SOUL BALM SPOTLIGHT: BREAKING DOWN THE BAKER ACT

JULY 11, 2019 | MMORRAN1 | EDIT

Ah, the dreaded Baker Act.

Here in Florida, we all know it. In fact we know it so well that its colloquial name has been turned into a verb: “oh no bro, I’m going to get Baker Acted!” or “they Baker Acted his ass so fast he didn’t even know what was happening.”

All jokes aside, it’s no secret this law is heavily abused and misused. Anyone with mental health issues knows to fear it for that reason.

The act itself has been shrouded in a sort of mythos for many years, legendary in the worst possible way. People gather round and tell their Baker Act stories and like a game of Telephone, the facts get jumbled beyond recognition with each telling.

No one really seems to know what the rules are except the people who now have power over you in the receiving facilities.

As they say, knowledge is power and the more you know about this law – the more power you have if and when you need to advocate for yourself in the hospital.

So gather round chilren as I break down the good, the bad, and the downright hideous parts of the Baker Act:

BUT FIRST SOME HISTORY

What if I told you the Baker Act, much feared and maligned, was actually there to improve the quality of mental health care?

I know, I laughed too.

But if I could – let me paint you a picture of what mental health care looked like in the early 1900s by telling you the harrowing tale of Mental Health America’s Founder, Clifford W. Beers.

Besides having the one of the most dope names in recorded history – Cliff had a few other things going for him: he was a fresh Yale graduate starting a new job as a Wall Street Financier roughly around 1900.

He also happened to have Bipolar Disorder, which caused him to have a particularly bad manic episode in which he attempted suicide by jumping out of a third story window. Miraculously, he survived but was greatly injured by the attempt.

He spent the next three years shuffled around hospitals in Connecticut, experiencing, shall we say, less than therapeutic care. At one point he was forced into a straight jacket for 21 nights among other horrors. He also witnessed the cruel treatment of other patients such as forced lobotomies, electro shock treatment, and solitary confinement lasting days or months.

Most institutions were underfunded and understaffed, a majority of the population still considered mental illness to be the work of the devil, and people could be admitted for any reason and held for indeterminate amounts of time. Patients lived in squalorous, often cruel conditions – put away for life for symptoms we could easily treat today.

So yeah….it was bad. Real bad.

It wasn’t until the 1940’s and 50’s that there was any great pushback in America to reform the Mental Health system. One of those said reformers was a Florida stateswoman known as Maxine Baker.

Our girl Maxine lobbied for the humane treatment of patients while institutionalized in Florida. The ensuing Florida Health Care Act of 1971 ensured that patients could only legally be held for up to two weeks instead of indefinitely, prohibited the indiscriminate admission or retention of persons without just cause, and mandated court appointed attorneys for patients. It also created bill of rights for patients undergoing psychiatric care.

This act was considered landmark legislation for its time, bringing mental healthcare back to the community versus a vast institutional system where people were just a number. It was meant to keep those with mental health issues out of the harsh legal system. Overall, it was a shining beacon of hope that’s been duplicated nationally and helped move the system lightyears forward.

But as we all know…there’s still more work to be done. But we’ll get to that later. I want to focus now on the main tenants of the Act and what they mean for you!

WHAT DOES THE BAKER ACT ACTUALLY DO?

The Baker Act provides the following protections to you while you’re in the hospital and up to 6 months after you’re discharged according to theDepartment of Child and Family Services website:

• Provide comprehensive services for persons requiring intensive short-term
and continued treatment
• Provide emergency service and temporary detention for evaluation when
required
• Admit persons to treatment facilities on a voluntary basis when extended
or continuing care is needed and unavailable in the community
• Ensure that any involuntary examination or treatment be accomplished in
a setting which is clinically appropriate and most likely to facilitate the
person’s return to the community as soon as possible
• Guarantee that the individual dignity and human rights of all persons who
are admitted to mental health facilities for examination or placement are
protected.
• Employ the least restrictive means of intervention based on the individual
needs of each person, within the scope of available services.

Basically, it entitles you to due process even if you’re considered of unsound mind and reiterates that you are to be treated humanely while in care.

HOW DOES IT WORK?

Basically when you get to the hospital, the Baker Act provides you with the following rights:

1. You have the right to a court appointed attorney at any time
2. If you have a development disability or are deemed incapable of making your own decisions (which happens, say, if you’re having a psychotic episode) a guardian advocate can be appointed for you by a judge who will adjudicate on your behalf and make sure your wishes are carried out.
3. No matter what anyone says, you can only be held involuntarily for up to 72 hours without a court order. You can be released before 72 hours but usually not before 12. Your 72 hours starts when you arrive at the facility.
4. If the facility determines that you need to involuntarily stay longer than the 72 hours, they will have to petition the court and can only keep you up to two weeks.
5. You have a right to see a physician and/or a clinical psychiatrist within 12 hours of arriving at a Baker Act Facility, if you don’t see one or both of them within that time period, your rights are being infringed upon.
6. You have the right not to be secluded and/or restrained against your will
7. You have the right to refuse medication and treatment at any time
8. You have the right to change facilities at any time if you don’t feel your care is being managed properly
9. Under certain criteria, you can actually be ordered to do an involuntary outpatient program, which is a lot better than being stuck in the hospital. There are a few extra hoops to jump through but it’s worth it.

So the Baker Act really does a lot to promote the health and well being of psychiatric patients. But as you’ll see below, it’s still not quite enough.

SOOOO…IF THE BAKER ACT IS SO GREAT, WHAT THE HEY HEY HAPPENED?

So the Baker Act itself is great, but like most legislation it runs into a few fundamental problems:

1. It’s got enough grey area to be interpreted widely, a fact exploited by LEO and doctors to shuffle patients around and get them off the streets or out of hospital beds. (Literally, folks, there are only 3 criteria to be admitted under a Baker Act and one of them is simply “has evidence of a mental disorder,” like who the heck doesn’t???)
2. It’s provisions are often forgotten, misunderstood, or just plain ignored by overwhelmed providers who, as a necessity, treat all patients as incapable.
3. Like most legislation, the Baker Act has struggled to keep up with the times. The status of mental health may have improved significantly but that doesn’t mean the laws don’t need maintenance. For instance, with the rise of school shootings – children are being pulled out of school and Baker Acted without their parents knowledge or consent; in some cases as early as two years old.

Maxine said it herself – “In the name of mental health, we deprive them of their most precious possession-liberty.”

Basically, it’s easy for people to forget that the good majority of us with mental illness, while we may sometimes not jive with the idea of being on this planet anymore, are perfectly capable of making our own choices, even in crisis.

In the end, the Baker Act is a good law with humane provisions. It’s not necessarily something to be afraid of, especially if you know a lot about it. Our job now is to take up Maxine’s torch by being advocates, consistently demanding reform, or at the very least spreading awareness like some kind of mental health Smokey the Bear.

If you want to learn more about the Baker Act itself as well as ongoing reform efforts go to the following links:

http://www.treatmentadvocacycenter.org

MENTAL ILLNESS POLICY ORG.

http://www.myfloridafamilies.com (Florida DCF)

DCF also offers online Baker and Marchman Act Training free to anyone who wants to learn. It’s a really great resource for families who want to support and understand their relatives with a persistent mental health disorder.