NAMI Santa Clara County and the Santa Clara County Mental Health Department have co-authored the “AB 1424 Form”, to assist families in organizing and distributing vital information to authorities about the psychiatric condition of a loved one who is being considered for involuntary psychiatric treatment.
How The AB 1424 Form Can Help You Communicate About Your Family Member
Assembly Bill 1424 requires that all individuals making decisions about involuntary psychiatric treatment consider information supplied by family members. The forms provide a means for family members to communicate about their relative’s mental health history to psychiatric and court authorities, who must read the information and keep a copy in a Consumer’s health chart or court record.
Below are listed printable versions of the AB 1424 form in English, Spanish, Chinese, Tagalog and Vietnamese. There is also a link to an “fillable PDF” English version that can be completed online, and either saved or printed.
- Information Provided by a Family Member or Other Support Person AB1424 form English
- Fillable PDF AB1424 form English
- 資訊由家屬提供 AB1424 form Chinese
- Información brindada por un familiar AB1424 form Spanish
- Impormasyong Ibinigay sa pamamagitan ng Kamag-anak o Iba pang Taong Tagasuporta AB1424 form Tagalog
- AB1424 Form Vietnamese Vietnamese
Instructions For Completing and Distributing The AB 1424 form
If at all possible, complete an AB 1424 form for your loved one before they have a mental health crisis, and become incarcerated or placed on an emergency involuntary psychiatric hold (5150). Emphasize information that supports the conclusion or decision you want the reader to make. Describe specific behaviors and events rather than general labels or feelings. Authorities such as psychiatrists or judges are less likely to read carefully or take seriously a lengthy or overly emotional report, so keep your writing as factual, concise and reasonable as possible. .
Update the content of your form after any significant incident or change in a family member’s situation. It helps if you keep a written or online daily journal of information, names dates, events and behaviors that you deem important.
If your loved one is being evaluated for psychiatric hospitalization, or already hospitalized, make at least 3 copies of the AB 1424 form. Create a cover letter to the hospital or intake center, and on that letter request that one copy be given to the psychiatrist, one to the social worker or case worker, and one copy be put into the person’s chart or record.
If your loved one is taken to jail, you can use the AB1424 Form to help persuade legal authorities to make decisions that consider your loved one’s mental health history. Your cover letter may, for instance, request that their case be moved to mental health court (where they judge can assign people to psychiatric treatment rather than sentencing them to jail time). Make 3 copies of the AB1424 Form to take to important court hearings. In court before the hearing, you may approach the Bailiff, and ask him or her to give one copy to the judge, one copy to the district attorney, and one copy to the public defender (or private attorney if there is one). When addressing the court on your loved one’s behalf, you can refer to the form to support your statements and requests.
Although privacy laws may prevent a psychiatrist, therapist, attorney or other authority from talking to you about your loved one, you do have the right to communicate to them, verbally or in writing, your own personal concerns about and knowledge of that person. The AB 1424 form helps you exercise that right in the most effective and persuasive way.
If you have any further questions or assistance on the AB 1424 form, contact the NAMI Santa Clara County Warmline Help Desk.