A comparison of respondents in initial and recommitment hearings.

Abstract

Legislators and researchers have focused on one aspect of civil commitment: initial commitments. Many patients, however, remain in the hospital after their initial commitment expires and, thus, must be recommitted ff they are to remain in involuntary treatment. Demographic, clinical, and treatment data were collected on 374 adults having initial or recommitment hearings during a 3-month period at a large state hospital in Virginia. Respondents in initial commitment hearings were younger and displayed acute symptoms; recommitment respondents were older with symptoms of chronic psychopathology, especially those associated with schizophrenia and organic brain syndrome. The subject of recommitment patients and hearings needs to be a focus of future research efforts to determine whether these differences are reflected in a greater relative gap between the letter and practice of the law in recommitment hearings.

Why the gap? Practice and policy in civil commitment hearings.

“…Elderly persons are a good example of a group that is often treated in mental hospitals but could probably be treated in less restrictive settings (Drinan, 1983). Our study of recommitment (C. D. H. Parry et al, 1991) showed that recommitment patients were significantly older than patients in initial commitments.…”

“…Similarly, Monahan et al (1982) found that a majority of emergency commitments were based on dangerousness to self or others, to the exclusion of grave disability; whereas for a sample of 14-day commitments, there was a significant decrease in dangerousness commitments and a significant increase in grave disability commitments. As will be discussed later in greater detail, C. D. H. Parry, Turkheimer, Hundley, and Creskoff (1991) have shown that, of patients being recommitted after the termination of their initial commitment, more than 90% were recommitted for grave disability alone.…”

“…We have recently completed a prospective study of 190 initial and 184 recommitment hearings at a large state hospital in Virginia, covering a rural and urban catchment area with a population of more than 2,000,000 (C. D. H. Parry et al, in press; C. D. H. Parry et al, 1991). Respondents in initial and recommitment hearings were found to represent distinct populations varying in age, chronicity, presence of acute psychological symptoms, and treatment history.…”

“…We have recently completed a prospective study of 190 initial and 184 recommitment hearings at a large state hospital in Virginia, covering a rural and urban catchment area with a population of more than 2,000,000 (C. D. H. Parry et al, in press; C. D. H. Parry et al, 1991).…”