Civil Commitment PSYCH-30111
Popular in Forensic Psychology
Popular in Psychlogy
This 4 page Class Notes was uploaded by Amy Turk on Wednesday April 13, 2016. The Class Notes belongs to PSYCH-30111 at Kent State University taught by Dr. Anthony Tarescavage in Spring 2016. Since its upload, it has received 6 views. For similar materials see Forensic Psychology in Psychlogy at Kent State University.
Reviews for Civil Commitment
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 04/13/16
CIVIL COMMITMENT ● Involuntary hospitalization or mandated treatment ○ Of mentally ill people ○ Who exhibit dangerous tendencies ○ Towards themselves or others ● Shaped by two major legal doctrines ○ Parens patriae = parent of the nation ■ Protect mentally ill from themselves ○ Police power = protect other people from mentally ill History ● Early 1900s ○ Patients hospitalized indefinitely based on a mental health professional’s recommendation ○ No need for a precise diagnosis or assessment of dangerousness to self or others ○ In 1955, over 500,000 people were psychiatrically hospitalized ● 1960s - current ○ As court cases gave patients more civil rights and antipsychotic medications were developed, the number of psychiatrically hospitalized individuals began to decrease ○ Currently less than 100,000 Landmark Cases ● Lake vs Cameron = 1966 ○ Required that treatment should be in least-restrictive setting ● Lessard vs Schmidt = 1972 ○ Commitment proceedings should have some safeguards as criminal proceedings ○ Ex. right to trial and right to attorney ● O’connor vs Donaldson = 1975 ○ An individual must exhibit both a mental illness AND dangerousness in order to be civilly committed Criteria ● Presence of a mental illness ● Presence of dangerousness to self or others Mental Illness ● Typically only severe and treatable mental illnesses like schizophrenia and major mood disorders qualify ● Labeling effects can impact whether or not someone is judged to have a mental illness ● People who have been institutionalized (or are being evaluated for institutionalization) are more likely to be labeled as mentally ill ● Labeling effects = a form of bias Rosenhan Study ● Sane in insane places ● “I hear a voice saying things like empty and thud.” ● The number of people admitted into the hospital and the average length of stay demonstrated the power of labeling effects Dangerousness ● At risk for committing bodily harm to others or engaging in suicidal attempts, gestures, or ideation ● We’re not good as risk assessment ○ More difficult in civil commitment evaluations because there is typically a need for an immediate decision with limited info ● Grave disability = occurs when a person is unable to care for themselves and provide for their own basic needs ○ Young people, not the elderly ● Two paths of civil commitment ○ Extended ○ Emergency Extended Commitment ● Numerous civil protections are in place ● Length of hearings = 12 minutes ● Patient is committed from 2 weeks to one year ● Periods of formal re-evaluation needed to maintain commitment ○ Every three months Emergency Commitment ● Less formal with fewer protections ● Authorized by a law enforcement officer or mental health pro ● Allows for a short hospitalization ○ 24 hours to one week ● Requires re-evaluation to maintain commitment ○ After 48 hours ○ Wancheck and Bonnie = this might be too soon ■ 72 hours instead Outpatient Commitment ● The person involuntarily participates in some form of treatment but does not reside at a facility 24 hours a day ● Traditional = meets criteria for civil commitment but the least restrictive setting is the community ● Preventative commitment = people do not meet criteria for civil commitment but expected to deteriorate and meet the criteria in the future ● Conditional release = person has been recently released from a psychiatric hospital with the condition that they participate in outpatient treatment Criticisms ● Traditional = if someone is dangerous enough to be civilly committed, they are too dangerous to be in the community ● Preventative = leads to more people who are involuntarily given treatment ● Conditional release = gives power back to mental health pros ● In practice, outpatient commitment is rarely used Coercion of Civil Commitments ● Over 30% of psychiatric patients are committed involuntarily ● Persuasion ● Threat or force ● Legal force ● Giving an order ● Deception Impact of Coercion ● A barrier to patients seeking mental health treatment ○ 36% afraid ● Huss & Zeiss = found that explaining to patients they had a right to a commitment hearing reduced their perceived level of coercion ○ Related to better treatment outcomes Sources of Coercion ● Mental health pros = most important source ● Perceptions of level of coercion is related to their perception of procedural justice = notion that an individual has been treated fairly regardless of outcome ● Frequency of coercion ○ Persuasion = 61% ○ No one asked patient for preferences = 57% ○ Legal force = 33% Civil Commitment Treatment Cases ● Wyatt vs Stickney = 1972 ○ Patients have a right to treatment that gives them a realistic opportunity to improve their mental conditions ● Washington vs Harper = 1992 ○ The state can forcibly medicate some people ● Sell vs United States ○ Patients hospitalized as incompetent to stand trial may be involuntarily medicated if… ■ The treatment is medically appropriate ■ The treatment does not have significant side effects ■ Less intrusive methods are considered Competency to Make Medical Decisions ● The majority of mentally ill are competent to make these decisions ● Appelbaum = 50% of schizophrenics and 76% of severely depressed patients had passing scores on a measure of competency Mental Health Advanced Patients ● Allow the patient to make any treatment decisions before they became incapacitated ● Hospital staff are largely unaware of their existence and are hesitant to encourage use ● Only 4 to 13% of psychiatric patients had signed one ● Over 77% reported they would complete one Assessment of Danger To Self ● Risk factors for suicide ○ History of suicide ○ Suicidal thoughts ○ Severe hopelessness ○ Family history of suicide ○ Acute abuse of alcohol ○ Loss or separation of relationships ● In general, assessment of grave disability is easier because you do not need to make a prediction ● Identification of mental illness as a risk factor is controversial ○ May encourage stereotypes of the mentally ill ○ Vast majority of mentally ill are not violent and are more likely to be victims of violence than perpetrators ● The relationship is a complex one and depends on the mental illness itself, presence of certain symptoms, and substance abuse ● Structured and actuarial violence risk assessments are not typically completed because of the lack of info available and the focus on immediate risk for violence
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'