Involuntary commitment

This artcle deals with the situation in the USA. Other countries also have laws governing Involuntary commitment.

Involuntary commitment is the practice of using legal means or forms to commit a person to a mental hospital, insane asylum or psychiatric ward against the will or over the protests of that person. In the United States, involuntary commitment is governed by state law and procedures vary from state to state, under laws often called mental hygiene laws. Involuntary commitment is typically used against people diagnosed with, or alleged to have, a mental illness, particularly schizophrenia.

An example of involuntary commitment procedures is the Baker Act used by the state of Florida. Under this law, a person may be committed only if he or she presents a danger to himself or others. A police officer may issue an emergency commitment order which lasts for up to 72 hours. Within this time, a person must appear before a judge who can extend the commitment. The Baker Act also requires that all commitment orders be reviewed every six months in addition to insuring certain rights to the committed including the right to contact outsiders. Also, a person under an involuntary commitment order has a right to counsel and a right to have the state provide a public defender if they cannot afford a private lawyer.

Though involuntary commitment has long been a practice of most societies, some individuals and groups have challenged it from a civil libertarian perspective, particularly in countries that are part of the Anglo-American judicial tradition. (Of particular concern to some civil libertarians is the acknowledged role of the United States Secret Service in obtaining involuntary psychiatric hospitalizations of those it believes to be a danger to protectees, without any claim that these "dangerous" individuals are "mentally ill.") Though few would argue that under no circumstances should a psychiatric patient be held against his will, exceptions to this have included Lawrence Stevens, an attorney who has argued that involuntary commitment is a violation of substantive due process under the United States Constitution (see link at end of article); most believers in the theory of reality enforcement and a small number of individuals who have maintained that in some cases the practice of involuntary commitment under the laws of U.S states may violate the First Amendment. Surrealism has also categorically opposed involuntary commitment. Dr. Thomas Szasz has also been prominent in challenging involuntary commitment (see "antipsychiatry" link at bottom of page). The mainstream debate has for the most part, however, regarded only the procedures of involuntary commitment. Until the 1960s, legal safeguards against involuntary commitment were lax and this led to a number of horror stories of people with no mental illness being trapped in an institution.

In the 1960s, there was a movement toward deinstitutionalization of mental patients from mental hospitals into community care centers, and this was matched with efforts at reform of involuntary commitment laws. (From the 1970s onwards a relatively small number of ex-mental patients and former "consumers of psychiatric services" have promoted what they call "mad liberation," often calling for the abolition of involuntary commitment.) The flaw in how the theory of deinstitutionalization was put into practice was that community care facilities were in general not well-funded; those who described themselves as "advocates for the mentally ill" complained that deinstitutionalized former inmates of mental hospitals often ended up homeless. In the 1980s, there was a return back to institutionalization and less strict commitment laws.

In the 1990s, a novel and extremely controversial use of involuntary commitment laws began to be practiced and that was to hold criminals, almost invariably sex offenders, after their terms have expired. Supporters claim that this is a valid use of involuntary commitment laws, while opponents claim that this is a potentially extremely dangerous way of bypassing the safeguards in the criminal justice system. This matter has been the subject of a number of cases before the Supreme Court of the United States.

Another trend of the same era was the development of laws expanding the power of courts to order people to take psychiatric medication on an outpatient basis. Though the practice had occasionally occurred earlier, outpatient commitment was used for many people who would otherwise have been involuntarily committed. The court orders often specified that a person who violated the court order and refused to take the medication would be subject to involuntary commitment.

Involuntary commitment is distinguished from conservatorship, was used by deprogrammers as a legal means to hold alleged cult victims against their will while talking them out of their faith. In hundreds of cases documented by attorney Jeremiah Gutman, deprogrammers were able to obtain conservatorship orders without having to bring the subject of the order before a judge.