Mental health counselors want to authorize emergency holds

Why it matters: Over 10,000 LMHCs across the commonwealth make up the front line for crisis evaluations during patient mental health episodes, but they cannot legally authorize "section 12" psychiatric hold orders that would send patients to facilities that hold them against their will.

• Counselors told lawmakers this week their inability to sign off on holds creates dangerous delays and forces them into legal workarounds.

State of play: Bills H.2219 and S.1381 would add LMHCs to the list of personnel authorized to issue holds for psychiatric emergencies.

• Currently authorized positions include physicians, psychologists, clinical social workers, advanced practice nurses and police officers.

Between the lines: Counselors say the gap creates absurd situations in which clinicians performing evaluations must find colleagues to sign paperwork in the middle of a crisis.

What they're saying: "Every second counts when there is someone threatening self-harm," Sonja Wagner, a co-response clinician with the Franklin Police, told the Mental Health, Substance Use and Recovery Committee at a State House hearing last week.

• Witnesses described situations in which authorized personnel sign blank section 12 forms and leave them with non-authorized clinicians to fill out in emergencies.

• Joe Weeks of the Massachusetts Mental Health Counselors Association testified that the end run to find an authorized signer for documents is "not only inefficient, it's questionable and legally risky."

The big picture: LMHCs say they complete nearly identical education, clinical hours and examinations as licensed independent clinical social workers, yet only those official LICSWs can authorize holds.