Department of the Attorney General

DISCLAIMER: If you or anyone you know is suffering from a medical or psychiatric emergency, call 911 or go to your nearest hospital.

The process for obtaining an Assisted Community Treatment (ACT) order begins with the filing of a petition. Under Hawaiʻi law, the Department of the Attorney General shall assist with the preparation and filing of any such petition and with the presentation of the case at any related court proceedings; provided that if a petitioner is a private provider or other private petitioner, the petitioner may decline the assistance. The purpose of this page is to provide guidance for obtaining assistance from the Department of the Attorney General with your ACT matters.

In 2013, the Hawaiʻi Legislature established the Assisted Community Treatment (ACT) program. The intent of ACT is to provide support for someone who has a mental illness or drug addiction, who has demonstrated that without such support they will likely become unsafe in the community, and who may have difficulty participating in treatment.  Treatment under this program is based in the community with proceedings to secure ACT orders held in the family court. To obtain an ACT order, an individual must satisfy the criteria under section 334-121, Hawaii Revised Statutes.

334-121  Criteria for assisted community treatment. A person may be ordered to obtain assisted community treatment if the family court finds, based on the professional opinion of a psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, that:

(1)  The person is mentally ill or suffering from substance abuse;

(2)  The person is unlikely to live safely in the community without available supervision, is now in need of treatment in order to prevent a relapse or deterioration that would predictably result in the person becoming imminently dangerous to self or others, and the person’s current mental status or the nature of the person’s disorder limits or negates the person’s ability to make an informed decision to voluntarily seek or comply with recommended treatment;

(3)  The person has a:

(A) Mental illness that has caused that person to refuse needed and appropriate mental health services in the community; or

(B)  History of lack of adherence to treatment for mental illness or substance abuse that resulted in the person becoming dangerous to self or others and that now would predictably result in the person becoming imminently dangerous to self or others; and

(4)  Considering less intrusive alternatives, assisted community treatment is essential to prevent the danger posed by the person, is medically appropriate, and is in the person’s medical interests.

To request assistance in pursuing an ACT order from the Department of the Attorney General, the following documents must be provided:

1. ACT Referral Form
2. ACT Certificate of Licensed Psychiatrist of Advanced Practice Registered Nurse (aka MH-10) – A licensed psychiatrist or advanced practice registered nurse must have examined the person within 20 days of the filing of a petition for ACT
3. Assisted Community Treatment Plan

Note that additional supporting documentation, such as medical or court records, may also be required.

Individuals seeking assistance in petitioning the family court for an ACT order may submit the above information by e-mail or mail to the following:

Email:   [email protected]

Mail:     The Department of the Attorney General
                Family Law Division
                1001 Kamokila Blvd., Ste. 211
                Kapolei, Hawaiʻi  96707

Someone from the Department of the Attorney General will contact you upon receipt of the referral. The Department will review and assess the referral for sufficiency.

Important: Submission of a referral does not guarantee that the Department can initiate an ACT proceeding. 

Appointment of Guardian Ad Litem (GAL)
If the subject of an ACT petition does not have a guardian, the family court will appoint a guardian ad litem (GAL) to act in the best interest of the subject. The GAL will make an independent assessment on the petition for an ACT order.

Evidentiary Hearing
The psychiatrist or advanced practice registered nurse who drafted the MH-10 will have to testify in person at a hearing. The clinician should always be able to provide an updated resume. The designated mental health provider/program who will be responsible for the care/management of the subject’s treatment will also be expected to testify. At a minimum, testimony will cover all issues in the MH-10 and treatment plan. Petitioners should inform these individuals/programs of this requirement and make arrangements for their appearance at the hearing.