Involuntary commitment#United Kingdom

For most jurisdictions, involuntary commitment is applied to individuals believed to be experiencing a mental illness that impairs their ability to reason to such an extent that the agents of the law, state, or courts determine that decisions will be made for the individual under a legal framework. In some jurisdictions, this is a proceeding distinct from being found incompetent. Involuntary commitment is used in some degree for each of the following although different jurisdictions have different criteria. Some jurisdictions limit involuntary treatment to individuals who meet statutory criteria for presenting a danger to self or others. Other jurisdictions have broader criteria. The legal process by which commitment takes place varies between jurisdictions. Some jurisdictions have a formal court hearing where testimony and other evidence may also be submitted and the subject of the hearing is typically entitled to legal counsel and may challenge a commitment order through habeas corpus.{{cite web | quote = The law provides a process known as Involuntary Commitment. Involuntary commitment is the use of legal means to commit a person to a mental hospital or psychiatric ward against their will or over their protests. |author=Texas Young Lawyers Association | title = Committed To Healing: Involuntary Commitment Procedures | publisher=State Bar of Texas |location=Austin, TX | date=January 2008 | url = https://www.texasbar.com/AM/Template.cfm?Section=Free_Legal_Information2&Template=/CM/ContentDisplay.cfm&ContentID=30801 |format=PDF |page=2 }} Other jurisdictions have delegated these power to physicians, though may provide an appeal process that involves the judiciary but may also involve physicians.{{efn|name=tribunals| For a discussion of the role of physicians in mental health tribunals and its effects see {{cite journal | last1=Thom | first1=Katey | last2=Nakarada-Kordic | first2=Ivana | title=Mental Health Review Tribunals in Action: A Systematic Review of the Empirical Literature | journal=Psychiatry, Psychology and Law | publisher=Informa UK Limited | volume=21 | issue=1 | date=2013-05-22 | issn=1321-8719 | doi=10.1080/13218719.2013.790004 | pages=112–126| s2cid=143237902 }} }} For example, in the UK a mental health tribunal consists of a judge, a medical member, and a lay representative.{{efn|name=tribunal-members|"The chair of each Mental Health Tribunal is a legal member who is known as a tribunal judge. There are usually three tribunal members at a hearing, one legal member, one medical member, and one other member, as defined above. Any three or more such members, constituted in this manner, may exercise the jurisdiction of a Mental Health Tribunal" {{cite book|author1=Basant Puri|author2=Robert Brown|author3=Heather McKee|author4=Ian Treasaden|title=Mental Health Law 2EA Practical Guide|url=https://books.google.com/books?id=pknOBQAAQBAJ|date=28 July 2017|publisher=CRC Press|isbn=978-1-4441-4975-3}} {{rp|99}} }}

Training is gradually becoming available in mental health first aid to equip community members such as teachers, school administrators, police officers, and medical workers with training in recognizing, and authority in managing, situations where involuntary evaluations of behavior are applicable under law.{{cite web |url=http://www.mentalhealthfirstaid.org/cs/background |title=About |website=Mental Health First Aid USA |publisher=National Council for Behavioral Health |date= 2013-10-10|access-date=2013-12-21}} The extension of first aid training to cover mental health problems and crises is a quite recent development.{{ cite journal |last1=Kitchener |first1=Betty A. |last2=Jorm |first2=Anthony F. | title = Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behaviour | journal = BMC Psychiatry |date=1 October 2002 | volume = 2 | page = 10 | pmid = 12359045 | pmc = 130043 | doi = 10.1186/1471-244X-2-10 |doi-access=free }}{{cite book |last1=Kitchener |first1=Betty |last2=Jorm |first2=Anthony |last3=Kelly |first3=Claire | title = Mental Health First Aid Manual | edition = 2nd | location=Parkville, Victoria |publisher=ORYGEN Youth Health Resource Centre | year = 2010 |isbn=978-0-9805541-3-7 |oclc=608074743 }} A mental health first aid training course was developed in Australia in 2001 and has been found to improve assistance provided to persons with an alleged mental illness or mental health crisis. This form of training has now spread to a number of other countries (Canada, Finland, Hong Kong, Ireland, Singapore, Scotland, England, Wales, and the United States).{{ cite journal |last1=Kitchener |first1=Betty A. |last2=Jorm |first2=Anthony F. |date=February 2008 | title = Mental health first aid: an international program for early intervention | journal = Early Intervention in Psychiatry | volume = 2 | issue = 1 | pages = 55–61 | pmid = 21352133 | doi = 10.1111/j.1751-7893.2007.00056.x |s2cid=11813019 }} Mental health triage may be used in an emergency room to make a determination about potential risk and apply treatment protocols.

{{Unreferenced section|date=October 2017}}

Observation is sometimes used to determine whether a person warrants involuntary commitment. It is not always clear on a relatively brief examination whether a person should be committed.

{{See also|Obligatory Dangerousness Criterion}}

Austria, Belgium, Germany, Israel, the Netherlands, Northern Ireland, the Republic of Ireland, Russia, Taiwan, Ontario (Canada), and the United States have adopted commitment criteria based on the presumed danger of the defendant to self or to others.{{cite journal|title=Almost a Revolution: An International Perspective on the Law of Involuntary Commitment|journal=Journal of the American Academy of Psychiatry and the Law |date=June 1997|volume=25|issue=2|pages=135–147|pmid=9213286|url=http://jaapl.org/content/25/2/135 |last=Appelbaum |first=Paul S.}}

People with suicidal thoughts may act on these impulses and harm or kill themselves.

People with psychosis are occasionally driven by their delusions or hallucinations to harm themselves or others. Research has found that those with schizophrenia are between 3.4 and 7.4 times more likely to engage in violent behaviour than members of the general public.

{{cite journal | last1=Fazel | first1=Seena | last2=Gulati | first2=Gautam | last3=Linsell | first3=Louise | last4=Geddes | first4=John R. | last5=Grann | first5=Martin | editor-last=McGrath | editor-first=John | title=Schizophrenia and Violence: Systematic Review and Meta-Analysis | journal=PLOS Medicine | publisher=Public Library of Science (PLoS) | volume=6 | issue=8 | date=2009-08-11 | issn=1549-1676 | doi=10.1371/journal.pmed.1000120 | page=e1000120| pmid=19668362 | pmc=2718581 | doi-access=free }} However, because other confounding factors such as childhood adversity and poverty are correlated with both schizophrenia and violence it can be difficult to determine whether this effect is due to schizophrenia or other factors. In an attempt to avoid these confounding factors, researchers have tried comparing the rates of violence amongst people diagnosed with schizophrenia to their siblings in a similar manner to twin studies. In these studies people with schizophrenia are found to be between 1.3 and 1.8 times more likely to engage in violent behaviour.

People with certain types of personality disorders can occasionally present a danger to themselves or others.{{cite journal|last1=Sansone|first1=Randy A.|last2=Sansone|first2=Lori|date=March 9, 2012|title=Borderline Personality and Externalized Aggression|journal=Innovations in Clinical Neuroscience|volume=9|issue=3|pages=23–26|pmid=22567607|pmc=3342993}}

This concern has found expression in the standards for involuntary commitment in every US state and in other countries as the danger to self or others standard, sometimes supplemented by the requirement that the danger be imminent. In some jurisdictions,{{which|date=October 2017}} the danger to self or others standard has been broadened in recent years to include need-for-treatment criteria such as "gravely disabled".{{cite book|title=State Standards for Civil Commitment |publisher=Treatment Advocacy Center |year=2018 |location=Arlington, Virginia}}

{{Main|Deinstitutionalisation}}

Starting in the 1960s, there has been a worldwide trend toward moving psychiatric patients from hospital settings to less restricting settings in the community, a shift known as "deinstitutionalization". Because the shift was typically not accompanied by a commensurate development of community-based services, critics say that deinstitutionalization has led to large numbers of people who would once have been inpatients as instead being incarcerated or becoming homeless.{{cite book|last1=Dear|first1=Michael J.|url=https://books.google.com/books?id=GPz_AwAAQBAJ&q=Deinstitutionalization+homeless&pg=PP1|title=Landscapes of Despair: From Deinstitutionalization to Homelessness|last2=Wolch|first2=Jennifer R.|publisher=Princeton Legacy Library|year=1987|location=Princeton, NJ|isbn=9781400858965}} In some jurisdictions, laws authorizing court-ordered outpatient treatment have been passed in an effort to compel individuals with chronic, untreated severe mental illness to take psychiatric medication while living outside the hospital (e.g. Laura's Law, Kendra's Law).{{cite web|title=Kendra's Law: Results from New York's First Ten Years with Assisted Outpatient Treatment|url=https://www.treatmentadvocacycenter.org/component/content/article/41|access-date=August 2, 2020|website=Treatment Advocacy Center}}{{cite book|url=https://mentalillnesspolicy.org/wp-content/uploads/lauraslawguidetac2009.pdf|title=A Guide to Laura's Law: California's Law for Assisted Outpatient Treatment|publisher=The California Treatment Advocacy Coalition & The Treatment Advocacy Center|year=2009}}

In a study of 269 patients from Vermont State Hospital done by Courtenay M. Harding and associates, about two-thirds of the ex-patients did well after deinstitutionalization.{{cite journal |last1=Harding |first1=C.M. |last2=Brooks |first2=G.W. |last3=Ashikaga |first3=T. |last4=Strauss |first4=J.S. |last5=Breier |first5=A. |date=June 1987 |title=The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later |journal=American Journal of Psychiatry |volume=144 |issue=6 |pages=718–26 |doi=10.1176/ajp.144.6.718 |pmid=3591991 }}

{{main|Involuntary commitment by country}}

In 1838, France enacted a law to regulate both the admissions into asylums and asylum services across the country. Édouard Séguin developed a systematic approach for training individuals with mental deficiencies,{{cite book|last1=King|first1=D. Brett|last2=Viney|first2=Wayne|last3=Woody|first3=William Douglas|title=A History of Psychology: Ideas and Context|date=2007|publisher=Allyn & Bacon|isbn=9780205512133|page=214|edition=4}} and, in 1839, he opened the first school for intellectually disabled people. His method of treatment was based on the idea that intellectually disabled people did not suffer from disease.{{cite encyclopedia|author1=((The Editors of Encyclopædia Britannica)) |title=Edouard Seguin (American psychiatrist)|url=https://www.britannica.com/EBchecked/topic/532753/Edouard-Seguin|encyclopedia=Encyclopædia Britannica|date=12 June 2013}}

In the United Kingdom, provision for the care of the mentally ill began in the early 19th century with a state-led effort. Public mental asylums were established in Britain after the passing of the 1808 County Asylums Act. This empowered magistrates to build rate-supported asylums in every county to house the many "pauper lunatics". Nine counties first applied, and the first public asylum opened in 1812 in Nottinghamshire. Parliamentary Committees were established to investigate abuses at private madhouses like Bethlem Hospital - its officers were eventually dismissed and national attention was focused on the routine use of bars, chains and handcuffs and the filthy conditions in which the inmates lived. However, it was not until 1828 that the newly appointed Commissioners in Lunacy were empowered to license and supervise private asylums.

File:Anthony Ashley-Cooper, 7th Earl of Shaftesbury by John Collier.jpg, a vigorous campaigner for the reform of lunacy law in England, and the Head of the Lunacy Commission for 40 years.]]

The Lunacy Act 1845 was a landmark in the treatment of the mentally ill, as it explicitly changed the status of mentally ill people to patients who required treatment. The Act created the Lunacy Commission, headed by Lord Shaftesbury, focusing on reform of the legislation concerning lunacy.{{cite journal |last=Unsworth |first=Clive |title=Law and Lunacy in Psychiatry's 'Golden Age' |journal=Oxford Journal of Legal Studies |volume=13 |issue=4 |date=Winter 1993 |pages=482 |doi=10.1093/ojls/13.4.479 |url=https://heinonline.org/HOL/LandingPage?handle=hein.journals/oxfjls13&div=34 |url-access=subscription}} The commission consisted of eleven Metropolitan Commissioners who were required to carry out the provisions of the Act;Wright, David: "Mental Health Timeline", 1999{{full citation needed|date=November 2014}} the compulsory construction of asylums in every county, with regular inspections on behalf of the Home Secretary. All asylums were required to have written regulations and to have a resident qualified physician. A national body for asylum superintendents - the Medico-Psychological Association - was established in 1866 under the Presidency of William A. F. Browne, although the body appeared in an earlier form in 1841.{{cite book |last1=Shorter |first1=E. |title=A history of psychiatry: from the era of the asylum to the age of Prozac |year=1997 |place=New York |publisher=Wiley |isbn=0-471-15749-X |oclc=34513743 |pages=34, 41}}

By the late 1800s, there were almost 300 public and private asylums in Britain and Ireland.[https://historic-hospitals.com/mental-hospitals-in-britain-and-ireland/asylums-in-the-united-kingdom-in-1898/ Historic Hospitals website, Asylums in the United Kingdom in 1898]Shorter, E. (1997), p. 34 By the late 1890s and early 1900s, those so detained had risen to the hundreds of thousands. However, the idea that mental illness could be ameliorated through institutionalization was soon disappointed.Shorter, E. (1997), p. 46 Psychiatrists were pressured by an ever-increasing patient population. The average number of patients in asylums kept increasing. Asylums were quickly becoming almost indistinguishable from custodial institutions,Rothman, D.J. (1990). The Discovery of the Asylum: Social Order and Disorder in the New Republic. Boston: Little Brown, p. 239. {{ISBN|978-0-316-75745-4}} and the reputation of psychiatry in the medical world had was at an extreme low.Shorter, E. (1997), p. 65

In modern times involuntary detention and treatment without agreement as regulated under one of various sections of the Mental Health Act 1983 is informally known as "sectioning".{{cite web | title=Mental Health Act |publisher=UK NHS| date=7 September 2022| url=https://www.nhs.uk/mental-health/social-care-and-your-rights/mental-health-and-the-law/mental-health-act/}}{{cite web | title=What are your legal rights if you are sectioned | website=Mind | url=https://www.mind.org.uk/information-support/legal-rights/sectioning/about-sectioning/ |date=July 2020}} Sectioning is now regulated by the Mental Health Act 2007 in England and Wales, the Mental Health (Care and Treatment) (Scotland) Act 2003 in Scotland and other legislation in Northern Ireland.

In the United States, the erection of state asylums began with the first law for the creation of one in New York, passed in 1842. The Utica State Hospital was opened approximately in 1850. The creation of this hospital, as of many others, was largely the work of Dorothea Lynde Dix, whose philanthropic efforts extended over many states, and in Europe as far as Constantinople. Many state hospitals in the United States were built in the 1850s and 1860s on the Kirkbride Plan, an architectural style meant to have curative effect.{{cite book|last=Yanni|first=Carla|title=The Architecture of Madness: Insane Asylums in the United States|publisher=Minnesota University Press|location=Minneapolis|year=2007|url=https://books.google.com/books?id=fJOC_rSW1kgC&pg=PP1 | isbn=978-0-8166-4939-6}}

In the United States and most other developed societies, severe restrictions have been placed on the circumstances under which a person may be committed or treated against their will as such actions have been ruled by the United States Supreme Court and other national legislative bodies as a violation of civil rights and/or human rights. The Supreme Court case O'Connor v. Donaldson established that the mere presence of mental illness and the necessity for treatment are not sufficient by themselves to justify involuntary commitment, if the patient is capable of surviving in freedom and does not present a danger of harm to themselves or others. Criteria for involuntary commitment are generally set by the individual states, and often have both short- and long-term types of commitment. Short-term commitment tends to be a few days or less, requiring an examination by a medical professional, while longer-term commitment typically requires a court hearing, or sentencing as part of a criminal trial. Indefinite commitment is rare and is usually reserved for individuals who are violent or present an ongoing danger to themselves and others.

New York City officials under several administrations have implemented programs involving the involuntary hospitalization of people with mental illnesses in the city.{{Cite news |last=Newman |first=Andy |date=2022-12-02 |title=35 Years of Efforts to Address Mental Illness on New York Streets |language=en-US |work=The New York Times |url=https://www.nytimes.com/2022/12/02/nyregion/mental-illness-homeless-streets.html |access-date=2023-07-10 |issn=0362-4331}} Some of these policies have involved reinterpreting the standard of "harm to themselves or others" to include neglecting their own well-being or posing a harm to themselves or others in the future. In 1987–88, a homeless woman named Joyce Brown worked with the New York Civil Liberties Union to challenge her forced hospitalization under new Mayor Ed Koch's administration program. The trial, which attracted significant media attention, ended in her favor, and while the city won on appeal she was ultimately released after a subsequent case determined she could not be forcibly medicated.{{cite book |last=Kasindorf |first=Jeanie |url=https://books.google.com/books?id=UuUCAAAAMBAJ&pg=PA36 |title=The Real Story of Billie Boggs |date=May 2, 1988 |publisher=New York |pages=36–44 |language=en |archive-url=https://web.archive.org/web/20230302140249/https://books.google.com/books?id=UuUCAAAAMBAJ&pg=PA36 |archive-date=March 2, 2023 |url-status=live |access-date=December 11, 2022}}{{cite news |last1=Hampson |first1=Rick |date=June 3, 1991 |title=Whatever Happened to Billie Boggs? |work=AP News |url=https://apnews.com/article/515e79d71cbab2ab9e404fa58dc8863a |url-status=live |access-date=September 28, 2020 |archive-url=https://web.archive.org/web/20220930194030/https://apnews.com/article/515e79d71cbab2ab9e404fa58dc8863a |archive-date=September 30, 2022}} In 2022, Mayor Eric Adams announced a similar compulsory hospitalization program, relying on similar legal interpretations.{{Cite web |last=Kim |first=Elizabeth |date=November 30, 2022 |title=New NYC policy to address mental illness will force more people to hospitals. Here's what to know. |url=https://gothamist.com/news/nyc-will-forcibly-hospitalize-mentally-ill-people-heres-what-to-know-about-the-plan-and-its-obstacles |url-status=live |archive-url=https://web.archive.org/web/20221130231901/https://gothamist.com/news/nyc-will-forcibly-hospitalize-mentally-ill-people-heres-what-to-know-about-the-plan-and-its-obstacles |archive-date=November 30, 2022 |access-date=December 1, 2022 |website=Gothamist |language=en}}{{Cite news |last=Kanu |first=Hassan |last2= |first2= |date=2022-12-08 |title=New York plan for forced 'removal' of mentally ill tests limits of the law |language=en |work=Reuters |url=https://www.reuters.com/legal/government/new-york-plan-forced-removal-mentally-ill-tests-limits-law-2022-12-08/ |access-date=July 10, 2023}}

Historically, until the mid-1960s in most jurisdictions in the United States, all committals to public psychiatric facilities and most committals to private ones were involuntary. Since then, there have been alternating trends towards the abolition or substantial reduction of involuntary commitment,{{cite book |first=Herbert |last=Hendin | title = Suicide in America | publisher = W. W. Norton | year = 1996 | isbn = 978-0-393-31368-0 |oclc=37916353 | page = 214 }} a trend known as deinstitutionalisation. In many currents, individuals can voluntarily admit themselves to a mental health hospital and may have more rights than those who are involuntarily committed. This practice is referred to as voluntary commitment.

In the United States, Kansas v. Hendricks established the procedures for a long-term or indefinite form of commitment applicable to people convicted of some sexual offences.{{Cite journal |last1=Testa |first1=Megan |last2=West |first2=Sara G. |date=October 2010 |title=Civil Commitment in the United States |journal=Psychiatry (Edgmont) |volume=7 |issue=10 |pages=30–40 |issn=1550-5952 |pmc=3392176 |pmid=22778709}}

United Nations General Assembly Resolution 46/119, "Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care", is a non-binding resolution advocating certain broadly drawn procedures for the carrying out of involuntary commitment.{{cite web |author=UN General Assembly |author-link=UN General Assembly |title=A/RES/46/119: Principles for the protection of persons with mental illness and the improvement of mental health care |date=17 December 1991 |website=United Nations |url=https://www.un.org/documents/ga/res/46/a46r119.htm |access-date=16 June 2016}} These principles have been used in many countries{{which|date=October 2017}} where local laws have been revised or new ones implemented. The UN runs programs in some countries to assist in this process.{{cite web|title=Mental Health and Development|url=https://www.un.org/development/desa/disabilities/issues/mental-health-and-development.html|access-date=August 2, 2020|website=United Nations}}

{{more citations needed section|date=May 2013}}

The potential dangers of institutions have been noted and criticized by reformers/activists almost since their foundation.{{Cite book |last=Scull |first=Andrew |editor-first1=George |editor-first2=Nick |editor-last1=Ikkos |editor-last2=Bouras |title=Mind, State and Society: Social History of Psychiatry and Mental Health in Britain 1960–2010 |publisher=Cambridge University Press |year=2021 |pages=306–307 |doi=10.1017/9781911623793|isbn=978-1-911623-79-3 |url=https://eprints.bbk.ac.uk/id/eprint/41918/9/41918a.pdf }} Charles Dickens was an outspoken and high-profile early critic, and several of his novels, in particular Oliver Twist and Hard Times demonstrate his insight into the damage that institutions can do to human beings.{{Cite web |last=Oliver |first=Adrienne |date=May 9, 2018 |title=Challenging Society in Charles Dickens's Oliver Twist and Bleak House |url=https://scholar.umw.edu/student_research/261 |url-status=live |archive-url=https://web.archive.org/web/20240603110425/https://scholar.umw.edu/student_research/261/ |archive-date=June 3, 2024 |access-date=October 30, 2024 |website=Eagle Scholar, University of Mary Washington Research}}{{Cite journal |last=Ponzio |first=Peter J. |date=March 2019 |title=Ineffective Institutions in Dickens's Hard Times |url=https://ijissh.org/storage/Volume4/Issue3/IJISSH-040312.pdf |journal=International Journal of Innovative Studies in Sociology and Humanities |volume=4 |issue=3 |pages=93}}

Enoch Powell, when Minister for Health in the early 1960s, was a later opponent who was appalled by what he witnessed on his visits to the asylums, and his famous "water tower" speech in 1961 called for the closure of all NHS asylums and their replacement by wards in general hospitals:[https://www.nuffieldtrust.org.uk/sites/default/files/2019-11/nhs-history-book/58-67/powell-s-water-tower-speech.html Nuffield Trust website, National Health Service History section, The Rt Hon J Enoch Powell, Minister of Health - Address to the National Association of Mental Health Annual Conference, 9 March 1961][https://dcmh.exeter.ac.uk/the-setting/de-institutionalisation-and-beyond/#:~:text=In%20his%201961%20'Watertower%20speech,health%20services%20into%20general%20hospitals. Devon County Mental Hospital website, De-institutionalisation and beyond]

{{blockquote|"There they stand, isolated, majestic, imperious, brooded over by the gigantic water-tower and chimney combined, rising unmistakable and daunting out of the countryside - the asylums which our forefathers built with such immense solidity to express the notions of their day. Do not for a moment underestimate their powers of resistance to our assault. Let me describe some of the defenses which we have to storm."{{cite web|url=http://studymore.org.uk/xpowell.htm|title=Enoch Powell's Water Tower Speech 1961|website=studymore.org.uk}}}}

Scandal after scandal followed, with many high-profile public inquiries.{{cite web|title=Official Inquiry Reports into National Health Service Mental Hospitals|date=6 June 1981|url=http://www.sochealth.co.uk/national-health-service/democracy-involvement-and-accountability-in-health/complaints-regulation-and-enquries/the-production-and-reproduction-of-scandals-in-chronic-sector-hospitals-1981/official-inquiry-reports-into-national-health-service-mental-hospitals/|publisher=Socialist Health Association|access-date=21 December 2013}} These involved the exposure of abuses such as unscientific surgical techniques such as lobotomy and the widespread neglect and abuse of vulnerable patients in the US and Europe. The growing anti-psychiatry movement in the 1960s and 1970s led in Italy to the first successful legislative challenge to the authority of the mental institutions, culminating in their closure. Nonetheless, the involuntary commitment has never ceased to be in force in Italy, despite the evidence of the positive results of its elimination. A prominent example is the work carried out by Giorgio Antonucci at the Osservanza and Luigi Lolli psychiatric hospitals in Imola, northern Italy, where any form of coercion had been eliminated by Antonucci, who applied a non-psychiatric approach to human suffering.{{cite book |last=Antonucci |first=Giorgio |title=Il pregiudizio psichiatrico |publisher=Elèuthera |year=1989–2020 |isbn=9788833020761}}

During the 1970s and 1990s the hospital population started to fall rapidly, mainly because of the deaths of long-term inmates. Significant efforts were made to re-house large numbers of former residents in a variety of suitable or otherwise alternative accommodation. The first 1,000+ bed hospital to close was Darenth Park Hospital in Kent, swiftly followed by many more across the UK. The haste of these closures, driven by the Conservative governments led by Margaret Thatcher and John Major, led to considerable criticism in the press, as some individuals slipped through the net into homelessness or were discharged to poor quality private sector mini-institutions.

{{Main|Political abuse of psychiatry}}

{{See also|Rosenhan experiment}}

There are instances in which mental health professionals have wrongfully deemed individuals to have been displaying the symptoms of a mental disorder, and committed the individual for treatment in a psychiatric hospital upon such grounds. Claims of wrongful commitment are a common theme in the anti-psychiatry movement.{{cite news|date=February 2, 2009|title=UNC study: Mental illness by itself does not predict future violent behavior|publisher=UNC Health Care|url=http://www.unchealthcare.org/site/newsroom/news/2009/January/elbogen/|url-status=dead|access-date=July 2, 2009|archive-url=https://web.archive.org/web/20090414194347/http://www.unchealthcare.org/site/newsroom/news/2009/January/elbogen/|archive-date=April 14, 2009}}{{cite journal|last=Desai|first=Nimesh G.|date=2005|title=Antipsychiatry: Meeting the challenge|journal=Indian Journal of Psychiatry|volume=47|issue=4|pages=185–187|doi=10.4103/0019-5545.43048|issn=0019-5545|pmc=2921130|pmid=20711302 |doi-access=free }}{{cite web|author=Henry A. Nasrallah|date=December 2011|title=The antipsychiatry movement: Who and why|url=http://www.currentpsychiatry.com/fileadmin/cp_archive/pdf/1012/1012CP_Editorial.pdf|url-status=dead|archive-url=https://web.archive.org/web/20150207004541/http://www.currentpsychiatry.com/fileadmin/cp_archive/pdf/1012/1012CP_Editorial.pdf|archive-date=2015-02-07|access-date=2013-08-14|website=Current Psychiatry}}

In 1860, the case of Elizabeth Packard, who was wrongfully committed that year and filed a lawsuit and won thereafter, highlighted the issue of wrongful involuntary commitment.{{cite journal|last1=Testa|first1=Megan|last2=West|first2=Sara G.|date=October 2010|title=Civil Commitment in the United States|journal=Psychiatry (Edgmont)|volume=7|issue=10|pages=30–40|issn=1550-5952|pmc=3392176|pmid=22778709}} In 1887, investigative journalist Nellie Bly went undercover at an asylum in New York City to expose the terrible conditions that mental patients at the time had to deal with. She published her findings and experiences as articles in New York World, and later made the articles into one book called Ten Days in a Mad-House.

In the first half of the twentieth century there were a few high-profile cases of wrongful commitment based on racism or punishment for political dissenters. In the former Soviet Union, psychiatric hospitals were used as prisons to isolate political prisoners from the rest of society. British playwright Tom Stoppard wrote Every Good Boy Deserves Favour about the relationship between a patient and his doctor in one of these hospitals. Stoppard was inspired by a meeting with a Russian exile.{{cite book |last=Caute |first=David | year = 2005 | title = The dancer defects: The struggle for cultural supremacy during the Cold War | publisher = Oxford University Press |location=Oxford | page = 359 | isbn = 978-0-19-927883-1 |oclc=434472173 }} In 1927, after the execution of Sacco and Vanzetti in the United States, demonstrator Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in a rally in support of the anarchists.{{cite book|last=Moshik|first=Temkin|author-link=Moshik Temkin|url=https://archive.org/details/saccovanzettiaff0000temk/page/316|title=The Sacco-Vanzetti Affair|publisher=Yale University Press Publishers|year=2009|isbn=978-0-300-12484-2|page=[https://archive.org/details/saccovanzettiaff0000temk/page/316 316]}}{{Pages needed|date=July 2020}} Throughout the 1940s and 1950s in Canada, 20,000 Canadian children, called the Duplessis orphans, were wrongfully certified as being mentally ill and as a result were committed to psychiatric institutions where they were allegedly forced to take psychiatric medication that they did not need and were abused. They were named after Maurice Duplessis, the premier of Quebec at the time, who deliberately committed these children to misappropriate additional subsidies from the federal government.{{cite web|date=Jun 18, 2004|title=Duplessis orphans seek proof of medical experiments|url=https://www.cbc.ca/news/canada/duplessis-orphans-seek-proof-of-medical-experiments-1.487094|url-status=live|archive-url=https://web.archive.org/web/20180128185759/http://www.cbc.ca/news/canada/duplessis-orphans-seek-proof-of-medical-experiments-1.487094|archive-date=January 28, 2018|website=Canadian Broadcasting Corporation}} Decades later in the 1990s, several of the orphans sued Quebec and the Catholic Church for the abuse and wrongdoing.{{cite news|last=Farnsworth|first=Clyde H.|date=1993-05-21|title=Orphans of the 1950s, Telling of Abuse, Sue Quebec|language=en-US|work=The New York Times|url=https://www.nytimes.com/1993/05/21/world/orphans-of-the-1950-s-telling-of-abuse-sue-quebec.html|url-status=live|access-date=2020-07-14|archive-url=https://web.archive.org/web/20181123121947/https://www.nytimes.com/1993/05/21/world/orphans-of-the-1950-s-telling-of-abuse-sue-quebec.html|archive-date=November 23, 2018|issn=0362-4331}} In 1958, black pastor and activist Clennon Washington King Jr. tried enrolling at the University of Mississippi, which at the time was white, for summer classes; the local police secretly arrested and involuntarily committed him to a mental hospital for 12 days.{{cite book|last=Tucker|first=William H.|url=https://books.google.com/books?id=C-jIEhfKPaYC|title=The Funding of Scientific Racism: Wickliffe Draper and the Pioneer Fund|publisher=University of Illinois Press|year=2002|isbn=978-0-252-02762-8|page=119|access-date=July 14, 2020|archive-url=https://web.archive.org/web/20200506164702/https://books.google.com/books?id=C-jIEhfKPaYC|archive-date=May 6, 2020|url-status=live}}[https://news.google.com/newspapers?nid=1798&dat=19580620&id=LgIdAAAAIBAJ&sjid=4YoEAAAAIBAJ&pg=7178,1936782 "Negro Pastor Pronounced Sane; Demands Mississippi Apologize".] UPI. Sarasota Journal 20 June 1958: 3.

Patients are able to sue if they believe that they have been wrongfully committed.{{cite web|date=2010-08-11|title=Detaining patients against wishes carries legal risks - amednews.com|url=https://amednews.com/article/20101108/profession/311089941/5/|url-status=live|archive-url=https://web.archive.org/web/20180829074638/http://www.amednews.com/article/20101108/profession/311089941/5/|archive-date=August 29, 2018|access-date=2020-07-13|website=American Medical News|language=en}}{{cite web|last=Orlando|first=James|date=Jan 24, 2013|title=Involuntary Civil Commitment and Patients' Rights|url=https://www.cga.ct.gov/2013/rpt/2013-R-0041.htm|url-status=live|archive-url=https://web.archive.org/web/20150320002558/http://www.cga.ct.gov/2013/rpt/2013-R-0041.htm|archive-date=March 20, 2015|website=Connecticut General Assembly}}{{cite web|title=Can an involuntary commitment be false imprisonment if it is not malpractice?: Thompson O'neil Law|url=http://www.thompsononeillaw.com/our-blog/wrongful-termination-and-discrimination/can-an-involuntary-commitment-be-false-imprisonment-if-it-is-not-malpractice.html|url-status=live|archive-url=https://web.archive.org/web/20191220003942/http://www.thompsononeillaw.com/our-blog/wrongful-termination-and-discrimination/can-an-involuntary-commitment-be-false-imprisonment-if-it-is-not-malpractice.html|archive-date=December 20, 2019|access-date=2020-07-13|website=Thompson & O'Neil Law}} In one instance, Junius Wilson, an African American man, was committed to Cherry Hospital in Goldsboro, North Carolina in 1925 for an alleged crime without a trial or conviction. He was castrated. He continued to be held at Cherry Hospital for the next 67 years of his life. It turned out he was deaf rather than mentally ill.{{cite web |last=Swofford |first=Stan|date=Jan 30, 1993|title=Locked up and castrated for a crime he wasn't convicted of |url=https://greensboro.com/townnews/law/locked-up-and-castrated-for-a-crime-he-wasnt-convicted-of-a-deaf-man-spends/article_cbd24d8c-6765-5ec1-a8a9-cf2ea955b98f.html}}{{cite web |last=Wright |first=Gary |date=June 24, 1993|title=Now 95, deaf man was castrated, locked up for decades|url=https://www.baltimoresun.com/news/bs-xpm-1993-06-24-1993175006-story.html}}{{cite web |website=AP News|date=Nov 10, 1992|title=Deaf Man To Be Released After 67 Years In Psychiatric Hospital|url=https://apnews.com/article/f2437200e764f6de97836b0ea2c5f560}}

In many U.S. states,{{cite web|last=Hamilton-Smith|first=Guy|date=2018-11-16|title=The Endless Punishment of Civil Commitment |url=https://ajustfuture.org/the-endless-punishment-of-civil-commitment-2/ |access-date=2020-11-18|website=Just Future Project|language=en-US}} sex offenders who have completed a period of incarceration can be civilly committed to a mental institution based on a finding of dangerousness due to a mental disorder.{{cite web|last=Signorelli|first=Nina|date=2020-07-09|title=A Backdoor Around Double Jeopardy|url=https://ajustfuture.org/a-backdoor-around-double-jeopardy/|access-date=2020-11-18|website=Just Future Project|language=en-US}} Although the United States Supreme Court determined that this practice does not constitute double jeopardy,{{cite court|litigants=Kansas v. Hendricks|vol=521|reporter=U.S. |opinion=346|pinpoint=361 |court= |date=1997|url=https://cite.case.law/us/521/346/|access-date=20 November 2020|quote=The thrust of Hendricks' argument is that the Act establishes criminal proceedings; hence confinement under it necessarily constitutes punishment. He contends that where, as here, newly enacted 'punishment' is predicated upon past conduct for which he has already been convicted and forced to serve a prison sentence, the Constitution's Double Jeopardy and Ex Post Facto Clauses are violated. We are unpersuaded by Hendricks' argument that Kansas has established criminal proceedings.}} organizations such as the American Psychiatric Association (APA) strongly oppose the practice.{{cite web|date=2019-11-08|title=APA Opposes Civil Commitment of Sex Offenders After Prison|url=https://ajustfuture.org/apa-opposes-civil-commitment-of-sex-offenders-after-prison/|access-date=2020-11-18|website=Just Future Project |language=en-US}} The Task Force on Sexually Dangerous Offenders, a component of APA's Council on Psychiatry and Law, reported that "in the opinion of the task force, sexual predator commitment laws represent a serious assault on the integrity of psychiatry, particularly with regard to defining mental illness and the clinical conditions for compulsory treatment. Moreover, by bending civil commitment to serve essentially non-medical purposes, statutes threaten to undermine the legitimacy of the medical model of commitment."{{Bluebook website|title=Dangerous Sex Offenders: A Task Force Report of the American Psychiatric Association|publisher=American Psychiatric Association|url=https://www.appi.org/Dangerous_Sex_Offenders |pin=173 |date=1999}}{{cite web|title=Assessing the Real Risk of Sexually Violent Predators: Doctor Padilla's Dangerous Data, Tamara Rice Lave and Franklin E. Zimring, 2018 |url=https://www.prisonlegalnews.org/news/publications/assessing-real-risk-sexually-violent-predators-doctor-padillas-dangerous-data-tamara-rice-lave-and-franklin-e-zimring-2018/|access-date=2020-12-03|website=Prison Legal News}}

{{columns-list|colwidth=30em|

• 5150 (involuntary psychiatric hold)
• Baker Act
• Civil confinement
• Conversion therapy
• Criminal justice
• Institutional syndrome
• John Hunt
• Medical law
• Mental Health Act 2007
• Special commitment center
• Giorgio Antonucci
• Ulysses contract

}}

• One Flew Over the Cuckoo's Nest (novel), (One Flew Over the Cuckoo's Nest (film)), (One Flew Over the Cuckoo's Nest (play))
• if....
• Forrest Gump novel and film based on the novel
• Cool Hand Luke
• Rebel without a Cause

{{notelist}}

{{reflist}}

{{Wikiquote|Commitment (mental health)}}

{{refbegin}}

• {{cite book |last=Atkinson |first=Jacqueline M. |date=2006 |title=Private and Public Protection: Civil Mental Health Legislation |location=Edinburgh |publisher=Dunedin Academic Press |isbn=978-1-903765-61-6 |oclc=475785132 }}
• {{cite book |first1=George |last1=Black |first2=Robin |last2=Munro |author2-link=Robin Munro |title=Black Hands of Beijing: Lives of Defiance in China's Democracy Movement |location=New York |publisher=John Wiley & Sons, Inc. |date=1993 |isbn=978-0-471-57977-9 |oclc=27186722 }}
• {{cite journal |last=Perlin |first=Michael L. |date=1993 |title=The ADA and Persons with Mental Disabilities: Can Sanist Attitudes Be Undone? |journal=Journal of Law and Health |volume=8 |issue=15 |pages=15–45 |url=http://engagedscholarship.csuohio.edu/jlh/vol8/iss1/4/ }}
• {{cite journal |last=Rosenhan |first=D.L. |date=19 January 1973 |title=On being sane in insane places |journal=Science |volume=179 |issue=4070 |pages=250–258 |pmid=4683124 |doi=10.1126/science.179.4070.250 |bibcode=1973Sci...179..250R |s2cid=146772269 }}
• {{cite journal |last=Spitzer |first=Robert L. |date=October 1975 |title=On pseudoscience in science, logic in remission, and psychiatric diagnosis: A critique of Rosenhan's 'On being sane in insane places' |journal=Journal of Abnormal Psychology |volume=84 |issue=5 |pages=442–452 |pmid=1194504 |doi= 10.1037/h0077124 }}
• {{cite news |last1=Sulzberger |first1=A.G. |last2=Carey |first2= Benedict |date=18 January 2011 |title=Getting Someone to Psychiatric Treatment Can Be Difficult and Inconclusive |newspaper=The New York Times |url= https://www.nytimes.com/2011/01/19/us/19mental.html |archive-url=https://ghostarchive.org/archive/20220103/https://www.nytimes.com/2011/01/19/us/19mental.html |archive-date=2022-01-03 |url-access=subscription |url-status=live }}{{cbignore}}
• {{cite book |last=Torrey |first=E. Fuller |date=1998 |title=Out of the Shadows: Confronting America's Mental Illness Crisis |location=New York |publisher=Wiley |isbn=978-0-471-24532-2 |oclc=502210396 }}
• {{cite journal |last=Tsesis |first=Alexander V.|author-link=Alexander Tsesis |title=Protecting Children Against Unnecessary Institutionalization |journal=South Texas Law Review |volume=39 |issue=4 |pages=995–1027 |date=Fall 1998 |ssrn=1031713 |pmid=12778917 }}
• {{UN doc |docid=A/RES/46/119 |body=General Assembly |session=46 |type=Resolution |resolution_number=119 |title=The protection of persons with mental illness and the improvement of mental health care |date=17 December 1991 }} [https://www.un.org/documents/ga/res/46/a46r119.htm HTML].
• Report of the Committee of Inquiry into allegations of ill-treatment of patients and other irregularities at the Ely Hospital, Cardiff, HMSO 1969 [http://www.sochealth.co.uk/history/Ely.htm]
• Extracts of the Report of the Committee of Inquiry into Normansfield Hospital - British Medical Journal, 1978, 2, 1560-1563 [http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1608780&blobtype=pdf]
• Erving Goffman Asylums
• Whyte, William H., The Organization Man, Doubleday Publishing, 1956. ([http://www.writing.upenn.edu/~afilreis/50s/whyte-main.html excerpts from Whyte's book])
• The Production and Reproduction of Scandals in Chronic Sector Hospitals Amy Munson- Barkshire 1981 [http://www.sochealth.co.uk/history/Scandal1.html]

{{refend}}

• [http://www.nrc-pad.org National Resource Center on Psychiatric Advance Directives] (United States)
• {{cite web |title=Baker Act Reporting Center |website=College of Behavioral and Community Sciences |publisher=University of South Florida |url=http://www.usf.edu/cbcs/baker-act/ }} Provides information related to Florida's Civil Commitment Statute.
• [http://www.nami.org National Alliance on Mental Illness] (United States)

{{Mental health law}}{{Anti-psychiatry}}

{{authority control}}

{{DEFAULTSORT:Involuntary Commitment}}

Category:Mental health law