Baker Act Overview
The Florida Mental Health Act, also known as the Baker Act, is the set of laws governing mental health treatment and services, including involuntary examination and placement. The Baker Act was designed to preserve individual rights while establishing guidelines for courts and qualified professionals to initiate involuntary examination and/or treatment for individual in crisis due to mental illness.
Baker Act Criteria
In order to temporarily commit someone who has or is believed to have a mental illness* (as defined in Baker Act statute) to a mental health facility, they must meet the following criteria:
• The individual has refused a voluntary mental health evaluation OR the individual is not able to determine whether an examination is needed;
• The individual presents an imminent threat of harm to self or others OR is unable or unwilling to care for themself, which poses an imminent threat of harm.
*For the purposes of the Baker Act, mental illness does not include a developmental disability (defined in Chapter 393, FL Statute), intoxication, or conditions manifested only by antisocial behavior or substance use impairment. Individuals in crisis are also able to choose a voluntary Baker Act, so long as they are willing and able to consent to treatment.
Baker Act vs. Marchman Act
Both the Baker Act and Marchman Act identify processes for those who are incapable of determining their need for treatment and present an imminent danger to self or others. The Baker Act applies to individuals incapacitated due to mental illness, whereas the Marchman Act relates to incapacity due to substance abuse. The Marchman Act can be initiated through similar avenues as the Baker Act.
Initiating Involuntary Examination
An involuntary examination can be initiated by any of the following ways:
• A licensed qualified professional (as defined in Baker Act) may determine an individual they examined within the preceding 48 hours meets the involuntary examination criteria.
• A law enforcement officer may determine a person meets the criteria for involuntary examination.
• A circuit court may enter an ex parte order requiring involuntary examination based upon petition and sworn testimony from related individual(s).
Ongoing Involuntary Placement
On evaluation, a psychiatrist may determine an individual continues to meet the initial Baker Act criteria, with less restrictive options judged inappropriate. A petition may then be submitted to the courts requesting involuntary inpatient placement. A hearing is then scheduled by the court to evaluate the petition, and the court either issues an order for involuntary placement or issues an order to release.
Time Frames & Actions
An individual may be held for up to 72 hours for involuntary examination. Once the examination is complete, one of the following must occur:
• No intervention is recommended, and individual is released (unless charged with a crime);
• Individual is released with a recommendation for outpatient treatment, which is voluntary (unless charged with a crime);
• Individual agrees to continued inpatient treatment voluntarily;
• A petition for involuntary placement is filed with the courts and a hearing scheduled. If involuntary placement is granted, the court may issue an order for involuntary placement for up to 180 days.
Please Note: These time frames do not indicate an individual’s expected length of stay. If a person does not wish to stay voluntarily, they must be released as soon as they are evaluated to no longer meet the Baker Act criteria.
Health Care Surrogates & Guardian Advocates
The ability to consent to treatment is evaluated and determined for each individual. If the psychiatrist determines an individual is unable to consent to medications/treatment, a Guardian Advocate may be pursued and appointed by the court. The Guardian Advocate will most often be a previously identified health care surrogate and/or relative, though in some cases the court determines a professional guardian is appropriate.
For minors without natural guardian involvement, a Guardian Advocate is required before medication can be provided if the current caregivers are unable to provide the appropriate legal documentation (i.e., Court Order or appropriately worded Advance Directive/Health Care Surrogacy or Power of Attorney document).
Discharge planning is a process that begins at admission. Staff work with the individual, related individuals, and the treatment team to prepare for discharge throughout the inpatient stay. When it is determined an individual no longer meets the involuntary Baker Act criteria, and they do not wish to stay or do not require continued inpatient treatment, they must be discharged.
In some cases where an individual remains in crisis (i.e., remains an imminent risk of danger to self/others) but is able to determine their need for treatment, they may be transferred to a voluntary status and remain inpatient for further stabilization. Everyone is provided a copy of their Discharge Plan, Safety Plan (if applicable), medication(s)/ prescription(s), and a follow-up appointment within seven (7) days of their discharge date. At this post inpatient appointment, individuals can be connected to additional aftercare services (e.g., counseling, medication management, primary care, etc.).
The brochure below contains more helpful information for you if your family member is in crisis.