October 11, 2023

On August 16, 2023, Governor Murphy signed S3929/A5182 into law, extending the amount of time that hospitals can involuntarily hold an individual from 72 hours to 144 hours. (Read Full Bills Here: 3929_R3.PDF (state.nj.us)/ 5182_R2.PDF (state.nj.us)).

The law (P.L.2023 c.139) “revises certain requirements for involuntary commitment for mental health treatment” including two concerning amendments:

1. Hospitals can now apply to the courts for additional time to hold individuals on involuntary status for a total of 144 hours (formerly 72 hours).
2. Hospitals no longer need a certificate of need to create additional psychiatric beds that can be used for involuntary commitment purposes.  

Opposing the Extension

More than 45 mental health, disability rights, civil justice rights, and racial justice organizations including MHANJ collaboratively addressed a letter to Governor Murphy in early summer 2023 urging him to veto the bill. The letter described core concerns regarding doubling the length of involuntary commitment, including:

• Exceeding National Standards of Care. 72 hours is the national standard for involuntary commitment. New Jersey should not be an exception.
• Trauma. Involuntary commitment is most often very traumatizing; individuals are sometimes restrained and even held on gurneys in emergency rooms without receiving appropriate care. This bill doubles the amount of time an individual may be subjected to such trauma. 
• External Factors. Efforts to locate community psychiatric beds are often compounded by circumstances outside of the individual's control, such as lack of insurance coverage, criminal justice involvement, lack of housing, or co-occurring physical and mental disabilities. Rather than holding individuals without appropriate treatment for an additional three days, community investments should be enhanced to connect individuals to community-based treatment.

Read the full letter here: s3929_a5182_sign-on_letter_to_governor_murphy_final.pdf (aclu-nj.org)

This law was enacted without adequate data to understand the extent and reality of this issue in our state. It also disregards the impact and efficacy of holding people for double the time. Ultimately, this law accepts the current failures of New Jersey’s mental health care system without resolving delays to accessing care or expanding community supports to improve outcomes for the individual. 

What Can I Do?

This law has the potential to require your loved one to be involuntarily held in a setting sometimes without appropriate psychiatric care. While the law has a sunset clause of 24 months, it is critical that the administration works on solutions to resolve this issue.

MHANJ recommends the following for individuals who may have experienced a mental health crisis:

1) Complete a Psychiatric Advance Directive (PAD):

• Individuals who may have experienced a mental health crisis in the past should consider completing a Psychiatric Advance Directive (PAD).
• A PAD is a written legal document that expresses the wishes of an individual about their mental health care regarding what types of treatments, services and other assistance he or she might want, or not want, during a personal mental health crisis.
• Completing a PAD will allow yourself or a loved one to express your care preferences in times of crisis and must be followed by healthcare professionals in the event of a crisis.
• For more information about PADS and to access the full form, please visit: Psychiatric Advance Directives (mhanj.org)

2) Report Any Instances of Lack of/Inappropriate Treatment While on Involuntary Status To:

• Mental Health Association in New Jersey (MHANJ)
• Website: The Mental Health Association of NJ (mhanj.org)
• Phone: (800)-367-8850
• Disability Rights New Jersey (DRNJ)
• Website: NJ’s Designated Protection & Advocacy Agency | Disability Rights New Jersey (disabilityrightsnj.org)
• Phone: 1-800-922-7233
• American Civil Liberties Union New Jersey (ACLU-NJ)
• Website: Seeking Legal Help From the ACLU-NJ | ACLU of New Jersey
• Phone: (973)-642-2084

Stay Vigilant to Assure the Law Does Not Become Permanent

Upon signing the bill into law, Governor Murphy issued a statement in which he noted that the law “is not intended to serve as a permanent framework."

(Read the Governor’s Full Statement Here: Microsoft Word - S3929 (d31hzlhk6di2h5.cloudfront.net)).

The hospital systems supporting this law have noted that hospital ERs do not have the staffing, capacity, or expertise to provide high-quality, specialized mental health services. Individuals are sometimes held on gurneys in hospital emergency departments with limited care and virtually no treatment planning. Rather than fixing a fragmented system of mental health care, this bill accepts system failures by denying appropriate treatment to the individual in crisis.

Moving forward, New Jersey must find alternative solutions versus extending involuntary holds which may further traumatize the individuals being held, strain facilities and their staff, and will not provide individuals with the care they need to achieve wellness in this critical period of time.

The MHANJ is a statewide non-profit organization that strives for children and adults to achieve victory over mental health and substance use disorders.

Contacts:

Carolyn Beauchamp – President & CEO (cbeauchamp@mhanj.org)

Barb Johnston - Director, Policy & Advocacy (bjohnston@mhanj.org)