Court Allows Forced Hospitalization of Man Despite No Mental Illness Diagnosis

The 18-year-old patient was admitted against his will after entering a psychotic state due to drug use. His two week hospitalization was extended to three months

FILE Photo: Sha’ar Menashe Mental Health Center, 2016.
Rami Chelouche

A court has allowed the forced hospitalization of a man who has not been diagnosed as mentally ill, which the Justice Ministry fears enables the committal of anyone deemed a risk to themself or others because of a physical or cognitive impairment such as autism or PTSD as a result of sexual or drug abuse.

The decision was made by a judge at the Haifa District Court, Shmuel Berliner, who allowed the forced hospitalization of an 18-year-old to be extended after he entered a psychotic state due to drug use. He was not diagnosed with a mental illness.

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The Justice Ministry’s Legal Aid Department is appealing the ruling to the Supreme Court. Three nonprofit groups have asked to join the appeal: Bizchut, which advocates for the disabled, Lishmat, which advocates for people with mental disorders, and a group catering to people on the autism spectrum.

Israeli law states that someone can be forcibly hospitalized only if he is found to have a mental illness and poses a danger to himself or others.

The young man was sent in early April, for the first time in his life and against his will, to the Sha’ar Menashe Mental Health Center between Haifa and Tel Aviv after doctors determined that he was in a severe psychotic state following drug use.

After two weeks, the hospital doctors asked to extend his forced hospitalization by three months – the longest period permitted by law after two weeks of hospitalization. The local psychiatric committee approved the request.

The committee said that the patient “looks neglected in his appearance, sloppy, a little tired, apparently influenced by medication. One cannot follow his train of thought, which is disjointed; he jumps from topic to topic … and one cannot understand the connection between his sentences. There is a great suspicion about the level of delusions and disorderly thinking expressive of an active psychotic state.”

The committee also said that the young man posed a high risk to himself and others. But during the two weeks of hospitalization, he was not diagnosed with any kind of mental disorder such as schizophrenia or manic depression.

The appeal by the Justice Ministry’s Legal Aid Department argues that three months of involuntary hospitalization is disproportionate for a young man who has never been hospitalized. But the main argument is that one cannot be committed to a psychiatric hospital if he is not mentally ill.

Berliner did not accept the arguments. He said the best solution for the young man, in view of his behavior and the risk he posed, was forced hospitalization in a psychiatric hospital.

“The law does not define what mental illness is and does not refer to the medical definitions as recorded in the medical literature, or to social conventions that try to define the nature of the patient’s mental impairment. And it seems that there are good reasons for this,” Berliner wrote.

He added that the law “does not state that it cannot apply to a person suffering from other illnesses, physical or cognitive, and it should be interpreted based on its purpose: to ... properly deal with an emergency situation in which a mentally ill person poses a risk to himself or others and needs treatment.”

Berliner said the young man was clearly a mentally ill person to whom the law applied.

Attorney Daniel Raz, the Justice Ministry official responsible for forced hospitalization, filed the appeal with attorney Yaniv Alon. Raz said it must be clarified to whom the law applied.

“The situation described in the ruling could lead to someone who suffered a head injury after a road accident or terror attack to be forcibly hospitalized because he has psychotic symptoms,” Raz said. “That’s not what forced hospitalization is for.”