This article discusses historical themes that led to the civil commitment reforms of the sixties and seventies. The changes in the substantive criteria for commitment are analyzed and critiqued. The author believes that the present criteria tend to focus so specifically on various external indicia of mental illness that they render commitment difficult for many seriously ill patients. An alternative commitment scheme is discussed.
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References
1.
1. Clifford D. Stromberg, “Developments Concerning the Legal Criteria for Civil Commitment: Who Are We Looking For?” in Psychiatry 1982: Annual Review, ed. L. Grinspoon (Washington, DC: American Psychiatric Association, 1982), pp. 334-350.
2.
Darold A. Treffert , “Dying with Their Rights On,”American Journal of Psychiatry, 130: 1041-1042 (Oct. 1973).
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Mark J. Mills , “The Problem of Public Psychiatry,”New England Journal of Medicine, 309:113-114 (July 1983).
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4. H. Richard Lamb, Alvin P. Sorkin, and Jack Zusman, “Legislating Social Control of the Mentally Ill in California,”American Journal of Psychiatry, 138:334-339 (Mar. 1981).
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Marc A. Rubenstein , Howard V. Zonana, and Lansing E. Crane, “Civil Commitment Reform in Connecticut: A Perspective for Physicians,”Connecticut Medicine, 41:709-717 (Nov. 1977).
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6. Frank T. Lindman and Donald M. McIntyre, The Mentally Disabled and the Law (Chicago: University of Chicago Press, 1961).
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7. Stephen Rachlin, “The Influence of Law on Deinstitutionalization,” in New Directions for Mental Health Services, ed. L. Bachrach (San Francisco: Jossey-Bass, 1983), pp. 41-54.
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8. Stephen J. Morse, “A Preference for Liberty: The Case against Involuntary Commitment of the Mentally Disordered,”California Law Review, 70:54-106 (1982).
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9. Alexander D. Brooks, “Defining the Dangerousness of the Mentally Ill: Involuntary Civil Commitment,” in Mentally Abnormal Offenders, ed. M. Craft and A. Craft (London: Balliere Tindall, 1984), pp. 280-307.
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10. Morton Birnbaum, “The Right to Treatment,”American Bar Association Journal, 46: 499-505 (May 1960).
11.
with respect to the courts, see Lessard v. Schmidt, 349 F. Supp. 1078 (E.D. Wisc. 1972; three-judge court), vacated and remanded on other grounds 414 U.S. 473, 94 Sup. Ct. 713 (1974), order on remand 379 F. Supp. 1376 (E.D. Wisc. 1974), vacated and remanded on other grounds 421 U.S. 957, 95 Sup. Ct. 1943 (1975), order reinstated on remand 413 F. Supp. 1318 (E.D. Wisc. 1976).
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12. Alan A. Stone, “Psychiatric Abuse and Legal Reform: Two Ways to Make a Bad Situation Worse,”International Journal of Law and Psychiatry, 5(1):9-28 (1982).
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13. Mark J. Mills, James C. Gracey, and Bonnie D. Cummings, “Legal Issues in Mental Health Administration,”International Journal of Law and Psychiatry, 6(1):39-55 (1983).
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Ronald D. Laing , The Divided Self (London: Tavistock, 1960).
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15. Harry Guntrip, Psychoanalytic Theory, Therapy and the Self (New York: Basic Books, 1971).
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16. Phillip A. Berger, “The Medical Treatment of Mental Illness,”Science, 200:974-981 (May 1978).
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Jonathan F. Borus , “Deinstitutionalization of the Chronically Mentally Ill,”New England Journal of Medicine, 305:339-342 (Aug. 1981).
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18. A. Louis McGarry, “Conclusions and Some Recommendations,” in Civil Commitments and Social Policy: An Evaluation of the Massachusetts Mental Health Reform Act of 1970, A. L. McGarryet al., Department of Health and Human Services pub. no. (ADM) 81-1011 (Washington, DC: Government Printing Office, 1981), pp. 137-146.
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Alan A. Stone , “Recent Mental Health Litigation: A Critical Perspective,”American Journal of Psychiatry, 134:273-279 (Mar. 1977).
20.
20. Treffert, “Dying with Their Rights On.”
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Lee C. Rubin and Mark J. Mills, “Behavioral Precipitants to Civil Commitment,”American Journal of Psychiatry, 140:603-606 (May 1983).
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22. “Mental Illness: A Suspect Classification?”Yale Law Journal, 83:1237-1270 (1974).
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23. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 2nd ed. (Washington, DC: American Psychiatric Association, 1968).
24.
24. Ibid., 3rd ed. (1980).
25.
25. There is no federal civil commitment statute although some commentators believe that there should be, so that those who become committed far from home can be legally transported home during treatment.
26.
26. Loren H. Roth, “Mental Health Commitment: The State of the Debate, 1980,”Hospital and Community Psychiatry, 31:385-396 (June 1980).
27.
on the lack of standards of defining dangerousness, see John Monahan, The Clinical Prediction of Violent Behavior, National Institute of Mental Health, Department of Health and Human Services pub. no. (ADM) 81:921 (Washington, DC: Government Printing Office, 1981).
28.
Stromberg , “Developments Concerning the Legal Criteria for Civil Commitment.”
29.
29. Monahan, Clinical Prediction of Violent Behavior.
30.
30. Monahan, Ruggiero, and Friedlender, “Stone-Roth Model.”
31.
31. Rubin and Mills, “Behavioral Precipitants to Civil Commitment.”
32.
32. Mills, Gracey, and Cummins, “Legal Issues in Mental Health Administration.”
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“Developments in the Law: Civil Commitment of the Mentally Ill,”Harvard Law Review, 87:1190-1406 (1974).
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34. E. Gruenberg, “The Social Breakdown Syndrome—Some Origins,”American Journal of Psychiatry, 123:1481-1489 (Dec. 1967).
35.
35. The Massachusetts civil commitment laws provide an example of a detailed and useful definition; see Mass. Gen. Laws chap. 123 (1983).
36.
36. Stromberg, “Developments Concerning the Legal Criteria for Civil Commitment.”
37.
Loren H. Roth , “A Commitment Law for Patients, Doctors and Lawyers,”American Journal of Psychiatry, 136:1121-1127 (Sept. 1979).
38.
38. Sometimes the separate but similar criteria of Stone and Roth are collapsed into one set, the so-called Stone-Roth criteria. They include the following: the person suffers from a severe mental illness, and without treatment the prognosis is for major distress; treatment is available; the illness impairs the person's ability to understand information about the illness; and the risk-benefit ratio is such that a reasonable person would consent to a therapeutic trial.
39.
39. Michael A. Peszke, Involuntary Treatment of the Mentally Ill (Springfield, IL: Charles C Thomas, 1975).
40.
40. “Developments in the Law.”
41.
Clifford D. Stromberg and Alan A. Stone, “A Model State Law on Civil Commitment of the Mentally Ill,”Harvard Journal on Legislation, 20(2):275-396 (1983).
42.
42. Ellen L. Bassuk, “The Homelessness Problem,”Scientific American, 251:40-45 (July 1984).
43.
43. Mary L. Durham and Glenn L. Pierce, “Legal Intervention in Civil Commitment: The Impact of Broadened Commitment Criteria,” this issue of The Annals of the American Academy of Political and Social Science.
44.
44. Mary L. Durham and Glenn Pierce, “Beyond Deinstitutionalization: A Commitment Law in Evolution,”Hospital and Community Psychiatry, 33:216-219 (Mar. 1982).
