It is the policy of the Port Gamble S’Klallam Tribe to promote the health, safety, culture, and general welfare of the Tribal Community and to recognize that individuals who attempt suicide are in need of assistance and care. These individuals are entitled to the opportunity to heal in the least restrictive and most culturally relevant environment possible.
(Res. 14 A 047, 3/25/2014)
The purpose of this chapter is to:
(a) 
Secure each person who attempts suicide or who self-harms such care and treatment as will be suited to the needs of the person. The Tribe intends to secure and ensure that care and treatment is skillfully and humanely administered with full respect for the person’s dignity and personal cultural integrity;
(b) 
Accomplish suitable care and treatment whenever possible in a community-based setting;
(c) 
Accomplish suitable care and treatment in an institutionalized setting, only when less restrictive alternatives are unavailable or inadequate and only when a person requires institutionalized care; and
(d) 
Assure that due process of law is accorded any person coming under the provisions of this chapter.
(Res. 14 A 047, 3/25/2014)
When the words listed in this section appear in this chapter, they shall have the following meaning unless a different meaning is clearly intended.
(a) 
"Applicant."
A person who makes an application for the admission of another into a treatment facility.
(b) 
"Attempted Suicide."
Any person who willfully attempts to cause his or her own death.
(c) 
"Court."
The PGST Tribal Court.
(d) 
"Director."
The administrator or other administrative officer of a treatment facility.
(e) 
"Emergency Situation."
A situation in which any person is in imminent danger of death or serious bodily harm from the attempt to commit suicide.
(f) 
"Next of Kin."
Any immediate family member including mother, father, sisters, brothers, grandparents, and adult children. Other family members may be considered as next of kin if the individual has a close familial bond with them.
(g) 
"Patient."
Any person who is under observation, care, or treatment in a treatment facility.
(h) 
"Professional Person."
A person who is a licensed medical doctor with Board Certification in Psychiatry or a person with a doctoral degree in Clinical Psychology or a person who meets criteria established by the Tribal Mental Health Department for certification as a Mental Health Professional in accordance with Tribally-approved Mental Health policies.
(i) 
"Reasonable Medical Certainty."
Reasonable certainty as judged by the standards of a professional person.
(j) 
"Reporter."
A person who reports another person as a suicide risk to the Tribal Police Department.
(k) 
"Respondent."
A person who has been recommended by formal report under this chapter for treatment.
(l) 
"Self-Harm/Non-Suicidal Self-Injury."
The direct or deliberate infliction of serious harm to oneself, for purposes not socially sanctioned, without the conscious intent to die.
(m) 
"Suicide Intervention Protective Services/Suicide Intervention Treatment."
Services intended to provide treatment for a person, either with or without the person’s consent, who is in imminent danger of death or serious bodily harm from the attempt to commit suicide.
(n) 
"Treatment Facility."
Any center or facility that is equipped and staffed to provide treatment for persons who attempt to commit suicide or who self-harm, whether on or off the reservation.
(Res. 14 A 047, 3/25/2014)
The care of our community members at risk of suicide is a family and a tribal responsibility. Any member of the Port Gamble S’Klallam Tribe and persons residing within the jurisdiction of the Tribe who have reason to believe that a person subject to the jurisdiction of the Tribe is in need of suicide intervention protective services may report such information to the Tribe’s Police Department.
Reporting under this section is mandatory for tribal employees and contractors with the Tribe who perform services to the community in the areas of education, health and human services, and law enforcement.
A law enforcement officer receiving such a report shall promptly investigate the person alleged to be in need of suicide intervention protective services. Tribal law enforcement shall forward all reports received, along with any investigation findings, to the Children and Family Services Behavioral Health Division Director.
(Res. 14 A 047, 3/25/2014)
A person making a report must provide his or her name to the Tribal Police. The identity and personal information of a person making a report is confidential unless there is a judicial proceeding that requires the information or the person consents. Reports under this section shall contain the following information if known:
(a) 
The name, address, and telephone number of the person at risk of suicide, the reporter, and if known, the closest relative of the person at risk of suicide;
(b) 
The reason(s) why the reporter believes the respondent is in need of suicide intervention protective services;
(c) 
Any available supporting evidence, including affidavits or written statements from physicians, mental health professionals, other appropriate professionals, or members of the community concerning the respondent; and
(d) 
Any other helpful information.
(Res. 14 A 047, 3/25/2014)
All persons who report or testify about a person in need of suicide intervention protective services are immune from civil liability and criminal prosecution. Conduct complying with the reporting and testifying provisions shall not be deemed a violation of any confidential communication privilege.
(Res. 14 A 047, 3/25/2014)
Any person who is required to report a person at risk of suicide under Section 16.09.04 of this code and who knowingly fails to report is subject to a civil fine not to exceed $5,000.00.
(Res. 14 A 047, 3/25/2014)
Any person acting in good faith upon either actual knowledge or reliable information who submits a report under Section 16.09.04 shall not be subject to civil or criminal liability for such act. Any person who knowingly submits a false report under 16.09.04 alleging that another person is in need of suicide intervention protective services shall be guilty of a misdemeanor 1.
(Res. 14 A 047, 3/25/2014)
Any person may apply for voluntary admission to any public or private hospital or other facility or program for treatment of attempted suicide or for self-harm injuries in accordance with the regulations of such facilities. Any person admitted for voluntary in-patient or similar custodial treatment in such facility shall be entitled to be unconditionally discharged from the facility within forty-eight (48) hours after delivery of a written request made to any official of such facility, unless an application for involuntary admission is filed under the provisions of this code within a forty-eight (48) hour period. Unless the voluntarily admitted person becomes the subject of an application for involuntary admission, such person shall not be subject to the provisions of involuntary admission in this chapter.
In order to streamline the process of voluntary admission to a community hospital for members of the PGST, the Tribal Mental Health Professionals (“MHPs”) have the authority to authorize inpatient hospitalizations for adults. MHPs will exhaust all possibilities for diversion from hospitalizations prior to considering an authorization.
(Res. 14 A 047, 3/25/2014)
The involuntary admission section of this chapter shall be construed to provide the least restrictive treatment or detention available that will serve the needs of individuals who attempt suicide and who are involuntarily admitted for recovery and rehabilitation while protecting the safety of the persons to be treated and members of the community.
(Res. 14 A 047, 3/25/2014)
A PGST MHP or any other professional person, including the Director of any treatment facility, may submit to the Court an application to have any person subject to jurisdiction of the Court involuntarily admitted to a treatment facility for treatment of attempted or threatened suicide. A person who self-harms or inflicts non-suicidal self-injury is not subject to an application for involuntary admission. Such application shall include:
(a) 
The name, address, and telephone number of the person at risk of suicide (the respondent), the person submitting the application, and if known, the closest relative of the person at risk;
(b) 
The reason(s) why the respondent is in need of suicide intervention protective services;
(c) 
Any available supporting evidence, including affidavits or written statements from physicians, mental health professionals, other appropriate professionals, or members of the community concerning the respondent;
(d) 
An explanation why reporting the respondent is in the respondent’s best interest to avoid suicide; and
(e) 
Any other helpful information.
If a person who is not a professional person believes that an individual who attempted suicide should be involuntarily admitted, that person may request that a MHP at the PGST Wellness Center initiate an investigation. A MHP shall contact and assess the individual and report the findings to the Mental Health Clinical Supervisor at the Wellness Center. If the Supervisor finds sufficient reason to involuntarily admit the individual, the Supervisor shall file an application for involuntary admission with the Tribal Prosecutor and notify the Children and Family Services Behavioral Health Division Director. The Tribal Prosecutor shall approve an application upon a finding of probable cause based on medical evidence.
(Res. 14 A 047, 3/25/2014)
The Tribal Prosecutor shall review an application for involuntary admission immediately before it is filed. If the Prosecutor finds that the application is insufficient to support a finding of probable cause that the respondent is in need of involuntary admission, the Prosecutor shall not accept the application for filing.
(Res. 14 A 047, 3/25/2014)
The following standards shall apply for emergency detention situations:
(a) 
When an emergency situation exists, a Tribal law enforcement officer may take any person, subject to the jurisdiction of the Court, who appears to be in need of suicide intervention protective services into custody only for sufficient time, but not to exceed the next regular business day, to contact the PGST Clinical Supervisor of the Wellness Center or other appropriate professional person for emergency evaluation. If practical, law enforcement shall first contact the Supervisor or the professional person prior to taking the person into custody.
(b) 
If the Supervisor or other professional person believes that an emergency situation exists and that the person held in custody is at serious risk of suicide, then the person at risk may be detained for up to seventy two (72) hours. At that time, the Supervisor or other professional person shall release the detained person or file an application with the Tribal Prosecutor for involuntary admission under 16.09.11. In either case, the Supervisor or professional person shall file a report to the Court explaining his or her actions.
(c) 
Where possible a person at risk of suicide or who attempts suicide shall be taken to a treatment facility on the Reservation. Where no on-Reservation treatment facility or health care facility can provide the emergency treatment or protection needed to protect the patient from imminent harm, a law enforcement officer or professional person may place the patient in an appropriate treatment facility off the Reservation.
(d) 
A law enforcement officer who takes a person into emergency detention may do so independently of whether a report has been filed. The officer shall immediately make all reasonable efforts to notify the detainee’s next of kin. The officer who detains a person under this section shall inform that person that detention is required in order to protect the person against suicidal self injury and that the Tribal Police have the authority to hold the person until a professional person assesses the person’s condition.
(Res. 14 A 047, 3/25/2014)
After receiving an application for involuntary admission, the Court shall immediately schedule a preliminary hearing. The hearing will be held immediately if possible and in all cases at the next Court date after the filing of the application.
A copy of the application and of the notice of the hearing on the application, including the date, time, and place fixed by the Court, shall be personally served on the person whose involuntary admission is sought (respondent) no less than five (5) days prior to the hearing. A copy of the application and of the notice of the hearing, including the date fixed by the Court, shall be served either personally or by any other means allowed under the law on the respondent’s next of kin, on a parent or legal guardian if the respondent is a minor, or on any other person the Court believes advisable.
The notice of the hearing shall state that the respondent has a right to the following:
(a) 
Retain counsel at respondent’s own expense, as provided in Chapter 1.05 of this code;
(b) 
Be present at the hearing;
(c) 
Testify, present documentary evidence, call witnesses, and ask questions of all witnesses.
There is no right to a jury trial at a preliminary involuntary admission hearing.
The Court shall conduct the preliminary hearing informally and shall close it to the public unless the respondent or authorized representative requests otherwise and the Court so orders. Where necessary, the hearing may be held where the respondent is detained.
The Judge shall appoint a professional person to the respondent and shall fix a date for a final hearing on the application at the next court date. The desires of the respondent shall be taken into consideration in the appointment of the professional person.
The professional person shall assess the respondent prior to the initial hearing. The Tribe may pay for such an assessment if the respondent is a tribal member or a non-Indian community member. The appointed professional person shall be present for the initial hearing and provide testimony before the Court.
If the Court finds at the preliminary hearing that the respondent is not suicidal or did not attempt suicide and does not require involuntary admission to a treatment facility it shall dismiss the application and order the respondent released.
(Res. 14 A 047, 3/25/2014)
Detention by jail of a respondent is prohibited unless detention is necessary for a reason other than the respondent’s risk of suicidal self-injury. If circumstances warrant detention of a respondent, the respondent shall be informed of his or her rights and the following prerequisites shall be met:
(a) 
The Court may only order detention of a respondent upon the Tribal Prosecutor’s request pending a preliminary or a final hearing and only on a showing of probable cause for the detention.
(b) 
In the event of detention, the respondent must be detained in the least restrictive setting necessary to assure the respondent’s safety, presence at the hearing, and the safety of others.
(c) 
If the respondent is detained, a professional person shall continue to evaluate and treat the respondent pending a hearing.
(Res. 14 A 047, 3/25/2014)
The Court shall ensure that the respondent is served with prior written notice of the date, time, and place of the final hearing no less than five (5) days prior to the hearing. Proper service is defined by the Service of Notice requirements under Section 3.02.04 of this code.
The standard of proof in any hearing held under this chapter is proof beyond a reasonable doubt with respect to any physical facts of evidence and clear and convincing evidence as to all other matters, except that suicidal intent shall be evidenced to a reasonable medical certainty. Overt acts of imminent threat of self-inflicted injury that are sufficiently recent in time as to be material and relevant to the respondent’s present condition shall be included in the medical assessment.
The professional person who submitted the application for involuntary admission must be present for the hearing and is subject to cross-examination. The hearing shall be governed by the Tribal Court Rules of Civil Procedure. The written report of the professional person may be attached to the application, but it must be verified by the professional person at the hearing before formal admission into evidence.
(1) 
The professional person may testify as to the ultimate issue of whether respondent is in need of suicide intervention treatment that the respondent does not consent to. This testimony is insufficient unless accompanied by evidence from the professional person or others that:
(a) 
The respondent has attempted or threatened suicide, or inflicted self-injury with the intent to die.
(2) 
If at the final hearing the Court determines that the respondent is not suicidal or did not attempt suicide and does not require involuntary admission to a treatment facility, the respondent shall be discharged and the application dismissed.
(3) 
If the Court determines that the respondent did attempt suicide or is suicidal and is in need of treatment based on involuntary admission, the Court shall:
(a) 
Order outpatient therapy; or
(b) 
Order the respondent to be placed in the care and custody of a relative, guardian, or other appropriate place other than a treatment facility; or
(c) 
Commit the respondent to an appropriate treatment facility for a period of not more than three (3) months or for a length of time determined by the professional person’s assessment or treatment plan; or
(d) 
Make some other appropriate order for treatment.
(4) 
In determining which of the above alternatives to order, the Court shall choose the least restrictive alternatives necessary to protect the respondent and the public and to permit effective treatment.
(5) 
If it is determined that the respondent attempted suicide or is suicidal but is not in need of treatment based on involuntary admission, the Court shall:
(a) 
Order outpatient therapy for a length of time determined by the professional person’s assessment; or
(b) 
Order the respondent be placed in the care or custody of a relative, guardian, or other appropriate person or facility for a length of time determined by the professional person’s assessment; or
(c) 
Make some other appropriate order for treatment other than involuntary admission.
(Res. 14 A 047, 3/25/2014)
Where there is no appropriate treatment facility available for a person who has been ordered involuntarily admitted, the order of admission shall remain in effect while an appropriate facility is sought. When a facility becomes available, the Court shall order an appropriate treatment personnel or law enforcement officer to transport the respondent to the facility. If a facility does not become available within a reasonable time, the Court may hold a review hearing where the professional person shall give an updated treatment recommendation.
(Res. 14 A 047, 3/25/2014)
A respondent may have appellate review of any order of short-term evaluation and treatment or long-term involuntary admission by appealing to an Appellate Court under Title 7 of this code.
(Res. 14 A 047, 3/25/2014)
An individualized treatment plan shall be developed for all persons ordered to treatment.
Where possible, the Mental Health staff at the Wellness Center shall develop an individualized treatment plan for any person ordered to treatment under Section 16.09.17.
Where Mental Health staff at the Wellness Center cannot develop a treatment plan, an appropriate professional person(s) shall develop a plan no later than ten (10) business days after a person’s admission. Each individualized treatment plan shall contain:
(a) 
A statement of the specific needs of the patient;
(b) 
A statement of the least restrictive treatment conditions necessary to achieve the purpose of involuntary admission;
(c) 
A description of treatment goals, with a projected timetable for their attainment;
(d) 
A specification of staff responsibility and a description of proposed staff involvement with the patient in order to attain the treatment goals; and
(e) 
Criteria for release to less restrictive treatment conditions and criteria for discharge.
A copy of the treatment plan shall be completed, filed with the Court for review and for inclusion in the patient’s Court file, and personally served to the patient, or a parent or legal guardian if the respondent is a minor, within five (5) business days after involuntary admission to a facility.
(Res. 14 A 047, 3/25/2014)
No later than thirty (30) days after a patient is involuntarily admitted to a mental health treatment facility, a professional person shall re-examine the patient and shall determine whether continued detention in the facility is required and whether the treatment facility has implemented the treatment plan developed for the patient. If the patient no longer requires detention in accordance with the facility’s standards of detention, the patient must be immediately released unless he or she agrees to continue with treatment on a voluntary basis.
(Res. 14 A 047, 3/25/2014)
Under jurisdiction of the Court, the patient’s detention may continue only if the patient receives regular care and treatment appropriate for her or his condition. The director or other representative of the treatment facility shall supervise the preparation and implementation of the patient’s treatment plan, record the patient’s progress under the plan, and report such progress to the Court.
The treatment facility shall file a progress report with the Court and shall serve a copy of the report to the patient no less frequently than every ninety (90) days and at least once during the period of detention. The Court shall have the discretion to fix the frequency of progress reports. The progress reports shall outline the treatment being administered, the patient’s progress toward recovery, and the director’s recommendation as to the need for continued detention.
(Res. 14 A 047, 3/25/2014)
The patient or the patient’s assigned professional person may at any time petition the Court for release from the treatment facility. The petition must be in writing, but it does not need to be in any particular form. Grounds for release include the improved health of the patient such that continued detention is no longer necessary under the standards of this chapter. Upon receipt of a petition for release, the Court shall review the petition and serve a copy upon the patient and the director. The director shall respond to the petition within seven (7) calendar days. If, after consideration of the petition and the director’s response, the Court finds substantial evidence that the patient may no longer be detained, the Court shall order and hold a hearing on the matter, following the procedures set forth in this chapter. The patient shall be present at the hearing.
Where the Court finds the patient is still in need of treatment but that outpatient treatment would enable the patient to function without danger to self or others, the Court may order the patient released subject to receipt of outpatient treatment. If the professional person providing outpatient treatment reports to the Court that the patient is no longer accepting treatment, the Court shall order the person immediately re-detained to an inpatient facility.
(Res. 14 A 047, 3/25/2014)
The director of the treatment facility where the patient is detained shall notify the Court at least seven (7) calendar days in advance of the planned release of the patient. The Court may conduct a hearing to determine whether the patient is still in need of detention in a treatment facility. If the Court determines that the patient should remain detained, the patient shall not be released from the treatment center.
(Res. 14 A 047, 3/25/2014)
The Port Gamble S’Klallam Tribe may provide adequate transitional treatment and care for a patient released after a period of detention for mental health treatment. Transitional care and treatment possibilities include but are not limited to psychiatric care, treatment by a therapist either in a clinic or in the patient’s home, a nursing or extended care home, a half-way house, outpatient treatment, or treatment in the psychiatric ward of a general hospital.
(Res. 14 A 047, 3/25/2014)
Whether the patient has filed a petition for release, the Court shall hold a hearing not less than once each year, following the procedures of this chapter, to determine if the basis for the original detention still exists. If the Court finds that there is no longer clear and convincing evidence that the patient should be detained, the Court shall order the patient immediately released.
(Res. 14 A 047, 3/25/2014)
All records and proceedings under this chapter shall be confidential and privileged information, except as may be provided otherwise by law. The captions and text of documents filed with the Court under this Chapter shall refer to the respondent patient by abbreviations of his or her full name.
Records under this chapter shall be accessible to the respondent, the respondent’s counsel, the respondent’s parent(s)/guardian(s), the Court, persons authorized by an order of the Judge, or persons authorized by written permission of the respondent. Upon application by the Prosecutor or by the director of the facility where the respondent is in detention and upon showing of good cause, the Court may order that the records shall not be made available to the patient if, in the judgment of the Court, the availability of such records to the respondent will adversely affect the respondent’s mental state and/or treatment plan.
(Res. 14 A 047, 3/25/2014)
Where tribal law enforcement officers are notified of a suicide attempt and no one has filed a report that the person is in need of suicide intervention protective services, law enforcement shall promptly investigate the incident. Based on the investigation, law enforcement shall either submit a report to the Court that the person is in need of suicide intervention protective services under Section 16.09.04, or law enforcement shall issue the person a notice to contact the PGST Wellness Center or other professional person for a mental health assessment. Law enforcement shall promptly forward the report of such notice to the PGST Wellness Center.
Where tribal law enforcement issues three (3) notices to complete a mental health assessment to the same person within a six (6) month period, an officer shall issue the person a notice to appear in Court along with the third notice to complete a mental health assessment with the PGST Wellness Center or other professional person. The officer shall forward a copy of the notice to appear in Court, along with any investigation findings, to the Children and Family Services Behavioral Health Division Director.
Under Section 16.09.11, where a professional person investigates and determines that the person who attempted suicide should not be involuntarily admitted, the professional person shall conduct a mental health assessment and then issue the person a notice to appear in Court.
The notice to appear in Court shall inform the person that the Court requires the person to complete a mental health assessment with a professional person prior to appearing in Court.
(Res. 14 A 047, 3/25/2014)
Where a person has been given notice to attain a mental health assessment with a professional person, the professional person shall examine and assess the person prior to the Court date in order to report to the Court on the person’s mental condition and to recommend a treatment plan. The professional person(s) shall be present for the hearing and provide testimony before the Court.
If an assessment cannot be conducted by reason of the respondent’s unwillingness to participate, the professional person shall file a statement with the Court that includes an opinion, if possible, as to whether the respondent’s unwillingness was the result of mental illness or deficiency.
(Res. 14 A 047, 3/25/2014)
When a person has attempted suicide or has inflicted a non-suicidal self-injury and has been issued a notice to appear in Court, the Court shall schedule a hearing on the next court date after the notice was issued. A copy of the notice to appear and of the notice of the hearing, including the date, time, and place fixed by the Court, shall be personally served on the respondent no less than five (5) days prior to the hearing. Proper service is defined by the Service of Notice requirements under Section 3.02.04 of this code.
The hearing shall be conducted informally and shall be closed to the public unless the respondent requests otherwise and the Court so orders. The Judge shall appoint a professional person to the respondent. The desires of the respondent shall be taken into consideration in the appointment of the professional person.
The professional person who conducted the assessment must be present for the hearing and shall testify as to the ultimate issue of whether the respondent is in need of suicide intervention treatment. If the professional person finds that the respondent is in need of suicide intervention treatment, the respondent may voluntarily enter into treatment under 16.09.09 or the professional person may file an application for involuntary admission under 16.09.11.
If the respondent is not in need of suicide intervention treatment, the Court shall order mandatory counseling. The nature, form, and duration of the counseling shall be within the Court's discretion, to be determined in accordance with the circumstances of each case.
Where the Court orders the respondent to attend mandatory counseling, the professional person or service providers who provide the court-ordered counseling to the respondent shall give compliance reports to the Court. The Court shall determine the frequency of reports, but the professional person must file at least two (2) compliance reports in a year. The Court may order the providers to report directly to the Court.
If the Court finds at the hearing that the respondent is not suicidal or did not attempt suicide and does not require suicide intervention treatment or mental health counseling, the respondent shall be discharged and the case dismissed.
In determining which of the above alternatives to order, the Court shall choose the least restrictive alternatives necessary to protect the respondent and the public and to permit effective treatment.
(Res. 14 A 047, 3/25/2014)
If the respondent has not completed a mental health assessment with a professional person prior to the hearing, the Judge shall order the respondent to complete a mental health assessment with the appointed professional person and shall schedule a final hearing on the next court date.
(Res. 14 A 047, 3/25/2014)
Where the respondent has not completed a mental health assessment with a professional person prior to the hearing, the Court shall schedule a final hearing on the next court date after the respondent completes an assessment.
The final hearing shall be conducted in the same manner as a hearing under 16.09.31.
(Res. 14 A 047, 3/25/2014)
The care of PGST community members at risk of suicide is a family and a tribal responsibility. If a respondent is unwilling to attend mandated counseling sessions, the Court may, at its discretion, order community service in addition to or in lieu of counseling. Examples of community service may include, but are not limited to, clean up of tribal lands, providing food and services to membership during events, cutting wood or providing other services for elders, or other culturally appropriate activities that benefit the tribe. The Court shall determine if the respondent is a suitable candidate for community service and if the respondent is likely to carry out the service faithfully.
If a respondent is unwilling to attend mandated counseling sessions, the Court may, at its discretion, order alternative treatment options in addition to or in lieu of counseling or community service. Alternative treatment options should promote the healing and general welfare of the respondent. In assigning alternative treatment options, the Court shall take the desires of the respondent into consideration.
Completion of community service or of alternative treatment option(s) may qualify as completion of Court requirements.
(Res. 14 A 047, 3/25/2014)
Any willful disobedience or interference with any lawful order or process of the Court shall constitute contempt under Chapter 1.06 of this code. The Court must exhaust every option before it may punish a respondent for contempt in accordance with the law and order code.
(Res. 14 A 047, 3/25/2014)
Should any court of competent jurisdiction declare any word, section, clause, paragraph, sentence, or part of this code invalid, such decision shall not affect the validity of any other part of this code that can be given effect without the invalid part(s).
(Res. 14 A 047, 3/25/2014)