IEA Family Guide Packet

“You are not abandoning them. You are trying to save their life.”

This guide covers:

• What an IEA is — and what it is not
• The legal standard: when refusal can be overridden
• The process, step by step, including the wait
• What to bring to the emergency department
• Your loved one’s rights
• How to take care of yourself through this
• What comes after — and planning for next time

What is an IEA?

An Involuntary Emergency Admissionis New Hampshire’s legal process (RSA 135-C) for holding and evaluating someone in a psychiatric crisis who won’t go voluntarily.

What it is not

• It is not a punishment and not a criminal arrest.
• It does notmean the person is “committed” long-term — longer involuntary commitment is a separate court process with a higher bar.
• It does not erase their rights: a judge reviews the hold within days, with a lawyer provided.

The legal standard

NH law allows involuntary treatment only when mental illness creates a likelihood of danger — in practice: serious threats or acts of self-harm, threats or acts toward others, or being so unable to care for oneself that health and safety are at serious risk. Being very ill, making bad decisions, or worrying you badly is not enough on its own. That is painful — and it is the line the process will apply.

The IEA process, step by step

1. 1. Getting evaluated — three common paths.(1) You persuade or bring the person to a hospital emergency department; (2) you call your community mental health center’s emergency services or NH Rapid Response (833-710-6477) and a clinician evaluates them, at home or at the center; or (3) in immediate danger, 911 — police can take someone into protective custody for evaluation.

2. 2. The petition and certificate. A family member (or clinician, or officer) completes a petition describing the specific dangerous behavior — your notebook matters here. A physician, APRN, or psychologist then examines the person; if the legal standard is met, they sign a certificate and the person can be held for placement at a designated psychiatric facility.

3. 3. The wait — honest expectations. There are often more people certified than beds available, so your loved one may wait in the emergency department for hours or days until a bed opens. It is distressing, and it is sadly normal. Ask the ED for updates and for a social-work consult — politely and often.

4. 4. The hearing. After admission the person is entitled to a probable-cause hearing before a judge within a few days, with a lawyer provided. You may be asked to testify about what you saw — specific and recent wins again. If probable cause isn’t found, the person is released; that outcome is hard, and it does not mean no one believed you.

5. 5. Treatment, discharge, and the conditional door. Treatment usually stabilizes a crisis in days to weeks. Ask the treatment team early about discharge planning and whether a conditional discharge(release with required outpatient treatment through the CMHC) is on the table — for many families it’s the most useful outcome of the whole process.

At the emergency department

What to bring (for them)

• Their current medications, or a written list (the bottles are best)
• Insurance card and ID, if you can find them
• Glasses or hearing aids
• Comfortable clothes — no drawstrings, belts, or shoelaces
• Their phone charger
• A list of their providers (therapist, psychiatrist, primary care)
• Their Psychiatric Advance Directive, if they have one

What to bring (for you)

• Your written timeline of what you saw and heard
• Your own charger, water, snacks, and something to read — this can take many hours

Your loved one's rights

• To know why they are being held
• To a lawyer — one is provided for the hearing
• To a probable-cause hearing before a judge within a few days of admission
• Questions about rights in a specific situation: NH Legal Assistance (1-800-639-5290) or the Disability Rights Center NH (drcnh.org)

Taking care of yourself tonight

• You did not do this wrong. You did not wait too long, or act too fast.
• Call NAMI NH (603-225-5359) — their family support specialists have been exactly where you are.
• Eat something. Drink water. Call someone who can sit with you.
• If you have children or dependents at home, it is okay to leave the ED to arrange care. Your loved one will not be alone.
• This crisis will end. The illness is not a choice — and neither was yours easy.

When your loved one is stable, help them create a Psychiatric Advance Directive (PAD)— a legal document where they write down, while well, what treatments they want and don’t want, who should speak for them, and what helps during a crisis. Having a PAD makes a future crisis less frightening for everyone. The full worksheet is at meridiannh.org/psychiatric-advance-directives.

Hospital they prefer:

Medications that have helped:

Medications to avoid (and why):

Person they trust to speak for them — name and phone:

What helps them during a crisis (and what makes it worse):

What comes after discharge

• The after-hospitalization guide — the first 24 hours, week, and month, for them and for you: meridiannh.org/guides/after-hospitalization
• Your catchment CMHC schedules follow-up care after discharge — find yours at meridiannh.org/map
• NAMI NH Family-to-Family: a free 8-session class taught by family members who have been where you are — call 603-225-5359
• NAMI NH family support groups — in person and virtual, statewide