Am J Psychiatry 1992; 149:1380-1384
Copyright © 1992 by American Psychiatric Association
Need-for-treatment criteria for involuntary civil commitment: impact in practice
RD Miller
Program for Forensic Psychiatry, Colorado Health Sciences Center, Denver 80262.
There has been considerable discussion in the literature on the differences
between criteria for involuntary commitment that are based on dangerousness
and criteria based on need for treatment. A number of states have adopted
clinical criteria, and other state legislatures are actively considering
them. Some libertarians argue that dangerousness is constitutionally
required if a person is to undergo the loss of liberty involved in
commitment. Citing widely publicized data from the state of Washington,
they predict that a return to clinical criteria would result in a deluge of
inappropriate commitments. Some clinicians counter that use of clinical
criteria would result in selection of a much more appropriate clinical
population and point to research indicating that strict observation of the
need-for-treatment provisions of the APA model commitment statute would
actually decrease the number of commitments. The author examines state
hospital admission and census data from eight states that added
need-for-treatment criteria to their commitment codes between 1975 and 1990
and argues that the data indicate that there is little reason to believe
that such changes would result in the deluge of admissions predicted by the
critics.
