Baker Act

Baker Act Features

The Baker Act is the informal name for the Florida Mental Health Act (FS 394). It includes:

• Definitions of mental health terms, services, and treatment programs
• Descriptions of where and how treatment should be offered to children and adults
• Differences between patients who are voluntary and those who are involuntary
• Procedures for admitting, transferring, and discharging patients between facilities
• Patient rights and grievance procedures
• Rules regarding patient transportation

Rules

Patients who are able to give expressed and informed consent can be admitted as voluntary patients. These are individuals who make a knowing and willful decision for psychiatric treatment without any element of force, fraud, deceit, duress, or another form of constraint or coercion.

A person can be taken to a receiving facility for an involuntary examination if there is reason to believe he or she is mentally ill and because of his or her mental illness has refused an exam or is unable to determine whether an exam is necessary. People can be “Baker Acted” if they are a serious danger to self or others, or if they are likely to suffer from neglect or harm if current behavior continues.

A certificate for an involuntary examination may be initiated by any one of the following:

• An Ex Parte order from the court
• Law enforcement officers
• Physicians
• Licensed clinical psychologists
• Psychiatric nurses
• Licensed clinical social workers

Emerald Coast’s Suggestions

Call Ahead
If you anticipate a patient will be coming to Emerald Coast, please call ahead to alert the admissions staff. Staff will review clinical information and will get approval for the admission.

Within a few minutes, you will be notified if it is appropriate to transfer the patient to Emerald Coast or another facility. Remember, involuntary patients MUST go to the nearest receiving facility. Staff will be happy to assist you in getting the patient to the appropriate place for help.

Be Prepared
The original BA52 form MUST accompany the patient. Before calling law enforcement to transport, call Emerald Coast for an approval to admit and then fax us the patient’s face sheet and BA52.

Quick Guide for Law Enforcement Officers

Sometimes it’s hard to know if you should “Baker Act” someone. You want to be a responsible officer and do the right thing to protect individuals and those nearby, but you’re not sure whether to take a person to jail or to initiate the Baker Act and take the person to a receiving facility.

This guide has been developed by the Mental Health Coalition of Pinellas County to help you make that decision in the field. We have outlined some common behaviors of those in crisis and summarized things to be on the lookout for.

Key Points

1. Your role is not to diagnose. However, if you have reason to believe someone appears to be mentally ill, you can decide if that person may be putting himself or herself or others in danger and meets the criteria for a complete evaluation.
2. You do not need to witness all the behaviors personally. You can consider credible eyewitness accounts from others as you determine the need for further assessment.
3. Officers must complete two forms when initiating the Baker Act: Report of Law Enforcement Officer Initiating Involuntary Examination (CF-MH 3052a) and Receiving Facility–Part I (CF-MH 3100).

Behaviors to Look For
Individuals with mental illness who may need further evaluation typically exhibit a combination of the following behaviors, characteristics, or indicators of their illness:

• Behaviors: rapid speech, flight of thought, no eye contact, quick movements, disconnected speech patterns, constant moving or pacing, trouble concentrating, mood changes quickly and frequently from the highs to the lows, disorganized thoughts, disoriented to time or place, acts of violence, cutting self, combative or aggressive behavior, inappropriate dress or nudity
• Hallucinations: sees people who are not there, hears voices telling them to hurt themselves or others, reports that the television is suggesting harm to others, turning the head as if listening to an unseen person
• Self-care issues: insomnia or increased sleep, has not eaten for days, not taking prescribed medications, home is in disarray, neglects household, property or personal hygiene (to the point of putting self or others at risk)
• Feelings: low self-esteem with feelings of hopelessness or helplessness, flat affect (not reacting with much feeling or interest)
• Suicidal risks: has weapons or access to weapons, speaks about previous attempts, makes direct comments about dying or hurting self, evidence of previous attempts such as scars on the wrists
• Elderly issues: wandering at night, leaving things on the stove unattended, not eating or sleeping or caring for personal needs, unrealistic fears, uncontrollable anxiety, confusion, quantity and age of unused foods in the home
• Substance use: excessive use of prescribed medications, use of alcohol or illegal substances while taking medications. (If substance use appears to be the only issue, the Marchman Act may be more appropriate.)

NOTE: If you have any doubts, don’t forget to contact your CIT Officers (Crisis Intervention Training) or one of the receiving facilities.