Legal Intervention in Civil Commitment: The Impact of Broadened Commitment Criteria

Abstract

Recent legal changes in Washington State have broadened the grave-disability criterion for civil commitment of the mentally ill. Analysis of data from state mental hospitals and from records of commitment authorities in Washington's two largest counties revealed that, while there was an increase in the number of involuntary hospitalizations immediately before and after the changes in law, there was a virtual disappearance of voluntary patients in state hospitals. Moreover, expansion of the definition of “grave disability” resulted in a move toward a parens patriae-dominated civil commitment system. Analysis of the empirical consequences of the legal changes on commitment decisions is presented, along with the response of mental health officials and the public.

Get full access to this article

View all access options for this article.

References

1. Clifford D. Stromberg and Alan A. Stone , “A Model State Law on Civil Commitment of the Mentally Ill,” Harvard Journal of Legislation, 20:275-396 (1983).

2. Project Release v. Prevost, 463 F. Supp. 1033 (1978).

ibid., 20 Nov. 1979.

Loren H. Roth , “A Commitment Law for Patients, Doctors, and Lawyers,” American Journal of Psychiatry, 136:1121-1127 (1979).

Walter Dickey , “Incompetency and the Nondangerous Mentally Ill Client,” Criminal Law Bulletin, 16:22-40 (Jan.-Feb. 1980).

6. See, for example, D. A. Treffert and R. W. Krajeck , “In Search of a Sane Commitment Statute,” Psychiatric Annals, 6:56-57, 61, 63-65, 69-70, 72-73 (June 1976).

7. Rev. Code of Wash. §71.23.010 (1970).

8. Ibid., (1974).

9. Ibid., §71.23.100 (1974).

10.

10. Personal communication with the authors from several state officials, Jan.-Feb. 1980.

11.

11. Rev. Code of Wash. §72.23.010.7 (1974).

12.

12. Ibid., §72.23.010.20 (1974).

13.

13. Ibid., §71.05.020 (1979); italics added, to indicate additions made by the 1979 amendments.

14.

14. Ibid.; italics added, to indicate additions made by the 1979 amendments.

15.

for Massachusetts, see A. Louis McGarry et al. , Civil Commitment and Social Policy, National Institute of Mental Health, Department of Health and Human Services pub. no. (ADM) 81-1011 (Washington, DC: Government Printing Office, 1981).

16.

16. Glenn L. Pierce , Mary L. Durham , and William H. Fisher , “The Impact of Public Policy and Publicity on Admissions to State Mental Hospitals,” Journal of Health Politics, Policy and Law (in press).

17.

17. Glenn L. Pierce , Mary L. Durham , and William H. Fisher , “The Impact of Broadened Civil Commitment Standards on Admission to State Mental Hospitals,” American Journal of Psychiatry, 142:104-107 (1985).

18.

18. Ibid.

19.

19. The analysis in this section employed the individual case records from King and Pierce counties.

20.

20. Mary L. Durham and John Q. La Fond , “The Empirical Consequences and Policy Implications of Broadening the Statutory Criteria for Civil Commitment,” Yale Law and Policy Review (in press).

21.

21. A new patient is defined as an individual who has not been committed in Washington State before; an old patient is an individual with a prior commitment history in the state.

22.

22. Durham and La Fond , “Empirical Consequences and Policy Implications.”

23.

23. Legislative Budget Committee , “Joint Study of the Washington State Involuntary Treatment Act” (Office of Program Research, Washington House of Representatives, 1983).