Mental Health Crisis Support (Title 25)

What is Emergency Detention?

Emergency detention is the legal process in which a police officer or examiner, defined as an individual who is licensed as a psychiatrist, physician, advanced practitioner nurse, physician’s assistant, psychologist, professional counselor, addictions therapist, clinical social worker, or marriage or family therapist, detains a person who is reasonably thought to be a danger to themselves, others, or who is unable to meet basic needs, as a result of mental illness.

Harm to self: There must be evidence of, or a substantial probability for, physical harm to the person and evidence of recent threats, or attempts, at suicide, or serious bodily harm.

Harm to others: There must be evidence of, or a substantial probability for, physical harm to others as shown through a recent homicidal act, attempt, or threat, or other violent act, attempt or threat, which places others in reasonable fear of serious physical harm.

Inability to Meet Basic Need: The person must demonstrate behavior by recent acts, or lack of action, due to mental illness, that s/he has been unable to satisfy the basic needs for nourishment, essential medical care, shelter, or safety. In this case, there must be a substantial probability that death, serious physical injury, serious physical debilitation, destabilization due to not taking prescribed psychotropic medications, or serious physical disease, will occur right away, unless the individual receives prompt and adequate treatment for the mental illness.

This document is intended to summarize the processes of Emergency Detention, as described in the Wyoming State Statute 25-10-109, which can be found at https://legisweb.state.wy.us.

What does “detained” mean? Where are you detained?

“Detained,” in this context, means that an individual has been taken into custody at a hospital or suitable facility appropriate under the circumstances. The individual may NOT be held at a jail or criminal detention center, except in extreme emergency or if no reasonable alternative is available.

Who can detain someone under this law?

A law enforcement officer or an examiner can make the initial decision to detain an individual under this law.

The First 24 hours

Upon being detained, the officer or examiner responsible will write a statement regarding the facts of the emergency detention. A copy of this statement will be given to the detained individual, any subsequent examiner, and the designated gatekeeper. If treatment for the detained individual is necessary, and the individual consents, it may be provided.

A gatekeeper is an individual who understands the emergency detention process and may coordinate with, and provide guidance to, the courts and detained individuals. Gatekeepers may also testify in court. They do not provide inpatient psychiatric treatment.

When detained, the law enforcement officer in charge will immediately contact the person responsible for the individual, if known, and explain the situation to them. For any other person to be contacted, the detained individual, or his/her guardian, must sign a release of information form. A preliminary assessment of the individual will be scheduled within 24 hours, and will be conducted by a licensed health or mental health professional. If the person is found to not be mentally ill or a danger to self or others, the person must be released.

If the preliminary assessment finds that the person is mentally ill and a danger to self or others, s/he will be temporarily detained for a period no longer than 72 hours, excluding Saturdays, Sundays, and legal holidays.

If detained, what happens in the next 48 hours?

A preliminary hearing must occur within 72 hours of the emergency detention (excluding Saturdays, Sundays, and legal holidays). The individual detained, his/her guardian, and his/her attorney will be given notice of the preliminary hearing. This hearing cannot be delayed unless requested by the detained individual, parent/guardian, or his/her attorney.

If the court finds that the detained individual is not mentally ill, the individual will be released. If the court finds the individual is mentally ill, it can order continued detention for not more than ten (10) days. The court, at the request of the individual or his/her attorney, may extend this    period. The court will also determine the individual’s competence (ability) to make informed decisions regarding treatment and the need for psychotropic medications. If found to be incompetent, the court may order the administration of such medications in order to stabilize the mental health of the individual.

Who pays for all of these costs?

The county in which the individual is detained is responsible for the costs of transportation and treatment provided within the first 72 hours of detention, including weekends and legal holidays. Medical care related to suicide attempts or serious bodily harm will be provided, and the county will cover these costs. The county will also cover court and attorney fees for Wyoming residents, and the Wyoming Department of Health will handle costs for non-residents.

Download a pdf version of this information: Emergency Detention Process.

If you are concerned about a family member or loved one, call your local police department’s crisis intervention line or send a text message to the Crisis Line at 741-741. You can also call the Substance Abuse & Mental Health Ombudsman at 888.857.1942.

*This section does not apply to individuals who have been committed to the hospital pursuant to a criminal proceeding.

Involuntary Hospitalization is a process that follows on from an Emergency Detention (please see the tab above or download the Emergency Detention Process handout).

This document is intended to summarize the processes of Involuntary Hospitalization, as described in the Wyoming State Statute 25-10-110, which can be found at https://legisweb.state.wy.us.

Who decides if an individual will be involuntarily hospitalized?

The decision to have an individual undergo involuntary hospitalization is made by a court of law.

Where does the hospitalization occur?

The individual will be admitted into a designated hospital or appropriate alternative facility, such as a veteran’s facility or federal agency facility, dependent on the facility’s ability to provide appropriate care and treatment.

When the proceedings for involuntary hospitalization have begun, the court provides the individual with notice of the purpose of the proceeding, the identity and authority of the examiner, the right of the individual to seek, or be appointed, legal counsel, the basis for  the proposed hospitalization, and that a hearing will be held if warranted.

The courts will appoint an examiner to the individual in question to conduct an assessment and to provide a written report of any findings, regarding the history and mental illness of the individual. This assessment will happen no later than seven (7) days from the date of notice. If the examiner  reports that the individual is not mentally ill, the court will stop the proceeding. If the examiner reports that the individual is mentally ill, the court will fix a date for a hearing.

At this hearing, if it is determined that the individual is mentally ill, the court will order and organize his/her hospitalization and subsequent required transportation. The court will also notify his/her next of kin or person responsible for care and custody, and will determine his/her competency (ability to make decisions) regarding treatment and prescribed psychotropic drugs, which the court may order the administration of based upon psychiatric review. The court may also suspend proceedings pending voluntary treatment, and order any disposition for which private resources are available and which is consistent with the best interest of the individual and with public safety. The individual will undergo a progress evaluation within three months of their admission to the facility.

At any point of the process, it may be determined if Directed Outpatient Commitment is a possible option. Directed Outpatient Commitment is when treatment continues, but is provided by a court ordered facility in an outpatient setting. This option may require periodic reporting, the continuation of medication, restriction of travel, drug and alcohol use, and additional reasonable  specifications ordered by the Court.

Additionally, an individual who has shown marked improvement may be considered for Convalescent (recuperating) Leave. This Leave is contingent on the individual having a plan  of treatment on an outpatient, or community based treatment provider, basis. Before one (1) year is completed of  Convalescent Leave status, and not less than yearly after, the hospital will reexamine the facts, and if it is decided that hospitalization is no longer likely, a report of  discharge will be made to the court and county attorney. The facility that granted the convalescent leave can also readmit the individual as an involuntarily hospitalized patient, if there is a reasonable belief that this is for the best interest of the  individual. Any individual who is on Convalescent Leave for two (2) continuous years will be discharged.

If Directed Outpatient Commitment and/or Convalescent Leave are not considered appropriate, the Involuntary Hospitalization will continue, and the individual will undergo progress evaluations every six (6) months.

Who pays for all of these costs?

The county in which the individual is detained or in which involuntary hospitalization proceedings are brought, is responsible for the costs of transportation and treatment provided within the first 72 hours of detention, including weekends and legal holidays. Medical care related to suicide attempts or serious bodily harm will be provided, and the county will cover these costs. The county will also cover court and attorney fees for Wyoming residents, while the Wyoming Department of Health will handle costs for non-residents.

Always call 911 for emergencies. If you are concerned about a family member or loved one, call your local police department’s crisis intervention line or send a text message to the Crisis Line at 741-741. You can also call the Substance Abuse &  Mental Health Ombudsman at 888.857.1942. For more information, go to https://health.wyo.gov/mhsa.

Download this document in pdf form here: Involuntary Hospitalization Process.

Click Here to find a Community Mental Health Center   The Mental Health Ombudsman can advocate for you or your family to help you access appropriate services, resolve problems, provide information, and other advocacy at no charge. To learn about the Mental Health Ombudsman Click Here or call them at (888) 857-1942.

Chris S. Stipulated Agreement
In 2002, the State of Wyoming entered into the Chris S. Stipulated Agreement to address adequate and appropriate facilities and services for persons within the state of Wyoming with mental illness.

Olmstead Decision
Olmstead v. L.C. is a United States Supreme Court decision. Under the Americans with Disabilities Act (ADA), individuals with mental health disabilities have the right to live in the community rather than in institutions. The Court found that unjustified isolation of a person with a disability is a form of discrimination under Title II of the ADA. You can find more about Olmstead via an internet search. Click here to find the Court decision.

Wyoming State Statute 35-22-301 through 35-22-308 defines the criteria for Psychiatric Advance Directives.  A Psychiatric Advance Directive allows people to make advance treatment decisions while they are stable and able to make treatment decisions which will guide their treatment should they become unstable. The focus of the law is on stabilization of the person and restoration to competence.

Download a document that can be used to Write Your Own Psychiatric Advance Directive.

When a person is emergently detained through the Title 25 process, one option for the court is to determined if Directed Outpatient Commitment is a possible option.

Directed Outpatient Commitment is when a court orders treatment through an outpatient setting. This option may require periodic reporting, the continuation of medication, restriction of travel, drug and alcohol use, and additional reasonable specifications ordered by the Court.