The Placement of Insanity

Abstract

This ethnography of legal proceedings examines how judgments of “grave disability” are formulated to effect involuntary mental hospitalizations. Such commitment decisions are based on judges' pragmatic evaluations of the viability of candidate patients' proposed community living situations and the ability of those situations to contain the havoc associated with mental illness. In assessing the tenability of candidate patients' proposed living arrangements, judges consider the following: (1) the person's ability to provide life's basic necessities; (2) the willing presence of a “caretaker” to supervise the candidate patient; and (3) the candidate patient's cooperation with a community-based treatment/custody regime. In the absence of any of these, social and psychiatric disturbances are considered inevitable, and hospitalization is likely to be ordered.