Involuntary Commitment (IVC) Procedure

⚖️ IVC Criteria

• Person has a mental illness and is dangerous to self or others, or has a mental illness and is in need of treatment in order to prevent further disability or deterioration that would predictably result in dangerousness.
• Person has a substance use disorder and is dangerous to self or others.

⚠️ Special Considerations

• Separate the patient from other patients for safety
• 1:1 / Line of Sight until a provider has assessed and ordered a lower level of observation
• Does the patient have a guardian?
• Check for advance directives / psychiatric advance directives
• Interpreter needed? The petition documentation has a field for this — determine now to avoid delays at the magistrate's office

📋 Procedure Checklist

• Identification & Assessment
• ✓ Staff member who witnesses or is involved in a high-acuity patient event reports to the patient's nurse or the nursing supervisor
• ✓ Nurse or nursing supervisor notifies the provider, the counselor/social worker (when available), and the patient advocate and administrator on call when appropriate
• ✓ Provider assesses the patient In consultation with team members, the provider may decide to suspend or continue the IVC process
• Team Decision
• ✓ A decision may be made to convene treatment team / urgent team
• ✓ If appropriate, the patient is brought to treatment team or urgent team occurs
• ✓ Decision is made to pursue a Petition for Involuntary Commitment
• ✓ DHHS Police are contacted and asked to stand by on property ☎️ 828-230-7491
• Preparation
• ✓ Treatment team delegates roles and responsibilities to staff and designates a petitioner During business hours: Ideally the physician goes to the magistrate, but another staff designee with first-hand knowledge may go if the provider is unable to.
  Overnight / after hours: The provider should remain at the hospital. A staff member with first-hand knowledge is designated and sent to the magistrate's office.
• ✓ Petition documentation is completed by the treatment team The correct legal paperwork is titled: Affidavit and Petition for Involuntary Commitment
• ✓ Ensure the "facts" section of the petition documentation describes observable behaviors and clinical findings, not legal conclusions Avoid terms like "assaulted," "harassed," "battered," "threatened" — magistrates cannot accept these as fact. Describe the specific behavior instead.
• Signing & Filing
• ✓ DO NOT sign the petition before leaving JFK. The petitioner must sign the petition in front of the magistrate — the magistrate must witness the signature. Petitioner takes the unsigned petition to the Buncombe County Magistrate's Office. All new petitions go to the Magistrate's Office regardless of the day or time. 📍 20 Davidson Drive, Asheville, NC 28801  |  ☎️ 828-250-4698
• ✓ Petitioner signs the petition under oath before the magistrate
• ✓ Custody Order for Involuntary Commitment is generated by the Magistrate's office
• Transport & Transfer
• ✓ Patient will remain supervised by staff until taken into custody
• ✓ Confirm which receiving facility will accept the patient Call Mission Hospital Psych Intake (828-641-5043) or other facility before law enforcement transport if possible
• ✓ Emergency Transfer Packet is completed prior to law enforcement arrival
• ✓ An order is written for either a LOA or a discharge order Discharge order in rare instances in which JFK secures confirmation that the patient will be admitted by the receiving hospital
• ✓ Debrief with law enforcement when they arrive
• ✓ Patient is transferred into law enforcement custody
• Follow-Up
• ✓ Report is called to Mission Hospital Charge Nurse and Psych Intake Charge: ☎️ 828-213-1863  |  Psych Intake: ☎️ 828-641-5043
• ✓ Patient is placed on LOA or discharged in Epic once they have left the facility
• ✓ A discharge note is written by the provider (if applicable)
• ✓ Provider documents clinical findings supporting IVC criteria in a Significant Event note Document clinical facts only — petition language should not appear in the medical record
• ✓ Patient advocate and administrator on call are notified of above events by nursing if not yet contacted Advocate: ☎️ 828-231-6763  |  AOC: ☎️ 828-450-9406

📞 Important Contact Information

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