Commitment

• Author: Jeffrey Lehman, Shirelle Phelps

Page 24

Proceedings directing the confinement of a mentally ill or incompetent person for treatment.

Pursuant to statutory and case law, DUE PROCESS protections are afforded to persons who have been involuntarily committed, including periodic JUDICIAL REVIEW. Commitment has often raised difficult issues of BALANCING the civil liberties of the person who is subject to commitment against other competing interests, including the rights of society to be protected from individuals who might prove dangerous as a result of their mental illness or incompetence, and the community's interest in ensuring that these individuals receive proper treatment.

Each state has its own detailed statutory scheme providing for the involuntary commitment of individuals who might be mentally ill or incompetent. These statutes usually contain language defining the types of mental illnesses and conditions covered by the law, as well as certain conditions that are excluded from coverage?generally mental retardation, epilepsy, developmental

Page 25

disabilities, and drug or alcohol addiction. In addition, most state commitment statutes set forth specific criteria or standards that link these conditions to justifications for involuntary commitment.

Most jurisdictions have at least one criterion that is based on a person's dangerousness to himself or herself, or others. Some states require that other criteria that are closely related to dangerousness be met, such as the presence of a grave disability or an inability to provide for one's basic human needs, or that some medical or psychological treatment is essential to the person's welfare. Since the 1980s, some states have moved significantly away from a strict dangerousness standard for involuntary commitment. In Arizona, for example, a person who is "persistently or acutely disabled" because of mental illness may be subject to commitment (Ariz. Rev. Stat. Ann. § 36-540 (A) [1995]), and in Delaware, an individual who cannot make "responsible decisions" about inpatient care and treatment may be committed (Del. Code Ann. tit. 16, § 5001 [1995]). An even broader standard has been enacted in Iowa, where the law provides that a person may be committed if he or she is likely to inflict serious emotional injury on family or others who "lack reasonable opportunity" to avoid contact with that person (Iowa Code Ann. § 229.1 [West 1995]).

In most jurisdictions, commitment requires a showing that inpatient hospitalization is the least restrictive treatment alternative for the person, in addition to a showing of dangerousness. This requirement is based on the principle, established by the U.S. Supreme Court, that even though a government purpose might be legitimate and substantial, the purpose "cannot be pursued by means that...