Do dangerousness-oriented commitment laws restrict hospitalization of patients who need treatment? A test.
A study at a large urban psychiatric hospital in Pennsylvania evaluated whether the state's dangerousness-oriented commitment criteria restricted hospitalization of patients whom emergency room clinicians considered highly in need of treatment but not dangerous. A total of 390 patients were studied. Eleven patients judged to be highly in need of treatment did not meet any of the commitment criteria, but they were largely compliant with the idea of being treated. An additional 17 patients considered highly in need of treatment met criteria for commitment based on inability to care for self, but most were hospitalized voluntarily. Only one patient who met none of the commitment criteria resisted recommended hospital care, and she was eventually committed involuntarily based on inability to care for self. The data suggest that dangerousness-oriented commitment criteria are flexible enough to provide for treatment of patients in serious need.
Cleveland
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S
Lincoln College, Oxford, England.
Mulvey
E P
EP
Appelbaum
P S
PS
Lidz
C W
CW
D000203:Activities of Daily Living; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003617:Dangerous Behavior; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy; D028642:Persons with Psychiatric Disorders; D008875:Middle Aged; D018579:Patient Selection; D010414:Pennsylvania; D014754:Violence