Last Updated: September 17, 2018
Method and Scoring: State involuntary civil commitment laws are evaluated using a 100-point grading scale. The scoring criteria is in accordance with the Treatment Advocacy Center’s values and policy preferences. Up to 50 points are awarded to a state based on the quality of its inpatient commitment law and up to 50 points are awarded based on the state’s assisted outpatient treatment law. Final letter grades are computed using the following scale:
| 97 or above A+ 93-96 A 90-92 A- |
87-89 B+ 83-86 B 80-82 B- |
77-79 C+ 73-76 C 70-72 C- |
67-69 D+ 63-66 D 62-60 D |
59 or below F |
| PART ONE: Inpatient Commitment Statute (up to 50 points) | |||
| Criterion | Citation | Specifications | Points |
| 1. Citizen access to court, emergency evaluation (5 pts) | Tex. Health & Safety Code Ann. § 573.011(a) | ☒Authorizes family/enumerated adults (3 pts) ☒Authorizes any responsible adult (2 pts) |
5 |
| 2. Quality of emergency petition process (5 pts) | Tex. Health & Safety Code Ann. § 573.012 | ☒Process specified and reasonable (2 pts) ☒Timelines specified and reasonable (2 pts) ☒Responsible entities identified (1 pt) ☐Requires certification by more than one professional (-2 pts) ☒Emergency evaluation criteria inconsistent with inpatient commitment criteria (-5 pts) (See comment below) |
0 |
| 3. Emergency hold duration (5 pts) | Tex. Health & Safety Code Ann. § 573.021(b) | ☒At least 48-hour hold allowed (3 pts) ☐At least 72-hour hold allowed (2 pts) No longer than 48 hours |
3 |
| 4. Citizen access to court, inpatient petition (5 pts) | Tex. Health & Safety Code Ann. § 574.001(a) | ☒Authorizes family/enumerated adults (3 pts) ☒Authorizes any responsible adult (2 pts) |
5 |
| 5. Quality of criteria for harm or violence to self or others (up to 10 pts) | Tex. Health & Safety Code Ann. § 574.034(a) | ☒Contains explicit criteria (10 pts) ☒Language is vague/ambiguous (-3 pts) ☐Harm must be imminent (-3 pts) |
7 |
| 6. Quality of criteria for grave disability/basic needs (up to 10 pts) | Tex. Health & Safety Code Ann. § 574.034(a) | ☒Contains explicit criteria (10 pts) ☐Language is vague/ambiguous (-3 pts) ☐Endangerment must be imminent (-3 pts) ☐Criteria require family to turn person out of home to receive treatment (-3 pts) ☐Unreasonably high risk of harm (-3 pts) |
10 |
| 7. Quality of criteria for psychiatric deterioration (up to 10 pts) | ☐Contains explicit criteria (10 pts) ☐Language is vague/ambiguous (-3 pts) |
0 | |
| SUBTOTAL | 30 | ||
| PART ONE: Extra Credit | |||
| 1. Specifies in which court a petition for inpatient commitment shall be filed (1 pt) | |||
| Extra Credit | 0 | ||
| PART ONE TOTAL | 30 | ||
| PART TWO: Outpatient Commitment Statute (up to 50 points) | |||
| Criterion | Citation | Specifications | Points |
| 1. AOT explicitly authorized (5 pts) | Tex. Health & Safety Code Ann. § 574.034(b) | ☐Requires local government to adopt (-3 pts) | 5 |
| 2. Citizen access to court for AOT (5 pts) | Tex. Health & Safety Code Ann. § 574.001(a) | ☒Authorizes family/enumerated adults (3 pts) ☒Authorizes any responsible adult (2 pts) ☐Authorizes citizen petition to mental health system only (-2 pts) |
5 |
| 3. Criteria sufficiently broad to provide actual access (up to 10 pts) | Tex. Health & Safety Code Ann. § 574.034(b) | Evaluate applicable provision only: ☐If inpatient/outpatient criteria are the same: ☐Inpatient criteria include psychiatric deterioration standard (10 pts) or ☐No psychiatric deterioration standard, adequate grave disability standard (5 pts) or ☒If outpatient criteria are distinct from inpatient criteria: ☒Allows consideration of length of treatment history ≥ 36 months (2 pts) ☐Does not exclude periods of incarceration or hospitalization (-1 pt) ☒Does not limit application to those currently dangerous or unstable (4 pts) ☒Does not limit application to those refusing service or currently lacking insight (4 pts) |
10 |
| 4. Authorizes AOT directly from community (5 pts) | Tex. Health & Safety Code Ann. § 574.034(b) | 5 | |
| 5. Procedures sufficiently detailed to guide practitioners (up to 5 pts) | Tex. Health & Safety Code Ann. § 574.037 | ☒Process specified and reasonable (1 pt) ☒Timelines specified and reasonable (1 pt) ☒Responsible entities identified (1 pt) ☒Periodic reporting to court required (1 pt) ☒Renewal process expressly specified (1 pt) |
5 |
| 6. Procedures require the treatment plan to be shared with the court (5 pts) | Tex. Health & Safety Code Ann. § 574.037(b) | 5 | |
| 7. Specifies procedures and consequences for nonadherence (5 pts) | Tex. Health & Safety Code Ann. § 574.037(c) | 5 | |
| 8. Duration of initial order (5pts) | Tex. Health & Safety Code Ann. § 574.034(g) | ☒=90 days (2 pts) or ☐>90 days (5 pts) 90 days |
2 |
| 9. Duration of continued order (5pts) | Tex. Health & Safety Code Ann. §§ 574.035(b), (h) | ☐=180 days (2 pts) or ☒>180 days (5 pts) Up to 12 months |
5 |
| SUBTOTAL | 47 | ||
| PART TWO: Extra Credit | |||
| 1. Specifies court for AOT (1 pt) | |||
| 2. Court monitoring of voluntary settlement agreements (5 pts) | |||
| Extra Credit | 0 | ||
| PART TWO TOTAL | 47 | ||
| FINAL SCORE | |
| PART ONE TOTAL | 30 |
| PART TWO TOTAL | 47 |
| TOTAL | 77 |
| GRADE | C+ |
Comment:
- While the inpatient standard requires “likel[ihood]” of serious harm to self/others, the emergency evaluation standard requires “substantial risk” of such harm.