BY: NATASHA JASPERSON
The use of involuntary mental health examinations on children, originally designed for adults experiencing crises, has become a significant concern across multiple states in the U.S. Laws like Florida’s Baker Act, officially the Florida Mental Health Act of 1972, allow for the involuntary evaluation of individuals believed to have a mental illness or pose a danger to themselves or others. While these laws were meant to ensure public safety and provide essential care, their misuse has led to distressing and traumatic experiences for many children and teens. Although the Baker Act is specific to Florida, similar laws exist nationwide, underscoring a widespread issue.
According to Mental Health America, involuntary commitment should be reserved for situations where a person is unable to live safely within the community, and no suitable alternatives are available. There must be clear evidence of likely harm that is serious, imminent, and physical. However, not all states uphold these standards, and children who may not need emergency psychiatric care are often caught up in a system that doesn’t always protect their best interests. Bacardi Jackson, managing attorney for the SPLC’s Children’s Rights Practice Group, emphasizes that such measures should be extremely rare and criticizes the frequent use of the Baker Act in Florida.
Every state has laws allowing for the involuntary examination of individuals, including minors, who show signs of a mental health crisis. Authorized personnel, such as health professionals, law enforcement officers, and judges, can initiate these examinations if they believe a person may be a danger to themselves or others. Yet, the criteria and duration of these holds vary widely across states. For example, while New Hampshire permits an emergency hold of just six hours, Louisiana allows holds for up to 15 days. The Treatment Advocacy Center reported that most states (43 out of 51) align with their recommendation for a minimum of 48-hour emergency holds.
The disparity in the number of minors subjected to involuntary examinations across states highlights a significant inconsistency in how mental health crises are addressed. In 2018, Florida reported the highest number, with 36,078 minors undergoing involuntary holds, far exceeding other states. California followed with 21,679 minors, while Colorado reported 8,038. In contrast, Virginia saw 2,208 minors, and Wisconsin recorded 693. Connecticut had just 3 cases, illustrating a dramatic difference from other states. These numbers suggest varying approaches to mental health intervention and a lack of standardized criteria or practices nationwide. It is important to note that not all states report the number of minors involuntarily examined, leaving gaps in the data and making it difficult to understand the national scope of this issue comprehensively.
Carolyn Gorman, a policy analyst at the Manhattan Institute, stated, “We would not want to see involuntary holds exceed 2-6% of the population.” This threshold aims to balance the need for mental health interventions with concerns about overuse or unnecessary confinement. In 2018, Florida’s youth population (age 5-17) of 3,082,114 had an involuntary hold rate of 1.17%. In comparison, Colorado’s youth population (age 5-17) in 2018 was 930,256 and had an involuntary hold rate of 0.86%.
It is essential to recognize that no child should undergo an involuntary examination for behavior stemming from a developmental disability like autism. Developmental and intellectual disabilities are not mental illnesses, and mental health facilities are not equipped to address the unique needs of these children. Despite this, children with these disabilities are sometimes subject to involuntary holds, highlighting a gap between policy and practice.
Gorman said, “It appears at face value that some of these involuntary mental health evaluations are being given inappropriately to kids who do not meet the level of requiring involuntary intervention or who do not have symptoms of serious mental health conditions. In other words, the wrong youth are being pushed into mental health treatment. This is problematic because if a child was thought to need involuntary mental health evaluation for behavior or symptoms stemming from a different, non-mental-health problem, then that different problem is not getting addressed, making the child worse off when a different intervention might be available. There will be fewer mental health resources going to kids who do have behavior or symptoms stemming from mental health problems.”
The involuntary examination of minors can have profound emotional and psychological impacts on students. The trauma of being forcibly removed from a familiar environment, sometimes in handcuffs, can lead to lasting psychological harm. Advocates have reported cases of youth experiencing nightmares and regression in social behaviors, illustrating how distressing these experiences can be. Caitlyn Clibbon, a policy analyst for Disability Rights Florida, noted that these traumatic events can lead to children becoming fearful of attending school, an environment they once enjoyed. The stigma associated with being subjected to involuntary examination can also hinder a child’s long-term mental health, leading to anxiety, depression, and a general mistrust of adults and authority figures.
Advocates warn that children who undergo these experiences might develop a fear of seeking future help, fearing that they might face similar treatment again. This could discourage them from accessing necessary mental health support. The distrust fostered by these experiences can extend beyond the school, causing children to lose faith in teachers, medical professionals, police officers, and other adults, thus undermining the very support networks meant to help them.
Southern Poverty Law (SPL) published a list of recommendations to help decrease the amount of involuntary examinations for minors. These recommendations include providing robust training at schools, residential treatment facilities, and law enforcement in de-escalation techniques, narrowing the criteria for involuntary examinations, notification of parents before an involuntary examination is requested, fully integrating mobile crisis teams, and credentialed school psychologists and social workers to help de-escalate and stabilize children experiencing crises, allowing parents, guardians, or medical professionals to transport children to psychiatric facilities or other non-traumatic crisis stabilization units instead of police, and if police escort is required that transportation occurs in the least restrictive method possible. SPL also stated, “School administrators, police departments, psychiatric facilities, and residential foster care facilities must be held accountable for any illegal or unnecessary use that fails to meet the stringent legal criteria required for such a consequential intervention.”
Michael Marden, Executive Director for the Florida Association of School Resource Officers, said, “Bringing a parent or guardian into the crisis is one alternative. If the parent/guardian is willing to seek help for the juvenile, the Baker Act shouldn’t be applied. Having licensed mental health counselors on campuses also mitigates Baker Acts as they have the ability to assist prior to law enforcement involvement. Many districts have specific schools that educate children with developmental disabilities and are staffed with the appropriate personnel to address those concerns. In our district, those schools typically have a lower statistic of Baker Acts than the general population campuses. This can be attributed to staff and school resource personnel being aware of individual education plans for students and understanding their challenges. ”
The inconsistencies across states, combined with the distressing nature of involuntary holds, especially when minors are transported by law enforcement, sometimes in handcuffs, underline the need for a more humane, consistent, and child-centered approach to mental health crises. Current practices can often do more harm than good, leaving children feeling traumatized and stigmatized. A nationwide standard that prioritizes de-escalation, appropriate care, and parental involvement is essential to ensure that children receive the support they need without unnecessary trauma. Every child deserves to be treated with dignity, with interventions that address their unique needs, rather than a one-size-fits-all approach that may not serve their best needs.
