civil commitment short paper
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Southern New Hampshire University *
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Course
570
Subject
Medicine
Date
Dec 6, 2023
Type
docx
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4
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Civil commitment is an issue that sparks debate among anyone working or involved within the legal
community. Civil commitment refers to a order by the judicial system where it is legally sanctioned for an
individual to be hospitalized for treatment against their will. This can either be through supervised
treatment as an outpatient or inpatient care in a psychiatric hospital. Criteria must be met before an
individual can be civilly committed which include “patients must exhibit dangerous behavior toward
themselves or others, they must be helpless and unable to provide for their basic daily needs, and there
is a danger of “essential harm” to their mental health if they do not receive mental care,” (Saya, et. al.,
2019).
In Missouri, statute 632 refers to psychiatric care. “In hearings for involuntary civil commitments, the
petitioner must prove by clear and convincing evidence that the respondent is either mentally ill, or is a
substance abuser, as applicable, and, in either case, presents a likelihood of serious physical harm to
himself or others,” (Section 39, n.d.). However, if there is clear evidence on imminent danger, an
individual may be committed without a court order by law enforcement or a licensed mental health
provider. The hold at the facility is a maximum of 96 hours unless the individual is still deemed a threat
to themselves or others. Missouri, until recently, also had civil commitment for those deemed “sexually
violent predators” where individuals would have inpatient treatment for as long as lifetime, if they were
deemed “as having a mental diagnosis that predisposes them to commit future sexual
violence,” (Prescott, 2019). This law was ruled unconstitutional by a Missouri federal judge in of 2019,
citing, “’systemic failures regarding risk assessment and release that have resulted in the continued
confinement of individuals who no longer meet the criteria for commitment, in violation of the Due
Process Clause,’ Fleissig wrote in her ruling,” (Federal, 2015).
Issues with this type of legislation are widely discussed among mental health professionals, prison
reformists, social advocates and friends and families of those committed. One issue is that civil
commitment has not shown a significant improvement in the lives of those committed, versus voluntary
commitment and voluntary commitment maintains autonomy. Another argument against civil
commitment is, “involuntary commitment violates the principle of beneficence,
because it can
stigmatize
homeless people with severe mental health and substance use disorders by implying that they
do not belong in public. Others contend it is cruel and coercive,” (Drabaik, 2023). Regarding legal
proceedings, involuntary commitment, especially outpatient, can leave room for the individual to not
fully follow the legal decree of their treatment plan. It can also hinder the administration of necessary
assessments for discharge or if there is a criminal element that needs assessed.
As with most issues related to the legal system, there is a disparity in the numbers of those involuntarily
committed, based on their race. An article written by Marvin Swartz found that, “People from racial-
ethnic minority groups are more likely than nonminority whites to access mental health services through
law enforcement involvement, and in the United States there are persistent racial-ethnic disparities in
such involvement and in involuntary commitment. Specifically, people who are Black are far more likely
to access services via involuntary commitment,” (Swartz, 2020). A solution to this would be the
employment of crisis workers to scenes with mental health emergencies as well as thorough training in
diversity and inclusion.
References
Drabiak, K. (2023). The ethical dilemmas behind plans for involuntary treatment to target homelessness,
mental illness and addiction.
College of Public Health.
Retrieved from
https://hscweb3.hsc.usf.edu/health/publichealth/news/the-ethical-dilemmas-behind-plans-for-
involuntary-treatment-to-target-homelessness-mental-illness-and-addiction/#:~:text=Critics%20also
%20assert%20that%20involuntary,it%20is%20cruel%20and%20coercive.
Federal judge finds unconstitutional Missouri’s operations of its sex-offender civil commitment program.
(2015).
Sentencing Law and Policy
. Retrieved from
https://sentencing.typepad.com/sentencing_law_and_policy/2015/09/federal-judge-finds-
unconstitutional-missouris-operation-of-its-sex-offender-civil-commitment-progra.html
Prescott, D. (2019). As courts censure civil detention practices, is it time for professionals to speak
up?
Prison Legal News.
Retrieved from https://www.prisonlegalnews.org/news/2019/jun/10/courts-
censure-civil-detention-practices-it-time-professionals-speak/
Saya, A., Brugnoli, C., Piazza, G., Liberato, D., Di Ciaccia, G., Niolu, C., & Siracusano. A. (2019). Criteria,
procedures, and future prospects of involutary treatment in psychiatry around the world: A narrative
review.
Front Psychiatry. 10
. 271. doi:10.3389./fspyt.2019.00271
Section 39. (n.d.). 16
th
Circuit Court of Jackson County Missouri. Retrieved
from
https://www.16thcircuit.org/Data/Sites/1/media/probate/probate-manual/ppm-section-39---
involuntary-civil-commitments---mental-health-and-substance-abuse-proceedings.pdf
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Swartz, M. (2020). The urgency of racial justice and reducing law enforcement involvement in
involuntary civil commitment. Psychiatric and Behavioral Services, Duke School of Medicine. https://doi-
org.ezproxy.snhu.edu/10.1176/appi.ps.711202
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