Involuntary Commitment: Justified?
Mental health is a large issue in this country. Although the stigmatization of mental illness has been waning in recent years, our society in large part continues to stigmatize individuals with mental illness on a large scale. In our legal system, individuals with severe mental illnesses are not so much stigmatized as they are feared. When an individual is thought to either be threatening to him or herself, or to other individuals, because of his or her mental illness, a court may mandate that the individual be committed into a psychiatric hospital regardless of whether the individual consents. The focus of this blog post is to discuss whether committing individuals without their consent should be legal.
Over the past few years, there have been several heinous acts committed by individuals many consider to be mentally ill. Using Mass Shooting Tracker, which defines a mass shooting as one in which at least four people are shot or killed in a single event at the same general location or time, there were 372 mass shootings that resulted in 475 people being killed and approximately 1,870 people being wounded just last year. Many argue that shootings at schools and public areas are often the result of mental illness. They believe that individuals suffering from mental illness should be committed to psychiatric hospitals to ensure the safety of the public. In turn, these same individuals often support involuntary commitment because “dangerous” individuals are committed before they are able to cause harm to anyone else. While it is true that even some mental health advocacy organizations, such as Mental Health America, argue that involuntary commitment is sometimes necessary, these organizations insist that voluntary treatment is the best action for recovery.
On the other hand, scientific evidence disputes any causal link between mental illness and crime. By some estimates, eliminating the population of everyone with a major mental illness would alleviate just ten percent of the public’s crime. The American Psychological Association conducted a study of crimes committed by mentally ill individuals and found that only 7.5 percent of the crimes were committed as a direct result of the individual’s mental illness. Within that 7.5 percent, two-thirds were found to have committed other, unrelated crimes directly related to issues such as poverty, homelessness, and substance abuse. Moreover, researchers in the MacArthur Violence Risk Assessment Study, which unlike other previous studies negated the effect of socioeconomic status and other broad environmental factors, determined that the prevalence of violence among those with a major mental disorder who did not abuse substances was indistinguishable from their non-substance abusing neighborhood controls.
Involuntary commitment has not just sprouted from thin air. The ability to imprison someone against their will has been around for thousands of years. Involuntary commitment is often considered immoral, illegal, or a combination of both because the decision to commit someone without his or her consent can often be arbitrary and subjective. Neither the intent to harm oneself nor the intent to harm others can be easily identified, even by professionals. Individuals that suffer from mental illness can often keep their thoughts internalized, leading them to look one way externally while feeling much different internally. Therefore, while it may appear justified to involuntarily commit an individual that poses an imminent threat, identifying that threat is much more difficult than the average person realizes. This might lead to individuals who do pose an imminent threat falling through the cracks and out of the system, while other individuals who do not pose a threat staying in the system and being subjected to a restriction of freedom that is not justified.
In the United States, prior to the 1960s, involuntary commitment was straightforward as individuals could be placed into psychiatric institutions against their will for extended periods of time without judicial oversight. In 1975, in O’Connor v. Donaldson, the U.S. Supreme Court decided arguably its most important “mental health” case in its history. The Court held that a state cannot constitutionally hold a non-dangerous individual who is capable of living freely on his own or with the care of his family and friends. The impact of the case has been tremendous, largely due to the decision’s interpretation by the ACLU. The ACLU interpreted the holding to mean that it is unconstitutional involuntarily commit an individual who is not an imminent danger, and has argued that individuals must be considered capable of surviving safely on his or her own if his life is not in immediate danger. Because the ACLU is a strongly-supported proponent for civil rights nationwide, the ACLU’s stance on this issue has made it difficult over the past three decades for States to change their civil commitment laws from a “dangerous” standard to a “need for treatment” standard.
All things considered, there are pros and cons to involuntary commitment. Whether it should be legal is controversial, and even psychologists who are trained to identify individuals with severe mental illness can differ on which individuals are dangerous to the extent that the law currently requires for involuntary commitment. Thus, to avoid the possibility that non-violent, mentally ill people have their freedom restricted and arguably constitutionally violated, involuntary commitment should either be made illegal or at the very least kept at the standard it is at now.