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

Abstract

The failure of civil commitment procedures to meet statutory requirements is one of the more reliable findings in the applied social sciences. Most states now require specific legal procedures and behavioral standards for involuntary hospitalization. Nonetheless, empirical studies have demonstrated that commitment hearings are rarely adversarial and clinical concerns continue to take precedence over legal issues. These findings are analyzed in the context of three related issues: the grounds for commitment that are used in civil commitment hearings, the particular difficulties of recommitment hearings, and the shortcomings of the national policy of deinstitutionalization. The authors conclude that a primary cause of the gap between legal standards and actual practice is the absence of viable, less restrictive alternatives to inpatient treatment.

Involuntary Inpatient Commitment in the Context of Mental Health Recovery

“…In addition to procedural shortcomings, the courts have also been criticized for summarily deferring to mental health professionals for the legal decision to civilly commit (Turkheimer & Parry, 1992;Hiday, 1981). It is not clear, however, whether this is a valid criticism since the courts must at least consider clinical assessment in civil commitment decisions.…”

“…Procedurally, the shortcomings of civil commitment hearings are well-documented. Hearings are often informal with both judges and lawyers transgressing their proper roles (Turkheimer & Parry, 1992). Attorneys sometimes function as either guardians to respondents or as mere bystanders (Hiday, 1983), and are often poorly prepared and fail to crossexamine hospital clinicians (Lelos, 1981).…”

The case against categorical risk estimates

“…For instance, “high risk” does not literally translate to “commit the defendant as a sexually violent predator.” However, the practical effect of using these terms is the same. Virtually never does an individual who is deemed “high risk” avoid loss of liberty in sexually violent predator commitment proceedings (Boccaccini, Turner, Murrie, Henderson, & Chevalier, ), in parole hearings for indeterminately sentenced inmates (Guy, Kusaj, Packer, & Douglas, ), or in psychiatric civil commitment hearings (Turkheimer & Parry, ). The argument that there is no necessary nexus between risk categories and legal decisions is specious as an empirical matter.…”

Advances in Psychology and Law

“…Furthermore, perceptions of risk tend 1 The legal decision-maker varies across the different applications for which a risk assessment is relevant. In psychiatric civil commitment, a judge or commissioner typically makes the ultimate legal decision (Turkheimer & Parry, 1992). In Sexually Violent Predator commitment proceedings, most states require that a jury of one's peers make the ultimate legal decision; only three states permit a bench trial (DeMatteo, Murphy, Galloway, & Krauss, 2015).…”