Involuntary commitment and treatment of adults

The district psychiatrist is authorized to issue two types of orders regarding involuntary commitment or treatment:

• An order for emergency involuntary examination or confinement.
• A non-emergency order for involuntary examination or confinement.

What are the criteria for issuing an order for involuntary examination or confinement

An order for emergency involuntary examination or commitment can be issued if all the following conditions are met:

• The person is in a psychotic state.
• There is imminent danger to self or others as a result of the person's psychotic state.
• The person refused voluntary examination or confinement.

A non-emergency order for commitment can be issued if the following conditions are met:

• The person is in a psychotic state.
• As result of the person’s psychotic state there is a risk of suicide or danger to self that is not imminent, or the person is causing severe emotional distress to others in a way which deprives them of a normal life.
• The person refused voluntary examination or confinement.

What is the process of the involuntary commitment

• The district psychiatrist issues an emergency or non-emergency involuntary commitment order according to the criteria listed above.
• The order must specify the name of the hospital or the psychiatric ward where the person is going to be committed.
• Transfer to confinement — one of the companies that carries out involuntary commitment orders will transfer the person.
  • In case of emergency involuntary commitment, the company must reach the person within 90 minutes.
  • In case of non-emergency involuntary commitment that is not an emergency, the company must reach the person within 24 hours after the order was issued.
• A Psychiatric examination and the decision regarding the need for commitment must be completed by a psychiatrist sanctioned by the district psychiatrist.
• Before being committed, the need for commitment will be explained to the person being committed.
• They will be given the option of committing themselves voluntarily. If they refuse, an involuntary commitment order will be issued.

How long can someone be involuntarily committed

• The commitment order is valid for 7 days.
• The hospital staff or the psychiatric department can apply to the district psychiatrist to extend the order by an additional 7 days.
• The hospital staff must apply to the district psychiatric board if they are interested in extending the commitment beyond 14 days.
• The hospital staff or the psychiatric ward staff can grant a conditional release during the period of involuntary commitment.
• The attending staff sets the date of discharge from involuntary commitment based on the mental condition of the person. If the family objects, the district psychiatrist must be consulted.
• If the district psychiatrist rejects the family's objection to the discharge, they can request to keep the person in confinement by appealing to the district psychiatric board.

How to appeal a district psychiatrist decision

• Family or an attorney of someone who is committed involuntarily can appeal the district psychiatrist's decision.
• You can submit the appeal to the district psychiatric board. The board must convene to discuss your appeal within 5 days.
• You can appeal the decision of the district psychiatric board by appealing to the district court.

The director of a psychiatric hospital or the director of a psychiatric ward in a non-psychiatric hospital, can order involuntary commitment for 48 hours only if all the following conditions are met:

• The person is in a psychotic state
• They are a danger to themselves or others because of their psychotic state
• They refuse to be admitted voluntarily
• They are on hospital premises

The staff can apply to the district psychiatrist (Hebrew) in order to issue an order for involuntary commitment if during a period of 48 hours after the order was issued, they feel it necessary to extend confinement, and only if the person refused admission.

Who can request involuntary commitment or observation by court order

• A person in police custody suspected of committing a crime or who has been indicted, can apply to the court in person or through their legal counsel to issue an order for examination or observation while in involuntary commitment. This is in order to determine if their mental state led to their actions or whether they are unfit to stand trial due to their mental state.
• The police can also ask the court for an examination or observation of the suspect or person in custody.
• If the person has been indicted the court can also order a psychiatric examination or observation on its own initiative.

How long is the psychiatric observation by court order

Usually the observation will take place in a psychiatric hospital and take from 3 days up to 3 weeks. Based on the examination by the psychiatric hospital’s medical staff, the court will decide whether the person’s mental state requires involuntary commitment or what the mental state of the suspect was at the time of the offense.

How to appeal the court's decision

The court’s decision can be appealed in due course of law.

If a person is committed involuntarily by court order, only the district psychiatric board is authorized to decide on their discharge or on their conditional release from the hospital.