Explain the four types of civil commitment procedures that the law permits.

Question

What will be an ideal response?

Answer 1

Answers may vary.The law permits four types of civil commitment: (1) emergency detention, (2) voluntary inpatient commitment, (3) involuntary inpatient commitment, and (4) outpatient commitment.Emergency detention is the means by which most individuals are initially admitted to hospitals. A police officer, a mental health professional, or sometimes a private citizen can initiate involuntary detention of another person. Usually, the cause is actual or anticipated harmful behavior by the patient either against self (e.g., attempted suicide) or against others. An examination is performed by a physician or a qualified mental health professional. Patients committed on an emergency basis can be detained for only a specified length of time-usually two or three days-before a review takes place. At that time a preliminary hearing must be held before the patient can be confined any longer.A person may volunteer to enter a psychiatric hospital, although he or she still must meet the criteria for hospitalization (typically some version of "mentally ill and in need of treatment"), but even those who are being hospitalized "voluntarily" may feel pressure from family, mental health personnel, or the legal system to enter the hospital. Individuals who have been provided with more information and given the chance to express their views report feeling less coercion, regardless of whether they are voluntarily or involuntarily hospitalized. While voluntarily hospitalized, the patient may find that the hospital has instigated commitment proceedings to challenge or delay release.The third type of commitment-involuntary inpatient commitment-requires a court order. The criteria for obtaining an involuntary civil commitment vary from state to state; in general, however, the person must be mentally ill and must also be dangerous to self and others, or so gravely disabled as to be unable to provide for his or her own basic needs. Although the criterion of "dangerousness" is the most often discussed standard and therefore is deemed the most important for involuntary hospitalization, grave disability is the standard that determines most commitments. To obtain an involuntary commitment, the concerned persons must petition the court for a professional examination of the individual in question. A formal court hearing usually follows the examination. In most states, the hearing is mandatory, and persons whose commitment is sought can call witnesses and have their lawyer cross-examine witnesses who testify against them.A fourth type of commitment procedure, known as outpatient commitment, is available in nearly all states and allows a patient to be mandated to receive treatment in an outpatient setting, such as a community mental health center, rather than in a hospital. Outpatient commitment often involves conditional release from a hospital. That is, formerly hospitalized patients are ordered to continue treatment in the community. It may also be used prior to hospitalization, as an alternative to inpatient commitment. This approach appears to have some promise. One study found that those released from involuntary hospitalization on outpatient commitment were more likely (relative to a group released without any kind of commitment) to use outpatient and residential mental health services and psychotropic medication. However, outpatient commitment should not simply be used as a mechanism for ensuring compliance with treatment if the individual does not meet the commitment criteria (which typically have a public safety component).