Civil Commitment

More than any other clinical intervention, civil commitment is subject to strict legal requirements and oversight. Although the rules and processes vary by jurisdiction, the legal proceedings in all jurisdictions are designed to balance the autonomy interests and constitutional rights of the patient against the state’s legitimate exercise of authority. This chapter reviews the legal principles underlying civil commitment and describes how those principles are applied in different ways, using examples from various jurisdictions. Using a case vignette, it explores a common scenario in which an emergency room physician who must make a decision regarding a patient’s need for hospitalization obtains a psychiatric consultation, and it follows the civil commitment process as it would play out in one jurisdiction. By its nature, civil commitment is both a clinical intervention and a legal process, and the chapter addresses some of the clinical challenges encountered in the course of involun...