Massachusetts law has long authorized certain providers to apply emergency restraints and initiate hospitalization of persons posing a risk of serious harm by reason of mental illness under Mass. Gen. Laws Ch. 123, § 12, often called Section 12 authority. Under companion legislation being considered, H.2206 and S.1387, physician assistants (PAs) in the Commonwealth would be added to the list of providers with Section 12 authority.
Current Law
Section 12 grants physicians, advanced practice registered nurses, qualified psychologists and licensed independent social workers the authority to restrain and apply for the hospitalization of persons if, after examination, they “have reason to believe that failure to hospitalize such person would create a likelihood of serious harm by reason of mental illness.” Where emergency circumstances render an examination impossible, these providers may restrain and temporarily admit the patient to the hospital based on the specific facts and circumstances at hand. Additionally, in an emergency situation where one of the aforementioned providers is not available, Section 12 permits police officers to restrain persons and apply for their emergency hospitalization.1
Proposed Law
The bills currently being considered by the Massachusetts legislature would add PAs to the list of providers with Section 12 authority. Additionally, the bills would require that all providers with Section 12 authority undergo three hours of training in “direct mental health evaluation” in accordance with regulations that would be issued by the Commonwealth’s Department of Mental Health.
Proposed Law in Context
Legislation granting Section 12 authority to PAs in the Commonwealth has been unsuccessfully introduced in the last four General Courts. In New England, Maine and New Hampshire already permit PAs to order the involuntary hospitalization of individuals posing a risk of serious harm due to mental illness.
In practice, this authority is typically invoked only in emergency circumstances, when immediate intervention is warranted because it can be difficult to staff appropriately in anticipation of such emergencies. The proposed law would expand the scope of qualified providers who can determine whether a hospital admission is needed based on an evaluation indicating that there is serious risk of harm related to mental illness.
Next Steps
The proposed legislation is pending with the Senate Ways and Means Committee after having been reported favorably to the Senate by the Joint Committee on Mental Health, Substance Use and Recovery (the Joint Committee), which has until March 18, 2026, to report back on H.2206. Both bills were previously discussed during a hearing of the Joint Committee on October 6, 2025.2
Holland & Knight will provide updates on the bills as they become available. In the interim, please contact the authors with any questions.
Notes
1 The authors also note that Massachusetts has what is known as Section 35, which allows for long-term involuntary treatment for alcohol or substance use disorders that are leading to a likelihood of serious risk of harm to self or others. However, if an individual is a risk to themselves or others due (solely) to a mental illness, without the added layer of substance abuse, and they are unwilling or unable to seek help voluntarily, Section 12 may be more appropriate. The proposed legislation impacts only Section 12. See also Mass. Gen. Laws Ch. 123, § 35 for reference.
2 The authors note that the Massachusetts Legislature is concurrently considering a series of other proposed bills that would impact PAs. Holland & Knight will separately provide summaries of these bills and continue tracking their status.