prior to

COVID-19, there were several news stories about the potential inappropriate use of Florida’s involuntary mental-health commitment law, commonly called the Baker Act, in its use for children and teens.

Many children and families report being traumatized by Florida’s outdated law, including children being handcuffed, dragged out of schools, separated from their parents, or parents not knowing where their children are being sent. There are too many cases that children, parents, and health professionals are not the ones making these calls, and this process is burdensome and actually harmful to many patients and families.

The law needs to be reformed to give more rights to children, their families, and mental-health professionals.

The antiquated Baker Act law basically does not allow children and parents to request admission on their own, except for one condition. The law allows for voluntary admission only if the child and parent have a hearing in front of a judge, which is so onerous and burdensome, it rarely happens, according to a report from the Florida Department of Children and Families. Therefore, admissions for minors are almost always involuntary.

An emergency room health professional or a mental-health professional can initiate a Baker Act after an evaluation of the child in a controlled environment and in discussion with the child’s family.

However, DCF says almost 70% of involuntary Baker Acts for children and adolescents are ordered by law enforcement officers, who are not trained in the diagnosis of mental illness and often make these decisions in the middle of a crisis.

Perhaps the crisis would be solved just from removing the child from the environment, without saying the child should be hospitalized for 72 hours. But the law requires an officer to initiate a Baker Act if they are concerned, and this gives them the authority to order a hospitalization for up to 72 hours.

Even if a mental-health professional is the one who decides to initiate a Baker Act, they are required by law to contact law enforcement to transport the child to a hospital. As previously stated, once a Baker Act is initiated, the child and family cannot bring the patient to a hospital on their own.

Being forced to call law enforcement itself can be traumatic, as officers have the right to place children and adolescents in handcuffs if the officers feels that would be the “safest” mode of transport.

Once a child is admitted to a psychiatric hospital, the doctor is required to start the process of asking a judge whether or not the child can stay in the hospital. According to the law, a judge must make the final decision for a child to stay, and requires the parent and child to appear in front of a judge with attorneys and the doctor to discuss why the child should or should not be in the hospital.

Some aspects of the current Baker Act law are helpful for cases when children and parents disagree with each other or with a health professional about whether a hospitalization is needed. Part of the intent with the current law is to ensure patients are not kept in a hospital against their will without due process, so children and their families should have an opportunity and a right to voice disagreement with a hospitalization.

However, children and parents have very little say about whether a hospitalization is even necessary, how the child is transported to a hospital, and whether the child stays in the hospital after being admitted.

There are several ways the law can be changed, and the following examples are all taken from other states’ laws:

■ Remove the ability of law enforcement to order a child be hospitalized for up to 72 hours; limit their authority to only transport individuals to an emergency room or hospital setting, in the least restrictive manner possible.

■ Utilize medical transport or other forms of transport rather than law enforcement.

■ Give parents the right to transport their children to an emergency room or hospital.

■ Give parents the right to admit young children to a hospital with a health professional’s order.

■ Allow adolescents to voice agreement to a parent’s decision for an admission.

■ Consider whether older adolescents like 16- or 17-year-olds can admit themselves to a hospital with a health professional’s order.

■ Only utilize the legal system when there is disagreement between parents and health professionals, or between parents and adolescents. Still allow disagreements to be heard.

If you would like any of these changes to be considered, please contact your state legislator.