Involuntary Commitment –
Involuntary commitment or civil commitment is a legal process that places an individual into treatment through a court order. Generally involuntary commitment is used for reasons of severe mental illness but in some situations it is also used in cases of severe addiction.
Considering involuntarily committing another person into rehabilitative care is a serious decision, and should only be a final resort with them refusing to make the decision for themselves. Having exhausted all other options and having tried various approaches with nothing working, it is understandable that you are giving this option some consideration. Morally this approach has some issues as you are removing free will, taking a person’s life out of their hands; you are making the decision for them. When addiction has gotten to a point where the addict’s life and the lives and well-being of others is at serious risk involuntary commitment can be the only option left.
Before we go on to look at the legal aspects and what the laws actually are in relation to committing someone, we will discuss the effectiveness of this approach in someone’s recovery. Some argue that addicts must make the choice themselves to get sober and enter rehab or embark on a journey of recovery. Some believe that if it has not been their own choice, such efforts are futile and relapse inevitable. The reality is that the majority of addicts do not volunteer for treatment, often it is court ordered or due to extensive pressure or ultimatums from family. The fact is that relapse is a reality regardless of the approach and most addicts will relapse on the first, second and even third shot at recovery. Evidence demonstrates that addicts who have been coerced and those who have not, do no worse or better in terms of their recovery. Involuntary commitment may not be able to save them completely but at the very least you can buy them some time and plant the seed. Drastic as this decision may seem, it could be the difference between life and death.
When we think of involuntary commitment we automatically imagine a family member forcing the addict into a rehabilitative center. This is not always the case and there are other forms of involuntary treatment that are very common. Medscape Medical News reports that there are three other extremely common forms- police pickup, emergency hospitalization and court ordered treatment (due to criminal offences). This highlights the fact that very few addicts enter recovery programs of their own volition.
There is no universal law or policy when it comes to involuntary commitment. The approaches vary from state to state. Of the 52 states in America 38 allow for some form of involuntary addiction treatment that is in no way linked to criminal activity. The terms vary in respect to the time frame, dangers posed, as well as the criteria used to determine if someone can be committed. Processes and guiding principles have changed over the years, admissions by family were much more common in the past, but it is now only enacted in severe cases as a last resort, when an individual is putting their own life or the lives of others in danger. The changes to involuntary commitment began in the 1960s with a growing concern for civil liberties; the practice of admitting people to hospitals and facilities was becoming far too regular and individual rights were being breached.
A U.S Supreme Court Case in 1979- Adddington v Texas brought about significant changes to the law regarding commitment. In brief the case related to a mother who had filed to indefinitely admit her son to a mental health facility, he appealed the decision on the basis that the court should have employed the “beyond reasonable doubt” standard of proof. It was found by a jury that Mr. Addington did require indefinite commitment but the Court of Appeals ruled that the usual “preponderance of the evidence” used must be increased to “clear and convincing” evidence. The new standard of proof in addition to stretched resources, namely limited funding, saw a decline in involuntary commitment. This somewhat clarifies the legalities surrounding involuntary commitment; however the laws do vary from state to state and case to case.
A more recent legal progression regarding involuntary commitment is the Marchman Alcohol and Other Drug Services Act of 1993.
Hal S. Marchman Act-
“provides for the involuntary or voluntary assessment and stabilization of a person allegedly abusing substances like drugs or alcohol, and provides for treatment of substance abuse.”
The act requires that at least three people who have direct contact with the addict can petition for them to be involuntarily admitted into rehab. Those involved must be able to prove that the addict’s life is out of control or that they are at risk of harming themselves or others. Similar laws exist in Ohio and Kentucky, New York allows for involuntary commitment but on different terms. The decision on such commitment is based on the addict’s need for treatment as opposed to their risk of harming themselves or others. Because of the variation from state to state it is crucial that you conduct research on the laws within your own state. In some states involuntary commitment is considered a violation of civil liberties and is illegal. Unfortunately this means the only way in which an addict will enter treatment is of their own free will.
Another recently enacted law is The Matthew Casey Wethington Act for Substance Abuse Intervention entered into law in the state of Kentucky. As with other laws relating to involuntary commitment it allows family to intervene in extreme addiction cases. Family and/ or friends can petition the court for forced treatment on behalf of the addict. If the petition is successful and the addict fails to comply, they are considered to be in contempt of court. This Act was sadly brought about by the death of Matthew Casey Wethington due to a heroin overdose at the age of 23. Casey’s family worked to have the law introduced in the state of Kentucky, as it was his “right” to choose whether or not he wanted treatment that led to his death. The Wethington family wanted to give other families the means of ensuring their loved one realised their right to live a life through recovery.
In most states across the country addicts under the age of 18 can be admitted, such addicts are considered under age, classed as children in the eyes of the law and are under the care and control of a parent or guardian. For adults, as we have seen it is much more challenging and if considering this approach you must be ready for a difficult journey and one that may not be successful. While some states are proactive and progressive with respect to involuntary commitment in extreme cases, others are not and it is extremely difficult to have someone involuntarily committed against their will. This reality will most likely hold a great bearing on your decision to seek a petition for admission into a facility. If you believe that a loved one’s life is in danger and that this is the only way they can be saved, then the struggle may be worth it. It is an arduous and personal decision, one that each family must make for themselves.