Involuntary commitment

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Involuntary commitment
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{{for|involuntary treatment in non-hospital settings|involuntary treatment}}{{redirect2|Sectioning|Sectioned|other uses|Section (disambiguation){{!}}Section}}Involuntary commitment or civil commitment (also known informally as sectioning or being sectionedWEB, August 2013, Being sectioned (in England and Wales), Royal College of Psychiatrists,weblink in some jurisdictions, such as the United Kingdom)WEB, What does 'being sectioned' mean?, Rethink Mental Illness,weblink is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe mental disorder is ordered by a court into treatment in a psychiatric hospital (inpatient) or in the community (outpatient).Criteria for civil commitment are established by laws which vary between nations. Commitment proceedings often follow a period of emergency hospitalization, during which an individual with acute psychiatric symptoms is confined for a relatively short duration (e.g. 72 hours) in a treatment facility for evaluation and stabilization by mental health professionals who may then determine whether further civil commitment is appropriate or necessary. If civil commitment proceedings follow, then the evaluation is presented in a formal court hearing where testimony and other evidence may also be submitted. The subject of the hearing is typically entitled to legal counsel and may challenge a commitment order through habeas corpus.WEB, The law provides a process known as Involuntary Commitment. Involuntary commitment is the use of legal means to commit a person to a mental hospital or psychiatric ward against their will or over their protests., Texas Young Lawyers Association, Committed To Healing: Involuntary Commitment Procedures, State Bar of Texas, Austin, TX, January 2008,weblink PDF, 2, Historically, until the first third of the twentieth century or later in most jurisdictions, all committals to public psychiatric facilities and most committals to private ones were involuntary. Since then, there have been alternating trends towards the abolition or substantial reduction of involuntary commitment,BOOK, Herbert, Hendin, Suicide in America, W. W. Norton, 1996, 978-0-393-31368-0, 37916353, 214, a trend known as "deinstitutionalisation".


In most jurisdictions, involuntary commitment is applied to individuals believed to be experiencing a mental illness that impairs their ability to reason to such an extent that the agents of the law, state, or courts determine that decisions will be made for the individual under a legal framework. In some jurisdictions, this is a proceeding distinct from being found incompetent.Involuntary commitment is used in some degree for each of the following although different jurisdictions have different criteria. Some jurisdictions limit court-ordered treatment to individuals who meet statutory criteria for presenting a danger to self or others. Other jurisdictions have broader criteria.

First aid

Training is gradually becoming available in mental health first aid to equip community members such as teachers, school administrators, police officers, and medical workers with training in recognizing, and authority in managing, situations where involuntary evaluations of behavior are applicable under law.WEB,weblink About, Mental Health First Aid USA, National Council for Behavioral Health, 2013-10-10, 2013-12-21, The extension of first aid training to cover mental health problems and crises is a quite recent development.BOOK, Kitchener, Betty, Jorm, Anthony, Kelly, Claire, Mental Health First Aid Manual, 2nd, Parkville, Victoria, ORYGEN Youth Health Resource Centre, 2010, 978-0-9805541-3-7, 608074743, A mental health first aid training course was developed in Australia in 2001 and has been found to improve assistance provided to persons with an alleged mental illness or mental health crisis. This form of training has now spread to a number of other countries (Canada, Finland, Hong Kong, Ireland, Singapore, Scotland, England, Wales, and the United States). Mental health triage may be used in an emergency room to make a determination about potential risk and apply treatment protocols.


{{Unreferenced section|date=October 2017}}Observation is sometimes used to determine whether a person warrants involuntary commitment. It is not always clear on a relatively brief examination whether a person is psychotic or otherwise warrants commitment.

Containment of danger

{{See also|Obligatory Dangerousness Criterion}}{{One source section|date=October 2017}}Austria, Belgium, Germany, Israel, the Netherlands, Northern Ireland, Russia, Taiwan, Ontario (Canada), and the United States have adopted commitment criteria based on the presumed danger of the defendant to self or to others.JOURNAL, Almost a Revolution: An International Perspective on the Law of Involuntary Commitment, Journal of the American Academy of Psychiatry and the Law, June 1997, 25, 2, 135–147, 9213286,weblink Appelbaum, Paul S., People with suicidal thoughts may act on these impulses and harm or kill themselves. People with psychosis are occasionally driven by their delusions or hallucinations to harm themselves or others. People with certain types of personality disorders can occasionally present a danger to themselves or others.{{citation needed|date=October 2017}}This concern has found expression in the standards for involuntary commitment in every US state and in other countries as the danger to self or others standard, sometimes supplemented by the requirement that the danger be imminent. In some jurisdictions,{{which|date=October 2017}} the danger to self or others standard has been broadened in recent years to include need-for-treatment criteria such as "gravely disabled".{{citation needed|date=October 2017}}


Starting in the 1960s, there has been a worldwide trend toward moving psychiatric patients from hospital settings to less restricting settings in the community, a shift known as "deinstitutionalization". Because the shift was typically not accompanied by a commensurate development of community-based services, critics say that deinstitutionalization has led to large numbers of people who would once have been inpatients as instead being incarcerated or becoming homeless.{{citation needed|date=September 2015}} In some jurisdictions, laws authorizing court-ordered outpatient treatment have been passed in an effort to compel individuals with chronic, untreated severe mental illness to take psychiatric medication while living outside the hospital (e.g. Laura's Law, Kendra's Law).{{citation needed|date=February 2014}}Before the 1960s deinstitutionalization there were earlier efforts to free psychiatric patients. Doctor Philippe Pinel (1745–1826) ordered the removal of chains from patients.WEB,weblink View of The Evolution of Public Health and Current Challenges: A Review,, 2018-12-19, In a study of 269 patients from Vermont State Hospital done by Courtenay M. Harding, Ph.D., and associates, about two-thirds of the ex-patients did well after deinstitutionalization.JOURNAL, Harding, C.M., Brooks, G.W., Ashikaga, T., Strauss, J.S., Breier, A., June 1987, The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later, American Journal of Psychiatry, 144, 6, 718–26, 10.1176/ajp.144.6.718, 3591991,

Around the world

United Nations

United Nations General Assembly Resolution 46/119, "Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care," is a non-binding resolution advocating certain broadly drawn procedures for the carrying out of involuntary commitment.WEB, UN General Assembly, UN General Assembly, A/RES/46/119: Principles for the protection of persons with mental illness and the improvement of mental health care, 17 December 1991, United Nations,weblink 16 June 2016, These principles have been used in many countries{{which|date=October 2017}} where local laws have been revised or new ones implemented. The UN runs programs in some countries to assist in this process.{{citation needed |date=June 2016}}

Politically motivated abuses

At certain places and times, the practice of involuntary commitment has been used for the suppression of dissent, or in a punitive way.In the former Soviet Union, psychiatric hospitals were used as prisons to isolate political prisoners from the rest of society. British playwright Tom Stoppard wrote Every Good Boy Deserves Favour about the relationship between a patient and his doctor in one of these hospitals. Stoppard was inspired by a meeting with a Russian exile.BOOK, Caute, David, 2005, The dancer defects: The struggle for cultural supremacy during the Cold War, Oxford University Press, Oxford, 359, 978-0-19-927883-1, 434472173, In 1927, after the execution of Sacco and Vanzetti in the United States, a demonstrator named Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in a rally in support of the anarchists.BOOK, Temkin, Moshik, The Sacco-Vanzetti Affair, Yale University Press, New Haven, CT, 978-0-300-12484-2, 973121902, 2009, 316,

See also

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Further reading

  • BOOK, Atkinson, Jacqueline M., 2006, Private and Public Protection: Civil Mental Health Legislation, Edinburgh, Dunedin Academic Press, 978-1-903765-61-6, 475785132,
  • BOOK, George, Black, Robin, Munro, Robin Munro, Black Hands of Beijing: Lives of Defiance in China's Democracy Movement, New York, John Wiley & Sons, Inc., 1993, 978-0-471-57977-9, 27186722,
  • JOURNAL, Perlin, Michael L., 1993, The ADA and Persons with Mental Disabilities: Can Sanist Attitudes Be Undone?, Journal of Law and Health, 8, 15, 15–45,weblink
  • JOURNAL, Rosenhan, D.L., 19 January 1973, On being sane in insane places, Science, 179, 4070, 250–258, 4683124, 10.1126/science.179.4070.250,weblink subscription,
  • JOURNAL, Spitzer, Robert L., October 1975, On pseudoscience in science, logic in remission, and psychiatric diagnosis: A critique of Rosenhan's 'On being sane in insane places', Journal of Abnormal Psychology, 84, 5, 442–452, 1194504, 10.1037/h0077124,
  • NEWS, Sulzberger, A.G., Carey, Benedict, 18 January 2011, Getting Someone to Psychiatric Treatment Can Be Difficult and Inconclusive, New York Times,weblink
  • BOOK, Torrey, E. Fuller, 1998, Out of the Shadows: Confronting America's Mental Illness Crisis, New York, Wiley, 978-0-471-24532-2, 502210396,
  • JOURNAL, Tsesis, Alexander V., Protecting Children Against Unnecessary Institutionalization, South Texas Law Review, 39, 4, 995–1027, Fall 1998, 1031713, 12778917,
  • {{UN doc |docid=A/RES/46/119 |body=General Assembly |session=46 |type=Resolution |resolution_number=119 |title=The protection of persons with mental illness and the improvement of mental health care |date=17 December 1991 }} HTML.

External links

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