Grave Disability, Basic Needs, and Welfare and Protection: Statutory Definitions for Involuntary Commitment Across States.

OBJECTIVE

The authors aimed to identify and describe standards, across U.S. states and the District of Columbia (DC), for involuntary commitment of people experiencing a psychiatric disability that impairs their ability to live independently.

METHODS

Statutes pertaining to involuntary commitment were compiled for all 50 states and DC. The authors focused on commitment criteria other than those regarding a person's danger to themselves or others and identified types and components of these standards, allowable evidence for meeting commitment standards, and other requirements and exclusions.

RESULTS

Most jurisdictions (N=47) allowed for involuntary commitment of individuals experiencing one of three types of psychiatric disability: grave disability (12 states), inability to meet one's own basic needs (28 states), and inability to provide for one's own welfare and protection (nine states); two states used a combination of standards. Components of the standards, potential consequences of the specified condition, allowable evidence to establish the standard, exclusions, and requirements for consideration of treatment alternatives varied widely.

CONCLUSIONS

Involuntary commitment infringes fundamental liberties, and states were found to be inconsistent in the circumstances under which those liberties could be overridden to protect people who are unable to survive safely in the community. Further research is needed to help identify whether different types of standards more effectively allow for the provision of involuntary care to the individuals most likely to benefit from such care and how variations in statutory language affect rates of involuntary commitment.