DOCSLIB.ORG

Involuntary Civil Commitment of the Mentally Ill: a System in Need of Change

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Involuntary Civil Commitment of the Mentally Ill: a System in Need of Change Volume 29 Issue 2 Article 2 1983 Involuntary Civil Commitment of the Mentally Ill: A System in Need of Change John E. B. Myers Follow this and additional works at: https://digitalcommons.law.villanova.edu/vlr Part of the Law and Psychology Commons Recommended Citation John E. Myers, Involuntary Civil Commitment of the Mentally Ill: A System in Need of Change, 29 Vill. L. Rev. 367 (1983). Available at: https://digitalcommons.law.villanova.edu/vlr/vol29/iss2/2 This Article is brought to you for free and open access by Villanova University Charles Widger School of Law Digital Repository. It has been accepted for inclusion in Villanova Law Review by an authorized editor of Villanova University Charles Widger School of Law Digital Repository. Myers: Involuntary Civil Commitment of the Mentally Ill: A System in Nee 1983-84] INVOLUNTARY CIVIL COMMITMENT OF THE MENTALLY ILL: A SYSTEM IN NEED OF CHANGE JOHN E. B. MYERSt Table of Contents Introduction .................................................. 368 I. THE RISE OF INSTITUTIONS ............................. 368 II. DEVELOPMENT OF INVOLUNTARY COMMITMENT LAW... 375 A. HistoricalDevelopment ..................... .......... 375 B. The Authority of the State to Impose Involuntay Commit- ment-The Parens Patriae Power ..................... 380 III. THE DEINSTITUTIONALIZATION MOVEMENT ............. 388 A. HistoricalDevelopment ................................ 388 B. The Contribution of the Courts to Deinstitutionah'zation.... 394 C. Treatment in the Least Restrictive Environment ........... 400 IV. FAILINGS OF THE DEINSTITUTIONALIZATION MOVEMENT ......................................................... 40 3 A. The "Community's" Failure to Provide Adequate Commu- nity-Based Treatment Resources ......................... 403 B. The Shortcomings of Denstitutionah'zationare Exacerbated by Restrictive Commitment Laws ........................ 409 V. ALTERNATIVES FOR CHANGE IN THE SYSTEM OF INVOL- UNTARY TREATMENT OF THE MENTALLY ILL ........... 412 A. Abolition of Involuntary Treatment ...................... 413 B. Fine Tuning the Present System ......................... 414 C. Guardianship Law .................................... 414 D. Adult Protective Services Statutes ....................... 416 E. A Proposalfor Alteration of the System of Involuntay Civil Commitment .......................................... 418 1. Overview of the Proposal ........................... 418 2. OperationalAspects of the ProposedSystem of Involun- tagi Treatment .................................... 425 a. Procedural safeguards ........................ 425 b. Judicial supervision of the system ............ 426 t Assistant Professor of Law, McGeorge School of Law. The author wishes to express appreciation to Ms. Joanne Slotnick, Esq. for her assistance in the prepara- tion of this article. (367) Published by Villanova University Charles Widger School of Law Digital Repository, 1984 1 Villanova Law Review, Vol. 29, Iss. 2 [1984], Art. 2 VILLANOVA LAW REVIEW [Vol. 29: p. 367 c. Intervention is permitted only after efforts to secure voluntary participation fail ............ 426 d. Involuntary treatment may be ordered only when an individual is likely to cause harm to him or herself, or suffer substantial mental or physical deterioration ........................ 427 e. Lack of rational decisionmaking capacity .... 428 (i) The danger of benevolent paternalism... 429 (ii) Adjudication of capacity for rational decisionmaking ......................... 431 f. Police power commitment will continue to be available ..................................... 432 g. The problem of enforcement ................. 432 V I. CONCLUSION ............................................ 433 INTRODUCTION T HIS article is written to propose a change in the law of involun- tary civil commitment of the mentally ill. The impetus for such a change is found in the present commitment system, which is outmo- ded and unresponsive to the needs of the mentally ill in contemporary society. To set the stage for the proposed change, an examination of the development of institutions for the mentally ill and the concomi- tant development of involuntary civil commitment is necessary. Fur- thermore, the development and effects of the deinstitutionalization movement must be scrutinized. I. THE RISE OF INSTITUTIONS In 1842 Charles Dickens traveled through much of America.1 During his travels, he visited several types of institutions, including hospitals for the mentally ill. In Boston, he described in glowing terms a "State Hospital for the insane, admirably conducted on... enlightened principles of conciliation and kindness."' 2 Dickens' description of the physical plant could easily be applied to many state operated facilities in existence today: Each ward in this institution is shaped like a long gal- lery or hall, with the dormatories of the patients opening from it on either hand. Here they work, read, play at skit- 1. See 1 E. JOHNSON, CHARLES DICKENS: His TRAGEDY AND TRIUMPH 357- 446 (1952). 2. C. DICKENS, AMERICAN NOTES AND PICTURES FROM ITALY 45 (London 1970) (first published in London, 1842) [hereinafter cited as AMERICAN NOTES]. https://digitalcommons.law.villanova.edu/vlr/vol29/iss2/2 2 Myers: Involuntary Civil Commitment of the Mentally Ill: A System in Nee 1983-841 INVOLUNTARY CIVIL COMMITMENT ties, and other games; and when the weather does not admit 3 of their taking exercise out of doors, pass the day together. On a later visit to another "Lunatic Asylum," Dickens offered a much less optimistic assessment: I cannot say that I derived much comfort from the in- spection of this charity. The different wards might have been cleaner and better ordered; I saw nothing of that salu- tary system which had impressed me so favorably elsewhere; and everything had a lounging, listless, madhouse air, which was very painful. The moping idiot, cowering down with long dishevelled hair; the gibbering maniac, with his hide- ous laugh and pointed finger; the vacant eye, the fierce wild face, the gloomy picking of the hands and lips, and munch- ing of the nails: there they were all without disguise, in na- ked ugliness and horror. In the dining-room, a bare, dull, dreary place, with nothing for the eye to rest on but the empty walls, a woman was locked up alone. She was bent, they told me, on committing suicide. If anything could have strengthened her in her resolution, it would certainly have been the insupportable monotony of such an 4 existence. These few lines from Dickens' pen indicate that the use of large institutions for the confinement of the mentally ill was commonplace by the middle of the nineteenth century. Already present were many of the institutional abuses challenged in the courts more than a cen- tury later.5 Prior to American independence, the mentally ill did not fare well.6 The dangerous or violent were frequently incarcerated with criminals, 7 while the non-dangerous were treated like common pau- 3. Id 4. Id. at 93. 5. For a discussion of these challenges in the courts, see notes 151-205 and ac- companying text infra. 6. See A. DEUTSCH, THE MENTALLY ILL IN AMERICA 39-54 (1949); COMPRE- HENSIVE TEXTBOOK OF PSYCHIATRY 1-75 (H. Kaplan, A. Freedman & B. Sadock eds. 3d ed. 1980) [hereinafter cited as TEXTBOOK OF PSYCHIATRY]. See also AMERI- CAN BAR FOUNDATION, THE MENTALLY DISABLED AND THE LAW 1-14 (S. Brakel & R. Rock eds. 1971). This treatise contains a useful description of legal treatment accorded the mentally ill from prehistoric times through the twentieth century. 7. See genera/I; L. BELL, TREATING THE MENTALLY ILL FROM COLONIAL TIMES TO THE PRESENT (1980). Deutsch states that [u]ntil the last quarter-century of the colonial period there were no hospitals in all the land to which the mentally ill might be sent. Generally Published by Villanova University Charles Widger School of Law Digital Repository, 1984 3 Villanova Law Review, Vol. 29, Iss. 2 [1984], Art. 2 VILLANOVA LAW REVIEW [Vol. 29: p. 367 pers.8 Responsibility for poor relief fell to local authorities,9 who fol- lowed the lines set down by the Elizabethan Poor Law of 1601.10 The Act's guiding spirit was repression, rather than relief, of pauperism."I By the second quarter of the eighteenth century, the dependent men- tally ill were often found languishing in workhouses and alms- houses.' 2 These early institutions were anything but therapeutic, and the lot of the mentally ill was certainly not pleasant. 13 Many were left to wander aimlessly about the countryside. In fact, early town records reveal that local authorities not infrequently escorted such in- 4 dividuals to the edge of town and instructed them not to return.' Some officials, who were still more resourceful, physically removed hapless individuals from one town and, under cover of darkness, they were not considered as a special class, but were disposed of as criminals or as paupers, as the case might be. They were ordinarily confined in jails, workhouses, poorhouses, or in private pens, cages and strongrooms. The object of public provision was frankly repressive or custodial; no thought was given to therapy. A. DEUTSCH, supra note 6, at 420. 8. The American Bar Foundation has opined that the non-dangerous mentally ill were treated as a monolithic mass; there was no attempt to analyze its compo- nents. A "drifter" was a "drifter" and nothing more. Whether he was men- tally or physically disabled or simply lazy made no difference to the townspeople, who feared they would have to support him. For these rea- sons the mentally
Load more

Recommended publications
  • Guardian's Authority to Involuntarily Hospitalize the Incompetent Ward JOHN L
    Guardian's Authority to Involuntarily Hospitalize the Incompetent Ward JOHN L. SULLIVAN, J.D.,LL.M.* A Guardian may give any consents or approvals that may be necessary to enable the ward to receive medical or other professional care, counsel, treatment or service. Section 5-312(a) (3) Uniform Probate Code If Section 5-312(a) (3) is accepted as a composite or representative definition of a guardian of the person's state law statutory authority to deal with the care and custody of his incompetent ward in matters relating to medical management, any private hospital could admit, on the signature of the guardian, any so-called "lucid" incompetent. The limitation to a consideration of private hospital admission is made because it is almost universal practice for state or governmental hospitals to demand a civil commitment order before admitting an involuntary patient, whether declared incompetent or not. The so-called "lucid" incompetent is the adjudicated incompetent who still can be heard to protest the decisions made for him by his guardian. The labeling and attendant distinction of the "lucid" incompetent is useful in categorizing those cases where courts have been called upon to render judgments relating to radical medical procedures such as experimental psychosurgery 1 or kidney transplants2 or negative medical procedures such as a discontinuance of medical suppon systems. 3 In such cases it has readily been seen that the bare authority of a guardian under state statutes is not sufficient to authorize medical procedures or cessation of them. It has been agreed that specific coun authority is required, and probably that of a court exercising equity jurisdiction.
    [Show full text]
  • The Cuckoo's Nest: an Examination of the National Commission Report on Psychosurgery Steven C
    Hofstra Law Review Volume 6 | Issue 4 Article 3 1978 Return to the Cuckoo's Nest: An Examination of the National Commission Report on Psychosurgery Steven C. Spronz Follow this and additional works at: http://scholarlycommons.law.hofstra.edu/hlr Recommended Citation Spronz, Steven C. (1978) "Return to the Cuckoo's Nest: An Examination of the National Commission Report on Psychosurgery," Hofstra Law Review: Vol. 6: Iss. 4, Article 3. Available at: http://scholarlycommons.law.hofstra.edu/hlr/vol6/iss4/3 This document is brought to you for free and open access by Scholarly Commons at Hofstra Law. It has been accepted for inclusion in Hofstra Law Review by an authorized administrator of Scholarly Commons at Hofstra Law. For more information, please contact [email protected]. Spronz: Return to the Cuckoo's Nest: An Examination of the National Commi NOTES RETURN TO THE CUCKOO'S NEST: AN EXAMINATION OF THE NATIONAL COMMISSION REPORT ON PSYCHOSURGERY One Flew Over the Cuckoo's Nest' describes the use of psychosurgery to rid MacMurphy, an inmate-patient who chal- lenged the authority of his "keepers" in a psychiatric institution, of his allegedly violent tendencies. The operation transformed him into a human vegetable. His friend, the "Chief," another patient at the hospital, recognized that MacMurphy's life was now without meaning and mercifully suffocated him. The author's indictment of abuses in mental institutions was published in 1962, when the practice of psychosurgery was waning in the United States. 2 Cuckoo's Nest should belong to a bygone era, one replaced by an age in which more humane treatments are administered.
    [Show full text]
  • Chapter 8 – Civil Commitments
    GENERAL DISTRICT COURT MANUAL CIVIL COMMITMENTS Page 8-1 Chapter 8 – Civil Commitments Civil Commitments include involuntary admissions of mentally ill/intellectual disability and medical emergency temporary detention. Civil mental illness/intellectual disability proceedings and medical emergency consent proceedings may be heard by a judge of the general district or juvenile and domestic relations district court or a special justice appointed by the chief judge of the applicable judicial circuit. Va. Code § 37.2-803. The involuntary mental commitment process begins when a petition is filed, and alleges a person is mentally ill and in need of hospitalization. For proceedings in this chapter, whenever the term “mental illness” appears, it shall include substance abuse. Va. Code § 37.2-800. The process may begin with a referral to the localities’ Community Service Board, or may be initiated at the magistrate’s office. Some clerk’s offices will only receive paperwork after the proceedings and hearings are over, while in some offices the judges themselves may hold the hearing. These are the procedures for filing and indexing under each circumstance. Transportation of a person who is the subject of an emergency custody order, temporary detention order, and a person under an involuntary commitment order may be provided by a family member or friend, representative of the Community Services Board (CSB), or other alternative transportation provided with staff trained to provide transportation is a safe manner. No person who provides alternative transportation pursuant to these sections shall be liable to the person being transported for any civil damages for ordinary negligence in acts or omissions that result from providing such alternative transportation.
    [Show full text]
  • Involuntary Commitment: Implication for Psychiatric Nursing Practice* a RTICLE
    O RIGINAL Involuntary commitment: implication for psychiatric nursing practice* A RTICLE INTERNAÇÃO INVOLUNTÁRIA: AS IMPLICAÇÕES PARA A CLÍNICA DA ENFERMAGEM PSIQUIÁTRICA INTERNACIÓN INVOLUNTARIA: IMPLICACIONES PARA LA CLÍNICA DE ENFERMERÍA PSIQUIÁTRICA Lilian Hortale de Oliveira Moreira1, Cristina Maria Douat Loyola2 ABSTRACT RESUMO RESUMEN The characteristics of involuntary psychiat- Quando nos deparamos com Internação Psi- Cuando nos encontramos con Internación ric commitment (IPI) may cause implica- quiátrica Involuntária (IPI), percebemos que Psiquiátrica Involuntaria (IPI), percibimos tions on the nursing/patient relationship. as características dessa internação podem que las características de internación pue- The objectives of this study were to list the causar implicações para a relação enferma- den causar implicaciones en la relación en- forms of nursing care delivered to psychi- gem/paciente. Relacionar os cuidados de fermería/paciente. Relacionar los cuidados atric patients, according to the type of com- enfermagem prestados ao paciente psiqui- de enfermería brindados al paciente psi- mitment; analyze the reaction of the nurs- átrico, considerando o tipo de internação; quiátrico, considerando el tipo de interna- ing team towards the IPI patient, and dis- analisar a reação da equipe de enfermagem ción; analizar la reacción del equipo de en- cuss on the implications that IPI have on the em relação ao paciente de Internação Psi- fermería en relación al paciente de IPI, y practice o psychiatric nursing. A field re- quiátrica Involuntária (IPI), e discutir as im- discutir las implicaciones de la IPI para la search was performed with the nursing plicações da IPI para a clínica da enferma- clínica de enfermería psiquiátrica. Investi- team of a psychiatric institution in Rio de gem psiquiátrica.
    [Show full text]
  • Mental Health Commitment Laws: a Survey of the States
    Mental Health Commitment Laws A Survey of the States February 2014 Research from the Treatment Advocacy Center 1 Mental Health Commitment Laws A Survey of the States Brian Stettin, Esq. Policy Director, Treatment Advocacy Center Jeffrey Geller, M.D. Professor of Psychiatry Member of the Board, Treatment Advocacy Center Kristina Ragosta, Esq. Director of Advocacy, Treatment Advocacy Center Kathryn Cohen, Esq. Legislative and Policy Counsel, Treatment Advocacy Center Jennay Ghowrwal, MHS Research and Communications Associate, Treatment Advocacy Center © 2014 by the Treatment Advocacy Center The Treatment Advocacy Center is a national nonprofit organization dedicated exclusively to eliminating barriers to the timely and effective treatment of severe mental illness. The organization promotes laws, policies and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder. 2 TACReports.org/state-survey EXECUTIVE SUMMARY The tragic consequences of ignoring the needs of individuals with the most severe mental illness who are unable or unwilling to seek treatment are on vivid display nationwide: on our city streets, where an estimated quarter million people with untreated psychiatric illness roam homeless; in our jails and prisons, which now house 10 times as many people with severe mental illness than do our psychiatric hospitals; in our suicide and victimization statistics, where individuals with psychotic disorders are grossly overrepresented; and in our local news, which reports daily on violent acts committed by individuals whose families struggled vainly to get them into treatment. In the U.S., primary responsibility for treatment of this vulnerable and at-risk population falls to state and local governments.
    [Show full text]
  • Involuntary Outpatient Commitment and Related Programs of Assisted Outpatient Treatment 1
    APA Resource Document RESOURCE DOCUMENT ON INVOLUNTARY OUTPATIENT COMMITMENT AND RELATED PROGRAMS OF ASSISTED OUTPATIENT TREATMENT 1 Prepared by the Council on Psychiatry and Law: Marvin S. Swartz, M.D. Steven K Hoge, M.D. Debra A. Pinals, M.D. Eugene Lee, M.D. Li-Wen Lee, M.D. Mardoche Sidor, M.D. Tiffani Bell, M.D. Elizabeth Ford, M.D. R. Scott Johnson, M.D. Approved by the Joint Reference Committee, October 2015 "The findings, opinions, and conclusions of this report do not necessarily represent the views of the officers, trustees, or all members of the American Psychiatric Association. Views expressed are those of the authors." -- APA Operations Manual. Involuntary outpatient commitment is a form of court-ordered outpatient treatment for patients who suffer from severe mental illness and who are unlikely to adhere to treatment without such a program. It can be used as a transition from involuntary hospitalization, an alternative to involuntary hospitalization or as a preventive treatment for those who do not currently meet criteria for involuntary hospitalization. It should be used in each of these instances for patients who need treatment to prevent relapse or behaviors that are dangerous to self or others. Executive Summary, Conclusions and Recommendations In 1987, the American Psychiatric Association’s Task Force Report on Involuntary Outpatient Commitment endorsed its use under certain circumstances (1) and reiterated its endorsement in the 1999 Resource Document on Mandated Outpatient Treatment (2). During the decades since publication of the 1987 Task Force Report, outpatient commitment has received a great deal of 1 Outpatient court-ordered treatment may be referred to as ‘assisted outpatient treatment’, ‘involuntary outpatient commitment’, ‘mandated community treatment’, or ‘community treatment orders’.
    [Show full text]
  • Involuntary Commitment to Outpatient Treatment © American Psychiatric Association, All Rights Reserved Page 1 of 10
    TABLE OF CONTENTS Involuntary Outpatient Treatment . 1 Surveys of Outpatient Commitment Statutes . 2 Studies of Outpatient Commitment . 2 The Impact of Recent Statutory Changes . 4 Implications for the Future Use of Outpatient Commitment . 5 Proposed Supplement to American Psychiatric Association . 6 Guidelines for Legislation on the Psychiatric Hospitalization of Adults References . 9 26 INVOLUNTARY OUTPATIENT TREATMENT Prior to the late 1960’s, involuntary treatment of the mentally ill was INVOLUNTARY COMMITMENT TO provided almost exclusively in long-term inpatient facilities. The majority of patients suffered from chronic illnesses for which there were no effective OUTPATIENT TREATMENT treatments which could permit many of them to be discharged into the community. Although the legal authority for commitment emanated from state statutes, the process, essentially dominated by clinicians, held few REPORT OF THE TASK FORCE ON procedural protections for patients facing commitment (1). INVOLUNTARY OUTPATIENT With the growing availability of effective treatment for chronic mental illnesses in the 1960’s, the community mental health movement and COMMITMENT advocates concerned with patients’ civil rights worked for the deinstitutionalization of as many hospitalized patients as possible (2,3). David Starrett, M.D., Chairperson Legislators were attracted to the movement by the prospect of saving Robert D. Miller, M.D. money through hospital closure and less expensive community treatment Joseph Bloom, M.D. (4). The combination of stricter commitment laws (most of which William D. Weitzel, M.D. incorporated the criterion of treatment in the least restrictive environment Robert D. Luskin, Esq., Consultant (5)) and the establishment of federally-supported community mental health centers led to a massive depopulation of the public mental hospital Publication authorized by the Board of Trustees, June 1987 system.
    [Show full text]
  • How the Involuntary Commitment of Persons with Mental Illness Violates the United States Constitution
    Hastings Constitutional Law Quarterly Volume 47 Number 4 Summer 2020 Article 3 Summer 2020 Worse than Punishment: How the Involuntary Commitment of Persons with Mental Illness Violates the United States Constitution Samantha M. Caspar Artem M. Joukov Follow this and additional works at: https://repository.uchastings.edu/ hastings_constitutional_law_quaterly Part of the Constitutional Law Commons Recommended Citation Samantha M. Caspar and Artem M. Joukov, Worse than Punishment: How the Involuntary Commitment of Persons with Mental Illness Violates the United States Constitution, 47 HASTINGS CONST. L.Q. 499 (2020). Available at: https://repository.uchastings.edu/hastings_constitutional_law_quaterly/vol47/iss4/3 This Article is brought to you for free and open access by the Law Journals at UC Hastings Scholarship Repository. It has been accepted for inclusion in Hastings Constitutional Law Quarterly by an authorized editor of UC Hastings Scholarship Repository. For more information, please contact [email protected]. A - CASPAR_ JOUVOK_CLQ_V47-4 (DO NOT DELETE) 4/6/2020 10:11 AM Worse than Punishment: How the Involuntary Commitment of Persons with Mental Illness Violates the United States Constitution by SAMANTHA M. CASPAR* & ARTEM M. JOUKOV** The most important deprivation of human and constitutional rights inflicted upon persons said to be mentally ill is involuntary mental hospitalization . – Dr. Thomas Szasz Individuals struggling with mental health ailments face many challenges, sometimes including the loss of liberty. While incarceration in jail or prison may follow criminal misconduct, this is not the most imposing threat to liberty faced by persons with mental illness. Instead, they must cope with the possibility of involuntary commitment to a treatment facility, a fate that may be worse than criminal incarceration.
    [Show full text]
  • Debate Psychiatry and the Control of Dangerousness: on the Apotropaic Function of the Term “Mental Illness” T Szasz
    J Med Ethics 2003;29:227–230 227 ....................... PSYCHIATRIC ETHICS J Med Ethics: first published as 10.1136/jme.29.4.237 on 20 August 2003. Downloaded from Debate Psychiatry and the control of dangerousness: on the apotropaic function of the term “mental illness” T Szasz he term “mental illness” implies that persons atric detention, also known as involuntary mental with such illnesses are more likely to be dan- hospitalisation or civil commitment. And the pro- Tgerous to themselves and/or others than are cedure is a patent violation of due process and the persons without such illnesses. This is the source presumption of innocence. of the psychiatrist’s traditional social obligation to We call all manner of human problems “(men- control “harm to self and/or others,” that is, tal) diseases”, and convince ourselves that drugs suicide and crime. The ethical dilemmas of and conversation (therapy) solve such problems. psychiatry cannot be resolved as long as the con- Solutions exist, however, only for mathematical tradictory functions of healing persons and problems and some medical problems. For human protecting society are united in a single discipline. problems, there are no solutions. Conflict, dis- Life is full of dangers. Our highly developed agreement, unhappiness, the proverbial slings consciousness makes us, of all living forms in the and arrows of outrageous fortune are challenges universe, the most keenly aware of, and the most that we must cope with, not solve. Only after we adept at protecting ourselves from, dangers. admit that our solutions are illusions can we Magic and religion are mankind’s earliest warn- begin to develop more rational and more humane ing systems.
    [Show full text]
  • There Are Cracks in the Civil Commitment Process: a Practitioner's Recommendations to Patch the System Donald Stone
    Fordham Urban Law Journal Volume 43 Number 3 Mental Health, the Law, & the Urban Article 8 Environment 2016 There Are Cracks in the Civil Commitment Process: A Practitioner's Recommendations to Patch the System Donald Stone Follow this and additional works at: https://ir.lawnet.fordham.edu/ulj Recommended Citation Donald Stone, There Are Cracks in the Civil Commitment Process: A Practitioner's Recommendations to Patch the System, 43 Fordham Urb. L.J. 789 (2016). Available at: https://ir.lawnet.fordham.edu/ulj/vol43/iss3/8 This Article is brought to you for free and open access by FLASH: The orF dham Law Archive of Scholarship and History. It has been accepted for inclusion in Fordham Urban Law Journal by an authorized editor of FLASH: The orF dham Law Archive of Scholarship and History. For more information, please contact [email protected]. THERE ARE CRACKS IN THE CIVIL COMMITMENT PROCESS: A PRACTITIONER’S RECOMMENDATIONS TO PATCH THE SYSTEM Donald Stone* Introduction ............................................................................................. 790 I. The Government’s Power to Confine, Minimal Due Process Protections, and the Remaining Void of Due Process Protections ......................................................................................... 791 A. The Government’s Power to Apprehend and Confine a Person with a Mental Illness ............................................. 791 B. Minimal Due Process Protections Afforded by the Supreme Court ...................................................................... 793 C. The Void of Due Process Safeguards in the Civil Commitment Process: Lessard v. Schmidt ......................... 794 II. The Constitutional Right To Remain Silent: Does It Apply To Civil Commitment Proceedings? ............................................... 798 A. Miranda and the Civil Commitment Process ....................... 799 B. State Laws on the Right to Remain Silent in the Civil Commitment Setting ............................................................
    [Show full text]
  • The Disability Studies Reader
    CHAPTER 7 A Mad Fight: Psychiatry and Disability Activism Bradley Lewis 100 SUMMARY The Mad Pride movement is made up of activists resisting and critiquing physician-centered psychiatric systems, finding alternative approaches to mental health and helping people choose minimal involvement with psychiatric institutions. They believe mainstream psychiatry over exaggerates pathology and forces conformity though diagnosis and treatment. In this chapter, Bradley Lewis highlights the political and epistemological similarities between the Mad Pride movement and other areas of disability studies. For instance, the social categories of normal and abnormal legitimize the medicalization of different bodies and minds and exert pressure on institutions to stay on the side of normality, or in this case, sanity. Lewis briefly traces the historical roots of Mad Pride to show how diagnoses of insanity were often political abuses aimed at normalizing differing opinions and experiences. The movement entered into the debate to fight involuntary hospitalization and recast mental illness as a myth rather than an objective reality. Today’s Mad Pride often works within mental health services systems by bringing together “consumers” (rather than “survivors” or “ex-patients”) who contribute real input for psychiatric policy. Nevertheless, Mad Pride still wages an epistemological and political struggle with psychiatry, which has undergone a “scientific revolution” that values “objective” data and undervalues humanistic inquiries. For example, biopsychiatric methods led to Prozac-type drugs being prescribed to 67.5 million Americans between 1987 and 2002. Mad Pride staged a hunger strike to protest the reduction of mental illness to a brain disease, arguing this model couldn’t be proved by evidence and limited consumers’ options for treatments like therapy or peer-support.
    [Show full text]
  • Involuntary Outpatient Commitment for the Chronically Mentally Ill Jillane T
    Nebraska Law Review Volume 69 | Issue 2 Article 5 1990 Involuntary Outpatient Commitment for the Chronically Mentally Ill Jillane T. Hinds University of Nebraska College of Law Follow this and additional works at: https://digitalcommons.unl.edu/nlr Recommended Citation Jillane T. Hinds, Involuntary Outpatient Commitment for the Chronically Mentally Ill, 69 Neb. L. Rev. (1990) Available at: https://digitalcommons.unl.edu/nlr/vol69/iss2/5 This Article is brought to you for free and open access by the Law, College of at DigitalCommons@University of Nebraska - Lincoln. It has been accepted for inclusion in Nebraska Law Review by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln. Jillane T. Hinds* Involuntary Outpatient Commitment for the Chronically Mentally Ill TABLE OF CONTENTS I. Introduction: The (Perceived) Need for Outpatient Commitment .............................................. 346 II. Commitment to Outpatient Treatment .................... 355 A. Outpatient Commitment or Conditional Release? .... 355 1. Conditional Release ............................... 356 2. Outpatient Commitment .......................... 358 B. Outpatient Treatment ................................. 361 1. Treatment Planning ............................... 361 2. Review ............................................. 365 3. Right to Refuse Outpatient Treatment ............ 367 III. Enforcement: Revocation of Outpatient Commitment .... 376 A. Statutory Procedures ................................. 376 B. Constitutional Requirements
    [Show full text]