What does the rights-based approach to crisis mental health care entail?

GREAT BAY--As reported previously, the Minister of Justice and the Minister of Public Health, Social Development and Labor (VSA) have signed a two-year cooperation agreement to ensure that people who are involuntarily placed or admitted to a facility for mental health reasons receive government-funded legal assistance from the very first moment their freedom is restricted. But what does the agreement actually entail? Lets get into it a bit.

The agreement, signed on January 14, 2026 by Minister of Justice Nathalie Tackling and Minister of VSA Richinel Brug, creates a temporary framework for both the delivery and financing of legal aid in cases commonly referred to as KZ placements. These measures are taken for care and safety under existing civil law provisions and the national ordinance governing supervision of persons with serious mental disorders.

Rights protections and why the agreement was needed

The Ministers pointed to St. Maarten’s legal protections, including Article 27 of the Constitution and Article 5 of the European Convention on Human Rights, which require a lawful basis for any deprivation of liberty, judicial oversight, and access to legal counsel.

In practice, however, legal aid for KZ placements did not have a dedicated operational and funding structure. Existing rules for free legal assistance mainly cover criminal cases and certain civil matters based on financial eligibility. The Ministers said KZ placement cases fall outside that scope because they involve liberty-restricting measures tied to care and safety, not a standard legal-aid program based on income. As a result, the existing legal-aid arrangement and related agreements with duty attorneys could not properly serve as the legal or financial basis for representation in these cases.

The agreement frames early access to a lawyer as part of what makes involuntary detention legally sound, rather than a discretionary social service. Government’s position is that if a person’s liberty is restricted for mental health reasons, the legal safeguards must start immediately.

What the agreement does

Under the cooperation agreement, government-funded legal aid must be provided right away once a person is placed, admitted, or held under specific parts of the ordinance that governs supervision of persons with serious mental disorders.

Legal aid includes:

• first contact and advice to the person involved and their family,
• assistance during judicial review of the placement, and
• necessary follow-up actions until the measure ends or is extended.

To implement the agreement, the Minister of Justice will sign separate contracts with duty attorneys registered with the St. Maarten Bar Association. Billing, administrative processing, and payments will follow procedures comparable to how legal-aid matters are handled under the existing system, but through a separate legal foundation created specifically for KZ placements.

Another practical safeguard sits alongside the agreement: the process is designed to ensure the courts are brought in quickly. Decisions that restrict a person’s freedom in these cases must be routed promptly for judicial review, so the legality of the measure is tested early, not months later.

The agreement is described as a temporary pilot approach while St. Maarten works toward modernizing the outdated ordinance governing involuntary mental health measures and updating the broader legal-aid framework.

The annual cost of legal aid under the pilot is estimated at up to XCG 50,000 per year, with the Ministry of Justice and the Ministry of VSA each covering 50%.

Any underspending or overspending will be managed within the two-year term. Unused funds from year one can carry into year two. If there is a shortfall in year one, it can be covered from the following year’s budget allocation.

The agreement takes effect on the first day of the month after it is signed and runs for two years. The Ministers will conduct a joint evaluation no later than three months before the end of the term to assess how the framework is working, how efficient it is, and whether it should be extended.

Policy rules on how decisions are made

Alongside the cooperation agreement, policy rules were issued to guide decision-making under the ordinance, including involuntary placement, conditional placement, and emergency holding measures.

These rules spell out how authorities should weigh interests, establish facts, and apply legal standards. They also emphasize medical grounding and timely safeguards: the person should be informed of the reasons for the measure and their rights, and if a situation is so urgent that normal steps cannot happen immediately, those steps must follow as soon as possible, including the involvement of the assigned attorney.

The policy approach also builds in a less restrictive option in suitable cases, using conditional placement when treatment outside a facility is realistic. If the situation deteriorates and a doctor indicates treatment at home is no longer workable, the measure can be escalated and brought for review.

Fee structure for duty attorneys

The model agreement sets fixed fees by case type, including:

• XCG 300 for emergency holding (in-bewaringstelling),
• XCG 500 for preliminary placement,
• XCG 500 for continued stay proceedings,
• XCG 750 for conditional preliminary placement,
• XCG 900 for extension proceedings, and
• XCG 900 for cassation and other requests, depending on the case.

The number of cases is currently estimated at approximately 30 to 40 per year, with a total annual cost estimate close to XCG 50,000.

The model agreement also sets boundaries to protect the integrity of the process, including restrictions on attorneys accepting outside gifts or compensation connected to these cases.

This initiative stems in part from a motion passed in Parliament, brought forward by Member of Parliament Sjamira Roseburg, calling for stronger legal safeguards and access to legal assistance for individuals subjected to involuntary mental health admission.

Upon signing the agreement, Minister Tackling emphasized that access to legal protection is a fundamental right, especially for people in vulnerable situations. Minister Brug underscored that involuntary admission is a serious step used in acute mental-health crises, and that care interventions should be matched with clear legal safeguards.

The Ministers said the cooperation agreement closes a gap in the current framework by ensuring affected individuals are informed of their rights and have access to legal support throughout the involuntary admission process. They added that work will continue to modernize the legislation governing involuntary admissions and build a more consistent, rights-based system for the future.

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