Admission to Psychiatric Facility

HRS div. 1, tit. 19, ch. 334, pt. IV

in effect

HRS §334-59 Emergency examination and hospitalization

334-59. Emergency examination and hospitalization (a) Initiation of proceedings. An emergency admission may be initiated as follows: (1) If a law enforcement officer has reason to believe that a person is imminently dangerous to self or others, the officer shall call for assistance from a mental health emergency worker designated by the director; provided that if a law enforcement officer is unable to reach a mental health emergency worker telephonically or has reason to believe the situation to be unstable to a degree that a delay of greater than two minutes would result in serious harm to the individual, others, or property, the law enforcement officer may act to gain control of the individual. Once the law enforcement officer has gained control of the individual, the law enforcement officer shall call for assistance from a mental health emergency worker designated by the director; provided that the law enforcement officer shall document why the situation necessitated that the law enforcement officer gain control of the individual. Upon determination by the mental health emergency worker that the person is imminently dangerous to self or others, the person shall be transported by ambulance or other suitable means to a licensed psychiatric facility or other facility designated by the director for further evaluation and possible emergency hospitalization. If a crisis intervention officer has probable cause to believe that a person is imminently dangerous to self or others, the crisis intervention officer shall call a mental health emergency worker to determine if the person shall be transported by ambulance or other suitable means to a behavioral health crisis center designated by the director as determined by a mental health emergency worker. A law enforcement officer may also take into custody and transport to any facility designated by the director any person threatening or attempting suicide. The law enforcement officer shall make application for the examination, observation, and diagnosis of the person in custody. The application shall state or shall be accompanied by a statement of the circumstances under which the person was taken into custody and the reasons therefor, which shall be transmitted with the person to a physician, advanced practice registered nurse, or psychologist at the facility. As used in this paragraph, "crisis intervention officer" has the same meaning as defined in section 353C-1; (2) Upon written or oral application of any licensed physician, advanced practice registered nurse, psychologist, attorney, member of the clergy, health or social service professional, or any state or county employee in the course of employment, a judge may issue an ex parte order orally, but shall reduce the order to writing by the close of the next court day following the application, stating that there is probable cause to believe the person is mentally ill or suffering from substance abuse, is imminently dangerous to self or others and in need of care or treatment, or both, giving the findings upon which the conclusion is based. The order shall direct that a law enforcement officer or other suitable individual take the person into custody and deliver the person to a designated mental health program, if subject to an assisted community treatment order issued pursuant to part VIII, or to the nearest facility designated by the director for emergency examination and treatment, or both. The ex parte order shall be made a part of the patient's clinical record. If the application is oral, the person making the application shall reduce the application to writing and shall submit the same by noon of the next court day to the judge who issued the oral ex parte order. The written application shall be executed subject to the penalties of perjury but need not be sworn to before a notary public; or (3) Any licensed physician, advanced practice registered nurse, physician assistant, or psychologist who has examined a person and has reason to believe the person is: (A) Mentally ill or suffering from substance abuse; (B) Imminently dangerous to self or others; and (C) In need of care or treatment, may direct transportation, by ambulance or other suitable means, to a licensed psychiatric facility or other facility designated by the director for further evaluation and possible emergency hospitalization. A licensed physician, an advanced practice registered nurse, or a physician assistant may administer treatment as is medically necessary, for the person's safe transportation. A licensed psychologist may administer treatment as is psychologically necessary. (b) Emergency examination. A patient who is delivered for emergency examination and treatment to a psychiatric facility or a behavioral health crisis center shall be provided an examination, which shall include a screening to determine whether the criteria for involuntary hospitalization listed in section 334-60.2 persists, by a licensed physician, medical resident under the supervision of a licensed physician, or advanced practice registered nurse without unnecessary delay, and shall be provided such treatment as is indicated by good medical practice. If, after the examination, screening, and treatment, the licensed physician, medical resident under the supervision of a licensed physician, or advanced practice registered nurse determines that the involuntary hospitalization criteria persist, then a psychiatrist or advanced practice registered nurse who has prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization shall further examine the patient to diagnose the presence or absence of a mental illness or substance use disorder, further assess the risk that the patient may be dangerous to self or others, and assess whether or not the patient needs to be hospitalized. If it is determined that hospitalization is not needed, an examination pursuant to section 334-121.5 shall be completed. (c) Release from emergency examination. If, after examination, the licensed physician, psychiatrist, or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization determines that the involuntary hospitalization criteria set forth in section 334-60.2 are not met or do not persist and the examination pursuant to section 334-121.5, where required, has been completed, the patient shall be discharged expediently, unless the patient is under criminal charges, in which case the patient shall be returned to the custody of a law enforcement officer. (d) Emergency hospitalization. If the psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization who performs the emergency examination has reason to believe that the patient is: (1) Mentally ill or suffering from substance abuse; (2) Imminently dangerous to self or others; and (3) In need of care or treatment, or both, the psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization shall direct that the patient be hospitalized on an emergency basis or cause the patient to be transferred to another psychiatric facility or other facility designated by the director for emergency hospitalization, or both. The patient shall have the right immediately upon admission to telephone the patient's guardian or a family member including a reciprocal beneficiary, or an adult friend and an attorney. If the patient declines to exercise that right, the staff of the facility shall inform the adult patient of the right to waive notification to the family, including a reciprocal beneficiary, and shall make reasonable efforts to ensure that the patient's guardian or family, including a reciprocal beneficiary, is notified of the emergency admission but the patient's family, including a reciprocal beneficiary, need not be notified if the patient is an adult and requests that there be no notification. The patient shall be allowed to confer with an attorney in private. (e) Release from emergency hospitalization. If at any time during the period of emergency hospitalization the treating physician determines that the patient no longer meets the criteria for emergency hospitalization and the examination pursuant to section 334-121.5 has been completed, the physician shall expediently discharge the patient. If the patient is under criminal charges, the patient shall be returned to the custody of a law enforcement officer. In any event, the patient shall be released within forty-eight hours of the patient's admission to a psychiatric facility or other facility designated by the director, unless the patient voluntarily agrees to further hospitalization, or a proceeding for court-ordered evaluation or hospitalization, or both, is initiated as provided in section 334-60.3. If that time expires on a Saturday, Sunday, or holiday, the time for initiation is extended to the close of the next court day. Upon initiation of the proceedings, the facility shall be authorized to detain the patient until further order of the court. [L 1976, c 130, pt of §4; am L 1977, c 76, pt of §3; am L 1984, c 188, §1; am L 1985, c 68, §6; am L 1986, c 335, §§2, 3; am L 1992, c 138, §1; gen ch 1993; am L 1994, c 58, §1; am L 1997, c 383, §45; am L 2009, c 151, §15; am L 2013, c 221, §§4, 24 and c 232, §3; am L 2015, c 27, §2; am L 2016, c 55, §51, c 114, §§2, 6, and c 183, §3; am L 2020, c 28, §3; am L 2024, c 86, §5]

HRS §334-59.5 Notice of admissions, examinations, and hospitalizations

334-59.5. Notice of admissions, examinations, and hospitalizations Notice of an individual's emergency admission, examination, and hospitalization under this chapter may be given to at least one of the following persons in the following order of priority: the individual's spouse or reciprocal beneficiary, legal parents, adult children, legal guardian, if one has been appointed, or if none can be found, the closest adult relative, as long as the individual: (1) Has capacity to make health care decisions and agrees; (2) Is given the opportunity to object and does not object, or the health care provider can reasonably infer from the circumstances based on the exercise of professional judgment that the individual does not object; or (3) Is incapacitated or an emergency circumstance exists and the health care provider determines based on the exercise of professional judgment that doing so is in the best interest of the individual. [L 2018, c 144, §2]

HRS §334-60.1 Voluntary admission for nonemergency treatment or supervision

334-60.1. Voluntary admission for nonemergency treatment or supervision (a) Acceptance for voluntary inpatient treatment at a psychiatric facility shall be in accordance with usual standards for hospital admissions. (b) A facility may admit for evaluation, diagnosis, or treatment any individual under fifteen years of age for whom application is made by the individual's parent or guardian. If application for admission is countersigned by a minor aged fifteen through seventeen years before a family court officer, no hearing shall be necessary. If the minor elects not to sign, involuntary hospitalization proceedings shall be initiated. (c) A facility shall discharge a voluntary patient who has sufficiently improved so that hospitalization is no longer desirable. A voluntary patient or the patient's guardian, representative, or attorney may request discharge in writing at any time following admission to the facility. If discharge would be dangerous to the patient or others, proceedings for involuntary hospitalization must be initiated as soon as possible but within twenty-four hours of the receipt by the administrator of the written request for discharge. If that time expires on a Saturday, Sunday, or holiday, the time for initiation is extended to the close of the next court day. Upon the initiation of the proceedings, the facility is authorized to detain the patient until further order of the court. If the patient was admitted on the patient's own application and the request for discharge is made by a person other than the patient, the discharge may be conditioned upon the agreement of the patient. (d) Notice of right to release. At the time of the patient's admission and each six months thereafter, a voluntary patient and the patient's guardian or representatives shall be notified in writing of the patient's right and how to apply for a discharge. [L 1984, c 188, pt of §3; gen ch 1985]

HRS §334-60.2 Involuntary hospitalization criteria

334-60.2. Involuntary hospitalization criteria A person may be committed to a psychiatric facility for involuntary hospitalization, if the court finds: (1) That the person is mentally ill or suffering from substance abuse; (2) That the person is imminently dangerous to self or others; and (3) That the person is in need of care or treatment, or both, and there is no suitable alternative available through existing facilities and programs which would be less restrictive than hospitalization. [L 1984, c 188, pt of §3; am L 1985, c 75, §2; am L 1986, c 335, §4; am L 2013, c 221, §§5, 24; am L 2016, c 114, §6]

HRS §334-60.3 Initiation of proceeding for involuntary hospitalization

334-60.3. Initiation of proceeding for involuntary hospitalization (a) Any person may file a petition alleging that a person located in the county meets the criteria for commitment to a psychiatric facility. The petition shall be executed subject to the penalties of perjury but need not be sworn to before a notary public. The attorney general, the attorney general's deputy, special deputy, or appointee designated to present the case shall assist the petitioner to state the substance of the petition in plain and simple language. The petition may be accompanied by a certificate of the licensed physician, advanced practice registered nurse, or psychologist who has examined the person within two days before submission of the petition, unless the person whose commitment is sought has refused to submit to medical or psychological examination, in which case the fact of refusal shall be alleged in the petition. The certificate shall set forth the signs and symptoms relied upon by the physician, advanced practice registered nurse, or psychologist to determine the person is in need of care or treatment, or both, and whether the person is capable of realizing and making a rational decision with respect to the person's need for treatment. If the petitioner believes that further evaluation is necessary before commitment, the petitioner may request such further evaluation. (b) In the event the subject of the petition has been given an examination, evaluation, or treatment in a psychiatric facility within five days before submission of the petition, and hospitalization is recommended by the staff of the facility, the petition may be accompanied by the administrator's certificate in lieu of a physician's or psychologist's certificate. (c) The petition shall include the name, address, and telephone number of at least one of the following persons in the following order of priority: the subject of the petition's spouse or reciprocal beneficiary, legal parents, adult children, and legal guardian, if one has been appointed. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult children, or legal guardian, or if none can be found, notice shall be served on at least one of the subject's closest adult relatives, if any can be found. [L 1984, c 188, pt of §3; gen ch 1985; am L 1994, c 58, §2; am L 2015, c 27, §3; am L 2018, c 144, §3]

HRS §334-60.4 Notice; waiver of notice; hearing on petition; waiver of hearing on petition for involuntary hospitalization

334-60.4. Notice; waiver of notice; hearing on petition; waiver of hearing on petition for involuntary hospitalization (a) The court shall set a hearing on the petition and notice of the time and place of the hearing shall be served in accordance with, and to those persons specified in, a current order of commitment. If there is no current order of commitment, notice of the hearing shall be served personally on the subject of the petition and served personally or by certified or registered mail, return receipt requested, deliverable to the addressee only, on the subject's spouse or reciprocal beneficiary, legal parents, adult children, and legal guardian, if one has been appointed. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult children, or legal guardian, or if none can be found, notice of the hearing shall be served on at least one of the subject's closest adult relatives, if any can be found. Notice of the hearing shall also be served on the public defender, attorney for the subject of the petition, or other court-appointed attorney as the case may be. If the subject of the petition is a minor, notice of the hearing shall also be served upon the person who has had the principal care and custody of the minor during the sixty days preceding the date of the petition if that person can be found within the State. Notice shall also be given to other persons as the court may designate. (b) The notice shall include the following: (1) The date, time, place of hearing, a clear statement of the purpose of the proceedings and of possible consequences to the subject; and a statement of the legal standard upon which commitment is authorized; (2) A copy of the petition; (3) A written notice, in plain and simple language, that the subject may waive the hearing by voluntarily agreeing to hospitalization, or with the approval of the court, to some other form of treatment; (4) A filled-out form indicating such waiver; (5) A written notice, in plain and simple language, that the subject or the subject's guardian or representative may apply at any time for a hearing on the issue of the subject's need for hospitalization, if the subject has previously waived such a hearing; (6) Notice that the subject is entitled to the assistance of an attorney and that the public defender has been notified of these proceedings; (7) Notice that if the subject does not want to be represented by the public defender, the subject may contact the subject's own attorney; and (8) If applicable, notice that the petitioner intends to adduce evidence to show that the subject of the petition is an incapacitated or protected person, or both, under article V of chapter 560, and whether appointment of a guardian is sought at the hearing. If appointment of a guardian is to be recommended, and a nominee is known at the time the petition is filed, the identity of the nominee shall be disclosed. (c) If the subject executes and files a waiver of the hearing, upon acceptance by the court following a court determination that the person understands the person's rights and is competent to waive them, the court shall order the subject to be committed to a facility that has agreed to admit the subject as an involuntary patient or, if the subject is at such a facility, that the subject be retained there. (d) Notice of adjournments, continuances, other delays, dates of rescheduled hearings, and waivers of the hearing under subsection (c) shall also be served on the persons specified in subsection (a). [L 1984, c 188, pt of §3; gen ch 1985; am L 1997, c 383, §46; am L 2004, c 161, §36; am L 2018, c 144, §4]

HRS §334-60.5 Hearing on petition

334-60.5. Hearing on petition (a) The court shall adjourn or continue a hearing for failure to timely notify the subject of the petition's spouse or reciprocal beneficiary, legal parent, adult child, surrogate, guardian, or relative, or other person determined by the court to be entitled to notice, or for failure by the subject to contact an attorney as provided in section 334-60.4(b)(7) unless the subject waived notice pursuant to section 334-60.4(a) or the court determines that the interests of justice require that the hearing continue without adjournment or continuance. (b) The time and form of the procedure incident to hearing the issues in the petition shall be provided by court rule. Unless the hearing is waived, the judge shall hear the petition as soon as possible and no later than ten days after the date the petition is filed unless a reasonable delay is sought for good cause shown by the subject of the petition, the subject's attorney, or those persons entitled to receive notice of the hearing under section 334-60.4. (c) The subject of the petition shall be present at all hearings unless the subject waives the right to be present, is unable to attend, or creates conditions that make it impossible to conduct a hearing in a reasonable manner as determined by the judge. A waiver is valid only upon acceptance by the court following a judicial determination that the subject understands the subject's rights and is competent to waive them, or is unable to participate. If the subject is unable to participate, the judge shall appoint a guardian ad litem or a temporary guardian as provided in article V of chapter 560, to represent the subject throughout the proceedings. (d) Hearings may be held at any convenient place within the circuit. Hearings may be conducted by video conferencing unless the court determines personal appearance is necessary. The subject of the petition, any interested party, or the court on its own motion may request a hearing in another circuit because of convenience to the parties, witnesses, or the court or because of the subject's mental or physical condition. (e) The department of the attorney general shall present the case for a petitioner for hearings convened under this chapter, unless a petitioner has retained private counsel who will be present in court and will present to the court the case for involuntary hospitalization. (f) Counsel for the subject of the petition shall be allowed adequate time for investigation of the matters at issue and for preparation and shall be permitted to present the evidence that the counsel believes necessary to a proper disposition of the proceedings, including evidence as to alternatives to inpatient hospitalization. (g) No individual may be found to require treatment in a psychiatric facility unless at least one qualified psychiatric examiner or psychologist who has personally examined the individual testifies in person at the hearing. This testimony may be waived by the subject of the petition. If the subject of the petition refuses to be examined by a qualified psychiatric examiner or psychologist, the subject may be examined by a court-appointed qualified psychiatric examiner or psychologist. If the subject refuses to be examined and there is sufficient evidence to believe that the allegations of the petition are true, the court may make a temporary order committing the subject to a psychiatric facility for a period of no more than five days for the purpose of a diagnostic examination. The subject's refusal to be examined shall be treated as a denial that the subject is mentally ill or suffering from substance abuse. Nothing in this section shall limit the subject's privilege against self-incrimination. (h) The subject of the petition in a hearing under this section has the right to secure an independent examination and present evidence thereon. (i) If after hearing all relevant evidence, including the result of any diagnostic examination ordered by the court, the court finds that a subject of a petition is not a person requiring medical, psychiatric, psychological, or other rehabilitative treatment or supervision, the court shall order that the subject be discharged if the subject has been hospitalized before the hearing. (j) If the court finds that the criteria for involuntary hospitalization under section 334-60.2(1) has been met beyond a reasonable doubt and that the criteria under section 334-60.2(2) and (3) have been met by clear and convincing evidence, the court may issue an order to any law enforcement officer to transport the subject of the order to a facility that has agreed to admit the subject as an involuntary patient, or if the subject is already a patient in a psychiatric facility, authorize the facility to retain the patient for treatment for a period of ninety days unless sooner discharged. The court may also authorize the involuntary administration of medication, where the subject has an existing order for assisted community treatment issued pursuant to part VIII of this chapter and in accordance with the treatment prescribed by that existing order. Notice of the subject's commitment and the facility name and location where the subject will be committed shall be provided to those persons entitled to notice pursuant to section 334-60.4. An order of commitment shall specify which of those persons served with notice pursuant to section 334-60.4, together with such other persons as the court may designate, shall be entitled to receive any subsequent notice of intent to discharge, transfer, or recommit. The court shall forward to the Hawaii criminal justice data center all orders of involuntary civil commitment or information from all orders of involuntary civil commitment, as requested by the Hawaii criminal justice data center, which in turn shall forward the information to the Federal Bureau of Investigation, or its successor agency, for inclusion in the National Instant Criminal Background Check System database. The orders or information shall also be maintained by the Hawaii criminal justice data center for disclosure to and use by law enforcement officials for the purpose of firearms permitting, licensing, or registration pursuant to chapter 134. This subsection shall apply to all involuntary civil commitments without regard to the date of the involuntary civil commitment. (k) Persons entitled to notice pursuant to this section shall also be entitled to be present in the courtroom for the hearing and to receive a copy of the hearing transcript or recording, unless the court determines that the interests of justice require otherwise. [L 1984, c 188, pt of §3; am L 1985, c 220, §1; gen ch 1985; am L 1994, c 58, §3; am L 1997, c 383, §47; am L 2004, c 161, §8; am L 2013, c 221, §§6, 24 and c 232, §4; am L 2014, c 87, §4; am L 2015, c 27, §4; am L 2016, c 114, §6; am L 2018, c 144, §5; am L 2025, c 219, §9]

HRS §334-60.6 Period of detention

334-60.6. Period of detention The psychiatric facility may detain a subject for a period of time ordered by the court not to exceed ninety days from date of admission unless sooner discharged by the facility pursuant to section 334-76 or section 334-74. At the end of the ninety-day period the subject shall be discharged automatically except as provided in sections 704-406, 704-411, and 706-607, unless before expiration of the period and by a proceeding initiated pursuant to section 334-60.3 the facility obtains a court order for the subject's recommitment. Recommitment for a period not to exceed ninety days may not be ordered unless the court determines that the criteria for involuntary hospitalization set forth in section 334-60.2 continue to exist. If at the end of a recommitment period the court finds that the criteria for involuntary hospitalization set forth in section 334-60.2 continue to exist and are likely to continue beyond ninety days, the court may order recommitment for a period not to exceed one hundred eighty days. Nothing in this section shall preclude a facility from accepting for voluntary inpatient treatment, in accordance with the procedures in section 334-60.1, a patient, for whom the facility contemplates discharge pursuant to section 334-60.7 and who voluntarily agrees to further hospitalization after the period of commitment has expired, or where the patient is no longer a proper subject for commitment. [L 1984, c 188, pt of §3; gen ch 1985; am L 1988, c 44, §1]

HRS §334-60.7 Notice of intent to discharge

334-60.7. Notice of intent to discharge (a) When the administrator or attending physician of a psychiatric facility contemplates discharge of an involuntary patient because of expiration of the court order for commitment or because the patient is no longer a proper subject for commitment, as determined by the criteria for involuntary hospitalization in section 334-60.2, the administrator or attending physician shall provide notice of intent to discharge, or if the patient voluntarily agrees to further hospitalization, the administrator shall provide notice of the patient's admission to voluntary inpatient treatment. The following requirements and procedures shall apply: (1) The notice and a certificate of service shall be filed with the family court and served on those persons whom the order of commitment specifies as entitled to receive notice, by mail at the person's last known address. Notice shall also be sent to the prosecuting attorney of the county from which the person was originally committed, by facsimile or electronically, for the sole purpose of victim notification; (2) Any person specified as entitled to receive notice may waive this right in writing with the psychiatric facility; (3) If no objection is filed within five calendar days of mailing the notice, the administrator or attending physician of the psychiatric facility shall discharge the patient or accept the patient for voluntary inpatient treatment; (4) If any person specified as entitled to receive notice files a written objection, with a certificate of service, to the discharge or to the patient's admission to voluntary inpatient treatment on the grounds that the patient is a proper subject for commitment, the family court shall conduct a hearing as soon as possible, prior to the termination of the current commitment order, to determine if the patient still meets the criteria for involuntary hospitalization in section 334-60.2. The person filing the objection shall also notify the psychiatric facility by telephone on the date the objection is filed; (5) If the family court finds that the patient does not meet the criteria for involuntary hospitalization in section 334-60.2, the court shall issue an order of discharge from the commitment; and (6) If the family court finds that the patient does meet the criteria for involuntary hospitalization in section 334-60.2, the court shall issue an order denying discharge from the commitment. (b) For civil commitments that do not result directly from legal proceedings under chapters 704 and 706, when the administrator or attending physician of a psychiatric facility contemplates discharge of an involuntary patient, the administrator or attending physician may assess whether an assisted community treatment plan is indicated pursuant to section 334-123 and, if so indicated, may communicate with an aftercare provider as part of discharge planning, as appropriate. [L 1984, c 188, pt of §3; am L 1988, c 44, §2; am L 2014, c 156, §1; am L 2018, c 144, §6]

HRS §334-61 Presumption; civil rights

334-61. Presumption; civil rights No presumption of insanity or legal incompetency shall exist with respect to any patient by reason of the patient's admission to a psychiatric facility under this chapter. The fact of the admission shall not in itself modify or vary any civil right of any such person, including but not limited to civil service statutes or rights relating to the granting, forfeiture, or denial of a license, permit, privilege, or benefit pursuant to any law, or the right to dispose of property, execute instruments, make purchases, enter into contractual relationships, and to vote. If the administrator of a psychiatric facility or the deputy is of the opinion that a patient should not exercise any civil right, application for a show cause order shall be made to the court under the above proceedings after notice pursuant to section 334-60.4. [L 1976, c 130, pt of §4; am L 1977, c 76, pt of §3; am L 1985, c 68, §7]

Source: Hawaii State Legislature (capitol.hawaii.gov), via Internet Archive capturesURL: http://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0334/HRS_0334-.htmFetched: 11/10/2026