Patients’ Rights Advocacy2022-05-04T15:14:43-04:00

Patients’ Rights Advocacy

People with mental health diagnoses have the same legal rights and responsibilities guaranteed to all other persons by the Federal Constitution and laws and the Constitution and laws of the State of California. In California, many of these rights are specifically emphasized and spelled out in state law, including the right to be free from abuse and neglect, the right to privacy, dignity, and humane care, and the right to basic procedural protections in the commitment process. The Patients’ Rights Advocates of the Mental Health Association of Alameda County (MHAAC) support and advocate on the behalf of clients and patients and their treatment.

MHAAC’s Patients’ Rights Advocates Program

Three County Mental Health Administrations in the Bay Area contract with MHAAC to provide Patients’ Rights Advocacy (PRA) services. Eight PRA in Alameda County, two PRA in San Mateo County and one PRA in Marin County make up the team staffing MHAAC’s Patients’ Rights Advocates Program. The team’s cultural and experiential diversity enhances their skills in protecting the civil rights of individuals receiving mental health treatment. Through the performance of their statutory duties, they support mental health consumers’ voices and their right to effective, humane, and respectful treatment that is provided in compliance with laws that protect their civil rights and the right to treatment that is least restrictive of personal liberty.

The program responds to questions and complaints from consumers being treated in psychiatric hospitals/facilities and from consumers who are residents of long term facilities or of adult residential facilities, who feel one or more of their rights have been denied.

County Patients’ Rights Advocates serve all mental health consumers, those who receive treatment in an outpatient setting and consumers being treated in a facility, regardless of whether they have health insurance, or whether they have public or private insurance. Our team recognizes that clients who are being held and treated involuntarily or in a locked facility are particularly vulnerable and their experiences are often disempowering. For this reason, we dedicate a higher percentage of our time serving clients located in locked facilities.

Anyone with a question or concern about treatment of a client receiving mental health services in Alameda, San Mateo or Marin County is welcome to call. Listed below are the services that the Patients’ Rights Advocates perform for clients. Some of the services provided to consumers also serve to support family members and treatment providers.

  1. Advocates Investigate complaints received of suspected abuse/neglect or violations of patients’ rights. In cases where complaints are substantiated, the program assists facilities to develop solutions and approaches to prevent future violations.
  2. Advocates monitor psychiatric facilities for compliance with codes and regulations related to mental health treatment and patients’ rights. The program advises facilities in their practices and procedures for maintaining compliance with mental health statutes. There is particular focus on statutes governing patients’ rights and regulating due process for clients subject to involuntary detention and treatment within mental health facilities.
  3. Advocates represent clients in hearings related to involuntary detention/treatment. Mental health consumers have the same legal and constitutional rights of all citizens. Advocates represent clients’ interests and present their positions in court proceedings legally mandated to safeguard clients’ liberties and due process rights in accordance with basic principles of the constitution.
    1. Advocates provide representation at Certification Review Hearings, automatically provided clients who are involuntarily detained in locked treatment facilities beyond the initial 72-hour detention (after a 5150 expires).
    2. Advocates provide representation at Capacity (Riese) Hearings, held when a doctor petitions for court authority to administer psychotropic medication to an involuntarily detained client who objects to taking the medication. In these hearings, the court must rule whether the doctor presents enough evidence to prove the symptoms of a mental illness are interfering with the client’s rational thought process. The PRA assists the client to demonstrate their capacity to understand information and their ability to weigh risks and benefits of the proposed medication. The advocate’s duty includes ensuring the doctor provides the client with facts needed to make an informed decision about accepting the prescribed medication. If the court believes the doctor proves their case, the client can be ordered to take the prescribed medication.

When the Patients’ Rights Advocate represents a client in one of these hearings, that advocate works on behalf of the consumer and presents legal arguments to support the position of their client. Advocates are not members of any treatment team and are not involved in clinical decisions. Advocates represent the expressed interest of their clients.

  1. Advocates provide education to consumers, facility staff members, family members and the general public. They give presentations on subjects related to patients’ rights, the interests of family members, laws governing involuntary treatment, and the right to self-determination. Education for consumers focuses on exercising our voices to take charge of our recovery and empowerment to make decisions and have input into treatment planning.
  2. Advocates provide consultation to treatment staff and administrators of locked facilities. They offer answers to questions such as how to best respect patients’ rights, which safety concerns are good cause for denial of some patients’ rights due process in initiating involuntary detention/treatment, hearings, and confidentiality. The advocacy staff can also answer questions from outpatient mental health providers, family advocacy programs, and anyone with concerns about the rights of mental health consumers. Providers are encouraged to consult with Patients’ Rights Advocates in any case where they are unsure whether a treatment decision may result in denying a client’s right and need to ensure they are in compliance with laws governing due process and patients’ rights in their effort to meet the clinical needs of their patients.

We hope that you will reach out to us. We are happy to answer your individual questions on the phone or schedule a presentation for your group, where many individuals can learn in an interactive manner that will deepen your understanding of the importance of the rights our society values.

Frequently Asked Questions

What are the criteria for involuntary detention?2022-05-04T15:26:33-04:00

A person can be detained and treated involuntarily under the criteria presented in WIC sections 5150, 5250, 5260, 5300, 5352.1, 5350, and 4011.6. Under WIC 5150 a person may be involuntarily taken to a mental health facility for psychiatric evaluation. This evaluation can last up to 72 hours. During this period, only a doctor may discharge the person.

These are the three criteria that meet the requirements for involuntary detention:

  1. The person presents a danger to him/herself.
  2. The person presents a danger to others.
  3. The person is incapacitated to the point of being gravely disabled. That means the person cannot provide for their own food, clothing, and/or shelter, or cannot make use of the food, clothing, and shelter available to him/her.

One or any combination of the above may be the reason for detaining an individual for an evaluation. These criteria apply only as a result of mental disorder. After the 72-hour evaluation period, a psychiatrist may petition for treatment up to an additional 14 days. The psychiatrist must file a “5250” or “certification for up to 14 days of intensive psychiatric treatment” with superior court. By law, the client must receive a copy of this certification.

The client is then entitled to an automatic hearing called a certification review hearing. This hearing is informal and a Patients’ Rights advocate from the Patients’ Rights Advocacy office represents the client.

At any point during an involuntary detention, a person may request a writ of habeas corpus. This is not automatic, and a request must be filed with the public defender.

It is important to remember that at any point during a 14-day hold, a person may be discharged based on physician’s discretion. A certification can last up to 14 days.

What is Legally Considered Good Cause for Denial of Patients Rights?2022-05-04T15:26:54-04:00

Some rights can only be denied if “Good Cause” exists. The facility must show it has good reason to believe that there is “good cause” because:

  • The exercise of the right would be injurious to the patient, or;
  • It would seriously infringe on the rights of others, or;
  • The facility would suffer serious damage if the right is not denied;
  • And there is no less restrictive way of protecting these three interests.
What rights do patients have in a hospital?2022-05-04T15:28:23-04:00

The specific rights afforded mental health clients are addressed in different places within the law. It is important to remember that in addition to the rights listed below, being a mental health client, whether voluntary or involuntary, does not automatically negate the rights that all citizens enjoy. The following laws contain information directly pertaining to patients’ rights:

  1. Welfare and Institutions Code (WIC), Division 4,5, & 6
  2. California Administrative Code (CAC), Title 9, Article 6
  3. California Administrative Code (CAC), Title 22

Rights that pertain specifically to mental health clients are stated in WIC 5325.1 and 5325. They include:

  1. The right to wear one’s own clothes
  2. The right to keep and use one’s own personal belongings
  3. The right to keep and spend a small amount of one’s own money for canteen expenses and small purchases
  4. The right to see visitors each day
  5. The right to have reasonable access to telephones, both to make and receive confidential calls or to have such calls made for them
  6. To have ready access to letter writing materials, including stamps, and to mail and receive unopened correspondence
  7. The right to refuse any type of convulsive treatment
  8. The right to refuse any type of psychosurgery in which brain tissue is destroyed
  9. The right to see and receive the services of a patients’ rights advocate who has no direct or indirect clinical or administrative responsibility for the person receiving mental health services (WIC 5325 and CAC 862)
  10. The right to receive materials notifying each person of his or her rights within 24 hours of admission to a facility in a language or modality in which the person may comprehend. The State Department of Mental Health furnishes copies of the Patients’ Right Handbook in English, Spanish, and Chinese. The facility is responsible for supplying each patient with a copy.

WIC 5325.1

  1. The right to receive treatment services which promote the potential of the person to function independently and which are provided in ways that are least restrictive of the individual’s personal liberty
  2. The right to dignity, privacy, and humane care
  3. The right to be free from harm, including unnecessary or excessive physical restraint, isolation, medication, abuse, or neglect.
  4. Medication shall not be used as punishment, for the convenience of staff, as a substitute for program, or in quantities that interfere with the treatment program
  5. The right to prompt medical care and treatment
  6. The right to religious freedom and practice
  7. The right to participate in appropriate programs of publicly supported education
  8. The right to physical exercise and recreational opportunities
  9. The right to be free from hazardous procedures

WIC 5325

  1. The right to have one’s record remain confidential (there are exceptions specified in the legislature).
  2. The right to not be discriminated against for filing a complaint.
  3. The right to have the same legal rights and responsibilities guaranteed all other persons unless specifically limited by federal or state laws or regulations.

Parents, guardians, or conservators may not waive any of the rights specified in WIC 5325.

WHAT ARE THE RIGHTS THAT MAY BE DENIED FOR GOOD CAUSE (W&I CODE §5325)?2022-05-04T15:28:59-04:00

The professional person in charge of the facility or their designee may, for good cause, deny any of the following rights:

  1. The right to wear one’s own clothing.
  2. The right to keep and use one’s own personal possessions, including toilet articles, in a place accessible to the patient.
  3. The right to keep and spend a reasonable sum of one’s money for small purchases.
  4. The right to have access to individual storage space for the person’s private use.
  5. The right to see visitors each day.
  6. The right to have reasonable access to telephones, both to make and receive confidential calls or to have such calls made for them.
  7. The right to have ready access to letter-writing materials, including stamps and to send and receive unopened mail and correspondence.
WHO CAN A PERSON CONTACT IF OUR RIGHTS HAVE BEEN VIOLATED?2022-05-04T15:30:09-04:00

Patients have the right to see and receive the services of a Patients’ Rights Advocate.

A Patients’ Rights Advocate can:

  • Educate us about our rights.
  • Advise us on the options we have when our rights are violated unjustly or punitively.
  • When working with a Patients’ Rights Advocate, we have the right to meet with them in private to discuss any concerns we may have.

*** Upon admission to a facility, each patient shall immediately be given a copy of a State Department of Mental Health prepared patients’ rights handbook..***

*** Patients’ Rights Posters should be in a visible area where all patients’ can have access to them.***

***A number to the Patients’ Rights Advocate Office is usually posted along with the Patients’ Rights poster***

ALAMEDA COUNTY
(510) 835-2505
alameda_ptadvocate@mhaac.org
SAN MATEO COUNTY
(650) 341-1889
smcpra@mhaac.org

MARIN COUNTY
(415) 473-2960
marinpra@mhaac.org

WHAT IS REQUIRED FOR THERE TO BE INFORMED CONSENT FOR TREATMENT WITH MEDICATION?2022-05-04T15:31:38-04:00

Voluntary Patients

If you are a voluntary adult patient, you have the right to consent to or refuse taking antipsychotic medications (except in an emergency). You may be treated with antipsychotic medications only after the hospital has completed the informed consent process, which is defined below.

Involuntary Patients

If you are on an involuntary hold, you have the right to refuse treatment with antipsychotic medications unless the situation is an emergency or a hearing officer or a judge has determined that you are incapable of making this decision.

The Informed Consent Process

Before you give your consent to take any antipsychotic medication, your doctor must first explain to you the following:

  1. The reasons for your taking this medication and the benefits that you can expect
  2. Your right to withdraw your consent at any time
  3. The type and the amount of medication and how often you must take it
  4. The common side effects from taking the medication, the effects that you are most likely to experience, and how long the doctor expects you will need to take the medication
  5. Alternative treatments that are available (if any)
  6. The potential long-term side effects of taking the medication
What rights do conservatees have?2022-05-04T15:21:55-04:00

Barring a court determination at the time the conservatorship is appointed, a conservatee retains the right to:

  1. Have the privilege of possessing a license with the DMV
  2. Enter into contracts
  3. Vote
  4. Possess a firearm pursuant to subdivision (e) of Section 8103
  5. Refuse or consent to treatment relating to the conservatee’s being gravely disabled
  6. Refuse or consent to medical treatment (except in emergency cases in which the conservatee faces loss of life or serious bodily injury)

At all times, a conservatee retains the rights listed in WIC 5325 and 5325.

For more information, please click the link below for the California Patients’ Rights Handbook.

English  |  Spanish  |  Tagalog  |  Vietnamese  |  Cantonese  |  Farsi

Call Now

To Connect with an Advocate

If you have a question, concern, or complaint regarding mental health care that you or a loved one received in Alameda County, call our Patients’ Rights Advocacy team today at (510) 835-2505. If you are a San Mateo County resident, call (510)-701-9728; if you are a Marin County resident, call (415) 473-2960.

Call Now