Commitment To A Mental Institution

Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in

Many ethical issues surround the involuntary psychiatric commitment of mentally ill patients. In the 1980s, the city of Manhattan was overwhelmed by the surplus of mentally unstable and homeless individuals residing on the streets. In an effort to help relieve the burden on the city, Project Help was created to provide assistance to the needy. Joyce Brown, a 40-year-old homeless woman, slept outside of an ice cream parlor for 18 months. Her appearance suggested that she was mentally unstable and in a state of constant self-neglect. Project Help forcibly admitted her to the emergency department of a local hospital and injected with antipsychotic drugs and tranquilizers. After being evaluated

Hagan, Claire. “Sheltering Psychiatric Patients from the DeShaney Storm: A Proposed Analysis for Determining Affirmative Duties to Voluntary Patients.” Washington and Lee Law Review, Jan. 2013, vol. 70, issue 1. EBSCOHost, http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=87120180&site=ehost-live.

In early years of the last century, housing mentally individuals in local jails or prisons was seen as inhumane and a reform movement led by Dorothea Dix began. This led to the building of mental hospitals. It was once believed that mentally ill individuals deserved to be treated and not punished. However, deinstitutionalization happened which was the emptying of state mental hospitals due to overcrowding and deterioration as well as the introduction of effective anti-psychotic medications and increased funding for the establishment of mental health centers. By the early 1970’s, it was becoming evident that the emptying of the state mental hospitals turned many prisons throughout the U.S into institutions. Despite this clear evidence, deinstitutionalization continues even to this day. The mentally ill, left with few resources, largely turned to petty crime, ending up in prison because there were no other better alternatives.

In the early 1960’s, Canada began its movement towards deinstitutionalization, based on the belief that community based care would better serve populations affected with mental illness (Davis, 2014). As a result, legislation sanctioning involuntary treatment within community settings became increasingly used (Davis, 2014). Currently under civil law, there are three methods of initiating mandatory outpatient treatment in Canada (Davis, 2014). In British Columbia, mandatory outpatient treatment occurs when an individual is placed on a leave provision following involuntary admission in hospital (Davis, 2014). Once this is completed, the individual is considered to be on extended leave, and their care is transferred to a community mental health

Within contemporary society, the legal process of placing an individual into a detention or psychatric treatment facility is called "civil commitment." Typically, this is reserved for the mentally ill, or those people who have satisfied the Court's rule that they are a danger to others, or to themselves. Society realizes that, at times, an individual may pose a danger to themselves or to society and be unable to make rational decisions. In fact, in most jurisdictions in the modern world, involuntary commitment procedures are specifically applied to individuals who have manifested some form of serious mental illness that acts to impair their reasoning to such extent that they are unable to make cogent and logical decisions. Therefore, at these times the state (the Court system) must intercede to find ways to make the appropriate decisions under a legal template. Involuntary commitment may have, in the past, been used in certain situations, inappropriately, but the statutory criteria that indicates one is a danger to self or others usually acts as a legal axiom (Korba, 2008).

The deinstitutionalization of state mental hospitals has left many individuals untreated and in the community where there come under police scrutiny due to their odd behavior, that is a manifestation of their illness. Majority of mentally ill offenders have not committed a serious crime and are subjected to inappropriate arrest and incarceration (Soderstrom, 2008). This new policy has become quite a concern to the fact that the correctional environment has proven to show no positive results in the mental health of the offender during their time of incarceration or upon their release date and thereafter (Soderstrom, 2008).

Deinstitutionalization is defined as the movement of severely mentally ill people out of large state institutions. In the 1950s, public hospitals housed well over 500,000 people. The reduction in the number of institutionalized people began in 1956. By 1980, the residential population in mental hospitals dropped by nearly three-quarters, an average of 154,000 individuals. This decrease is due to the process of closing public hospitals and transferring patients to community-based mental health services. Consequently, community services were implemented (Talbott 2004).

Given the number of incarcerated inmates who suffer from some form of mental illness, there are growing concerns and questions in the medical field about treatment of the mentally ill in the prison system. When a person with a mental illness commits a crime or break the law, they are immediately taken to jail or sent off to prison instead of being evaluated and placed in a hospital or other mental health facility. “I have always wondered if the number of mentally ill inmates increased since deinstitutionalization” Since prison main focus is on the crimes inmates are incarcerated; the actual treatment needed for the mentally ill is secondary. Mentally ill prisoners on the surface may appear to be just difficult inmates depending on the

The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus

Although there are many people who support involuntary commitment, there are also those who do not. Despite all of the support for involuntary commitment of dangerous, mentally disturbed individuals; there will always be people in opposition to this practice. In America especially, it is currently a very controversial topic. Those against involuntary commitment of the mentally disordered argue that it “is an extraordinary exercise of paternalism and the police power of the state” (Morse 58).

Civil commitment procedures and policies vary across the nation, Virginia holding one of the shortest procedures in emergency response to mental health crisis. Virginia’s mental health reform needs comes to the forefront of the political agenda after tragedy ensues itself. Although, prior reports and evaluations identify service gap issues and problems with the emergency services system. The preferred political system is the problem stream that opens a policy window to allow support much needed reform. In 2005, Virginia established a commission to study problems and service gaps identified throughout the 1990’s that included civil commitment procedures. Virginia strict civil commitment practice and interpretation made involuntary admission

The incarceration of those who are mentally ill is on the continual rise. Many states juggle with the decision of placing offenders in Mental Hospital or locating them in State Prisons. Latessa and Holsinger (2011) discuss two major reasons for the increase of those with mental illness within the prison system. First, many states have no longer allow for the insanity plea during criminal trials, thus those who suffer from mental illness are not required to receive mandatory mental treatment. This is due to the discomforting idea that criminal offenders should not be given the same living conditions as those whom are patients of mental wards. Secondly, longer sentences have created a surplus of mentally ill offenders needing treatment. Soderstrom (2007) added that the lack of mental health support systems in

The shutdown of state mental hospitals and lack of available financial and institutional resources force mentally ill people to the United States Judicial System for mental health. Every year thousands of people are arrested for various crimes and they are sent to jail. Sixteen percent of these people have some type of mental health problem (Public Broadcasting System , 2001). When we consider that the United States has the largest incarcerated population in the world at 2.2 million, this number is staggering (Anasseril E. Daniel, 2007). This is about 1% of the entire population of the United States. There are many reasons as to why the situation has taken such a bad turn and when the history of the treatment of mental illness is examined one can see how the situation developed into the inhumane disaster it is today.

Jails have been described as “de facto mental hospitals” because they have filled the void created when state psychiatric hospitals began closing in the early 1960s through a process known as deinstitutionalization. Supporters of deinstitutionalization thought the process would help individuals suffering from a mental illness live more self-reliantly while being treated by community mental health programs. However, the federal government did not provide the necessary funding to meet the mounting demand for these programs, leaving numerous untreated. Individuals with serious mental illnesses are often poor or homeless and are likely to have substance abuse problems. Therefore, when they are left untreated, they are more likely to commit minor crimes that have been the focus of law enforcement in recent years (H. Richard Lamb and Linda Weinberger).