Involuntary commitment is the judicial procedure for compelling you to receive court-ordered mental health treatment, even if you refuse, either on an inpatient or outpatient basis.
Chapter 122C of the North Carolina General Statutes outlines the typical commitment procedures:
- initiation of the process by petition before a magistrate or the clerk of superior court.
- Law enforcement will take custody of you and transport you for commitment examination by a local commitment examiner. You may receive more than one commitment examination during your court ordered detention.
- a second examination once admitted to a 24-hour psychiatric hospital, if inpatient commitment is recommended by the commitment examiner(s); and
- district court review of involuntary commitment within ten days of the date you are taken into law enforcement custody on the most recent custody order if you have been admitted to a 24-hour psychiatric facility.
The right to counsel is established in G.S. 7A-451(b) for commitment proceedings. Counsel is appointed after admission to a 24-hour psychiatric facility, but delays may occur.
The commitment examiner may detain you for consecutive seven-day detentions after the issuance of a custody order if a 24-hour psychiatric facility is not immediately available.
This creates a possibility of detention continuing based upon a commitment examiner’s opinion, but without immediate appointment of counsel. If you are being held in a temporary bed at in a hospital emergency room or a mental health crisis station, you may contact the clerk of court in the county where you are being detained to inquire about appointment of counsel prior to admission to the 24-hour psychiatric facility.
Special counsel, private assigned counsel, or an attorney you have hired will attend court with you. A meeting with you is important in preparing the case, with follow-up meetings as necessary. During that meeting, the attorney will determine whether you want to demand discharge at the district court hearing. Other responsibilities of the attorney include reviewing your medical/psychiatric records, consulting with treatment providers, and talking with potential witnesses and opposing counsel. Remaining calm during the stress of involuntary commitment will help your attorney defend you against continued restraint of your liberty.
You will appear before a judge; the judge will hear testimony about your hospitalization.
The hearing is not open to the public. Only your doctor, the hospital’s lawyer, your lawyer, and the judge must be there if you contest.
Family members and hospital workers may be asked to testify about the circumstances led to your hospitalization.
You may attend the hearing if you like but are not required to.
Discharge: Your doctor may let you go before the hearing. If this happens, the court case is dismissed.
Voluntary: If you think you need treatment, you may change your legal status from an involuntary patient to a voluntary patient with your doctor’s agreement.
Inpatient (treatment in the hospital): You may be committed by court order for up to 90 days at the initial hearing. After the first rehearing, you can be committed for up to 180 days. At subsequent hearings, you can be committed for up to 365 days (one year). Your doctor can discharge you before your time is up.
Outpatient (treatment outside the hospital): If your doctor agrees, you can stay in your hometown with supervision and treatment. You can be treated outside the hospital for up to 90 days after the first hearing, or up to 180 days after re-hearings. If you miss appointments, don’t take your medication, or become dangerous, you can be brought back to the hospital.
Split Commitment: Your treatment can be part inpatient and part outpatient, totaling the allowed time by your hearing. For example, 30 days inpatient and 60 days outpatient if the order is for 90 days.
Substance Abuse Commitment: If you use drugs or alcohol and may harm yourself or others, the court may send you to a treatment center for up to 180 days. Your doctor can also keep you at the hospital for up to 45 days. The treatment center decides your treatment once you are there.
Definitions:
Danger to Others: Past infliction or threats of serious bodily harm, or extreme property destruction with a probability of recurrence.
Danger to Self: Inability to manage daily responsibilities, risk of serious physical debilitation without treatment, or suicidal tendencies.
Procedures: Sworn petitions, factual basis for custody orders, appointed counsel for indigent respondents, mandatory examinations within 24 hours, and hearings within 10 days.
Commitment Outcomes: Outpatient commitment with community supervision, inpatient commitment with restricted rights, or dismissal if criteria are not met.
Note: This is a brief overview. For more detailed information, refer to the Defender Commitment Manual or the North Carolina Civil Commitment Manual.
The Process:
Initiation of IVC: A petitioner files an affidavit and petition with the clerk of superior court or magistrate, seeking involuntary commitment (IVC) based on G.S. § 122C-3(11)(a)-(b). The petition must detail underlying facts supporting the commitment request. If deemed appropriate, a custody order is issued to law enforcement to transport the individual to a 24-hour facility for a qualified physician examination within 24 hours (G.S. § 122C-263). The clerk must appoint counsel if the respondent is indigent (G.S. § 122C-268, 7A-450).
Examinations and Hearings: The first examination assesses if the individual meets G.S. § 122C-3(11) criteria for outpatient or inpatient commitment. If outpatient, rights are maintained but forcible detention or medication is not permitted. For inpatient, a second examination within 24 hours of arrival at a 24-hour facility confirms the need for inpatient care (G.S. § 122C-266). A hearing must occur within 10 days, requiring clear, cogent, and convincing evidence for commitment (G.S. § 122C-268). The court considers past conduct and probability of future prohibited conduct, with rights and freedoms significantly restricted if commitment is upheld. Appeals must be filed within 30 days of the final judgment (G.S. §§ 122C-224.3(h); 122C-272; Rule 3 of the North Carolina Rules of Appellate Procedure).
If you are a voluntary patient, or an involuntary patient that changed their status to voluntary, and you think you no longer need treatment, you can ask to be discharged by completing the Request for Discharge form. You will be allowed to leave within 3 days (72 hours) unless your doctor feels you need further treatment. If this is the case, the doctor may petition/re-petition you and begin the IVC process.