Tuesday, January 21, 2014

Involuntary Commitment Laws for Substance Abuse Vary Across States

Civil commitment statutes vary greatly by state in terms of clarity and specificity regarding which mental illnesses are included for the purpose of involuntary hospitalization. The status of substance abuse is especially problematic: many states do not clearly reference substance abuse in civil commitment laws while others specifically exclude it.  Those are the findings of a report appearing online in Psychiatric Services in Advance,Statutory Definitions of Mental Illness for Involuntary Hospitalization as Related to Substance Use Disorders.”

Robin Williams, M.D., M.B.E. and colleagues in the Department of Psychiatry at New York University School of Medicine, examined state mental health statutes to better understand the national landscape of civil commitment law with a specific focus on substance use disorders.

“In New York City, individuals gravely disabled by substance use disorders repeatedly present to emergency rooms,” the authors stated. “Although these individuals are at high risk of death and often lack the capacity to make treatment decisions, the laws in New York State are unclear about whether substance use disorders qualify as mental illnesses for the purpose of involuntary hospitalization."

Their review revealed that New York is not alone. They found that 21 states and Washington, D.C., do not reference substance use disorders in their statutory definitions of mental illness. Of the 29 that do, eight states include substance use disorders, and 21 explicitly exclude them. In addition, nine states have separate inpatient commitment laws specifically addressing substance use disorders.

“Mental health professionals and policymakers should discuss whether individuals gravely disabled by substance use disorders, a complex and vulnerable population, should be more widely included under standard civil commitment law,” they wrote.

For more on involuntary treatment see the Psychiatric News article, "Rulings Guide Psychiatrists on Forced-Treatment Limits."

(Image: Yanik Chauvin/shutterstock.com)


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