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Involuntary Commitment

Involuntary commitment is the practice of using legal means or acts as part of a mental health law to commit a person to a mental hospital, psychiatric ward, institution, or other facility, against their will or over their protests. Different states have different mental health laws governing involuntary commitment – some require a court hearing, while others allow involuntary commitment at the request of physicians (or other mental health professionals) that must follow set legal procedures. Sometimes these laws fall under what are called “mental hygiene” laws.

In most jurisdictions, involuntary commitment is specifically directed at a person claimed (or found) to be suffering from a mental illness which impairs their ability to reason to such an extent that the state or courts find that the person’s decisions should be, or must be, made for them under a legal framework. In some jurisdictions, there is a distinct court proceeding from which the person is determined to be found “incompetent."

Different jurisdictions have different criteria. Some allow involuntary commitment only if the person both appears to be suffering from a mental illness and that the effects of the mental illness produce a risk to themselves or others. Other jurisdictions have criteria that are broader.

Observation is sometimes used to determine if a person warrants involuntary commitment. It is not always clear on a relatively brief examination whether a person is psychotic or otherwise warrants commitment to a facility, so sometimes a person is admitted for a period of time to observe their behavior.

This period of observation can be helpful in determining the actual diagnosis, but can also tend to produce an expectation of disease which may alter the perceptions and behavior of the staff. D.L. Rosenhan wrote a paper called “On Being Sane in Insane Places,” which demonstrated this phenomenon. 1 In this experimental study, a number of volunteers mimicked mental illnesses to obtain admission to a hospital, and then subsequently behaved normally. The staff, however, continued to perceive that they were exhibiting signs of the illness for which they were diagnosed on admission, and treated them as such. Rosenhan’s paper illustrates the subjective nature of mental diagnoses.

A common reason given for involuntary commitment is to prevent danger to the individual or to society at large. People with suicidal thoughts may act on these thoughts and harm or kill themselves. People with psychoses are occasionally driven by their delusions or hallucinations to harm themselves or others. People with personality disorders, such as Borderline Personality Disorder, are occasionally violent. Therefore, it is felt that these people need to be hospitalized (institutionalized) to prevent harm to themselves and/or others. This concern has found expression in the standards for involuntary commitment of a number of jurisdictions in the U.S. as the "danger to self or others" standard. Usually, the standard will include the phrase that the danger must be “imminent,” however.

Involuntary commitment regarding juveniles is governed by state law and procedures vary from state to state. In some jurisdictions, laws regarding the commitment of juveniles may vary, with what is the involuntary commitment of a juvenile perhaps defined as "voluntary" if his/her parents agree, though he/she may still have a right to protest and attempt to get released.

1. Rosenhan, D.L. (1973). On Being Sane in Insane Places. Science, 179, 250-258.

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

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