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HARRISBURG — Days before law enforcement officials say Cody Balmer broke into the governor’s mansion armed with Molotov cocktails and a hammer, his mother called local police seeking help for her son.
According to the Penbrook Borough Police Department, Christie Balmer called on April 10 and requested a 302, or involuntary mental health commitment, for her son, who had stopped taking his psychiatric medications.
His behavior had become “irritable and agitated,” she told the department.
But when officers arrived at the hotel where Cody had been staying, he had already checked out. Staff told officers he “appeared fine,” according to the department. Under state law, they didn’t have enough information to commit him to inpatient mental health treatment.
Cody Balmer has not entered a plea on charges including attempted homicide and arson. He told a judge he does not have a mental illness, though the AP reports that his court-appointed lawyers may seek a competency review.
Questions about Balmer’s mental health and whether involuntary services could have prevented the alleged arson have thrust into the spotlight a decades-old but increasingly contentious portion of state law, section 302 of the Mental Health Procedures Act.
Here’s what we know about Section 302 and the involuntary commitment process.
What is a 302?
A “302” is the colloquial term for an emergency order that commits a person to receive mental health care whether they want it or not.
The term comes from the section of the Mental Health Procedures Act of 1976 that outlines the process for hospitalizing someone for psychiatric treatment without their express consent.
If approved, the committed person receives psychiatric treatment for no more than 120 hours, unless a judge extends the order.
Where the person receives that treatment can vary by county and available resources. Some counties have access to care at one of the six remaining state-run psychiatric hospitals, but available beds at those institutions are extremely limited.
Otherwise, a person can receive treatment in the psychiatric unit of a private hospital, an inpatient psychiatric clinic, or other kinds of psychiatric rehabilitation programs.
Who can be involuntarily committed?
Involuntary commitment is intended to be a last resort meant to impose treatment on someone who otherwise would not seek it voluntarily, but who could be a danger to themselves and others.
“You are taking someone's rights away,” said Joan Erney, who previously served as the deputy secretary of the state Office of Mental Health and Substance Abuse Services, which oversees mental health care in Pennsylvania.
“You are eliminating their ability to make a choice,” she said. “But if someone is, for example, currently psychotic, and they can't make that decision, then it's a tool that you can use that can bring them in for treatment."
The statute allows for involuntary commitment if someone presents a “clear and present danger of harm to others or to himself.”
The person presents danger to others if they, in the prior 30 days, caused or tried to cause another person serious bodily harm.
The person presents danger to themself if they recently attempted suicide, attempted self-harm, or are likely to do either in the near future.
Intervention is also allowed if a person is unable to care for themself, and for that reason, is at danger of serious bodily injury or death. When Erney worked in crisis intervention in Dauphin County, she would often rely on this portion of the law to seek treatment for someone who was vulnerable, but not violent.
“Somebody wasn't suicidal or homicidal, but they were actively psychotic, they were homeless, they were on the streets, they were a mess, and they absolutely could not take care of themselves,” Erney said.
How does it work?
Any “responsible party” can petition the county for a 302 order, including police officers, family, friends, or doctors.
Getting it approved is another matter.
If an application for a 302 order is filed by someone other than a police officer or medical doctor, a county administrator must review and “warrant” the application to confirm that the person it addresses meets the standards for involuntary commitment.
If the county administrator approves the application, a police officer or some other approved person can take the patient to the hospital for an evaluation.
If, however, a doctor or police officer directly observes behavior they think might reach the threshold for involuntary commitment, they can bring the person directly to a hospital without a warrant.
Regardless of how they arrive, the person must be seen by a doctor within two hours and be evaluated to determine if continued involuntary care is necessary, per the statute. If the standard for commitment is met, the person receives forced psychiatric treatment for no more than 120 hours.
After 120 hours, a judge must extend the order.
But if at any point a person has stabilized and they no longer pose a threat, they must be discharged, a requirement that can be frustrating for those trying to help their loved one, Erney said.
“I had a woman … trying to have her brother who was clearly extraordinarily paranoid, very delusional,” she said. “He was assessed probably five different times, but he always pulled it together enough that they couldn't do the petition.”
Why is the bar for commitment so high?
States are obligated by federal law to ensure people who have mental illnesses or disabilities receive treatment in the least restrictive setting possible.
This mandate comes from a 1999 U.S. Supreme Court decision in Olmstead v. L.C., a case brought by two Georgia women who sued their home state for keeping them hospitalized despite care plans clearing them for discharge. They fought for their liberty and in turn won it for the rest of the country.
Under the Americans with Disabilities Act and the U.S. Constitution, people with mental illnesses deserve the same right to an unrestricted life and community-based care as any other person, the court said.
This means state and local officials must take extreme caution when taking that freedom away from someone just because they have a mental health condition.
Are there alternatives to involuntary commitment?
Yes, but the availability of mental health resources depends on where a person lives and their ability to pay.
In Pennsylvania, the state provides a majority of the funding for community mental health care, but deciding what those dollars will pay for is up to county governments. Community mental health funding was cut in the 2012-13 budget under former Gov. Tom Corbett and stayed flat for more than a decade.
Counties saw a $20 million bump in the last two budget cycles, but have continued to advocate for increased mental health spending, as the infusion does not return their coffers to pre-Corbett levels, nor does it make up for inflation. Shapiro has proposed an additional $20 million in his 2025-26 budget.
With the limited funding available, counties make different choices about the resources they can provide and how residents pay for them.
Dauphin County, where Balmer lived, offers no-cost crisis intervention services, including a telephone hotline, a walk-in clinic, and a mobile unit that will travel to the person in need.
Some counties also offer higher levels of care, including partial hospitalization programs and residential services for people who may need lifelong support.
But Pennsylvania lacks services in general, said state Rep. Michael Schlossberg (D., Lehigh), and that underlies overreliance on involuntary commitments for people who may not meet the threshold.
Anyone can call the 988 hotline to connect with services in their county.
Is there an option for people to direct their own care?
Yes. Section 201 of the Mental Health Procedures Act outlines the process for voluntary commitment, whereby a person can seek inpatient care for themself. A person who is hospitalized under an involuntary order can, once stabilized, choose voluntary care rather than discharge.
People who have a serious mental illness that interferes with daily life can also create a mental health advance directive, or a treatment plan in case they lose the ability to direct their care.
“It's a wonderful tool,” Erney said.
“It's a legal vehicle to say, Joan, when you're in your right mind, tell me what preferences you have, what hospital do you want to go to? What meds should you avoid?”
The care plan can also designate someone, such as a spouse or family member, who can make decisions on the person’s behalf.
What are lawmakers considering?
Lawmakers on both sides of the aisle have suggested taking a look at Pennsylvania’s processes for ensuring people who may pose a danger to themselves or others can get the care they need.
In the days following the attack, state Senate Majority Leader Joe Pittman (R., Indiana) advocated for identifying the root causes of an “epidemic of violence in our society,” whether mental health treatment and services or otherwise.
Schlossberg, who co-chairs the Pennsylvania House mental health caucus, has been considering legislative changes to the Mental Health Procedures Act since last year. He hopes to hold hearings in May, he told Spotlight PA, that will explore the nearly 50-year-old law and lead to updates.
The law was “written for a system that no longer exists,” Schlossberg said, where people who were involuntarily committed would be sent to state-run psychiatric hospitals for treatment. Many of those facilities are now closed.
The law also lacks clarity around logistics: where an emergency petition can happen, who can warrant it, when the clock on the 120 hours starts, how to transport a person, Schlossberg said.
And counties don’t uniformly provide this support.
“You've got 67 counties, 67 different mental health administrators, 67 different ways of interpreting the act,” he said.
Schlossberg hopes hearings around the act will bring together experts who can help update and standardize the process, while protecting the civil rights of people who have mental health needs.
“Trying to balance those tensions is a challenge, to put it politely,” he said.
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