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Involuntary commitment, civil commitment, or involuntary hospitalization/hospitalisation is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe
mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
is detained in a
psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative ...
(inpatient) where they can be treated involuntarily. This treatment may involve the administration of
psychoactive drugs A psychoactive drug, psychopharmaceutical, psychoactive agent or psychotropic drug is a chemical substance, that changes functions of the nervous system, and results in alterations in perception, mood, consciousness, cognition or behavior. T ...
, including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community; this is sometimes referred to as
outpatient commitment Outpatient commitment—also called assisted outpatient treatment (AOT) or community treatment orders (CTO)—refers to a civil court procedure wherein a legal process orders an individual diagnosed with a severe mental disorder to adhere to an o ...
and shares legal processes with commitment. Criteria for civil commitment are established by laws which vary between nations. Commitment proceedings often follow a period of emergency hospitalization, during which an individual with acute psychiatric symptoms is confined for a relatively short duration (e.g. 72 hours) in a treatment facility for evaluation and stabilization by mental health professionals who may then determine whether further civil commitment is appropriate or necessary. Civil commitment procedures may take place in a
court A court is any person or institution, often as a government institution, with the authority to adjudicate legal disputes between parties and carry out the administration of justice in civil, criminal, and administrative matters in accordance ...
or only involve physicians. If commitment does not involve a court there is normally an
appeal In law, an appeal is the process in which cases are reviewed by a higher authority, where parties request a formal change to an official decision. Appeals function both as a process for error correction as well as a process of clarifying and ...
process that does involve the judiciary in some capacity, though potentially through a specialist court. Historically, until the mid-1960s in most jurisdictions in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
, all committals to public psychiatric facilities and most committals to private ones were involuntary. Since then, there have been alternating trends towards the abolition or substantial reduction of involuntary commitment, a trend known as ''
deinstitutionalisation Deinstitutionalisation (or deinstitutionalization) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the late ...
''. In many currents, individuals can voluntarily admit themselves to a mental health hospital and may have more rights than those who are involuntarily committed. This practice is referred to as
voluntary commitment Voluntary commitment is the act or practice of choosing to admit oneself to a psychiatric hospital, or other mental health facility. Unlike in involuntary commitment, the person is free to leave the hospital against medical advice, though there ...
. In the United States, an indefinite form of commitment is applied to people convicted of some sexual offences.


Purpose

For most jurisdictions, involuntary commitment is applied to individuals believed to be experiencing a mental illness that impairs their ability to reason to such an extent that the agents of the law, state, or courts determine that decisions will be made for the individual under a legal framework. In some jurisdictions, this is a proceeding distinct from being found
incompetent Incompetence is the inability to perform; lack of competence; ineptitude. Aspects of incompetence include: *Administrative incompetence, dysfunctional administrative behaviors that hinder attainment of organization goals *Incompetence (law), a p ...
. Involuntary commitment is used in some degree for each of the following although different jurisdictions have different criteria. Some jurisdictions limit involuntary treatment to individuals who meet statutory criteria for presenting a danger to self or others. Other jurisdictions have broader criteria. The legal process by which commitment takes place varies between jurisdictions. Some jurisdictions have a formal court hearing where testimony and other evidence may also be submitted and the subject of the hearing is typically entitled to legal counsel and may challenge a commitment order through
habeas corpus ''Habeas corpus'' (; from Medieval Latin, ) is a recourse in law through which a person can report an unlawful detention or imprisonment to a court and request that the court order the custodian of the person, usually a prison official, t ...
. Other jurisdictions have delegated these power to physicians, though may provide an appeal process that involves the judiciary but may also involve physicians. For example, in the UK a mental health tribunal consists of a judge, a medical member, and a lay representative.


First aid

Training is gradually becoming available in mental health first aid to equip community members such as teachers, school administrators, police officers, and medical workers with training in recognizing, and authority in managing, situations where involuntary evaluations of behavior are applicable under law. The extension of first aid training to cover mental health problems and crises is a quite recent development. A mental health first aid training course was developed in Australia in 2001 and has been found to improve assistance provided to persons with an alleged mental illness or mental health crisis. This form of training has now spread to a number of other countries (Canada, Finland, Hong Kong, Ireland, Singapore, Scotland, England, Wales, and the United States).
Mental health triage Mental health triage is a clinical function conducted at the point of entry to Health care, health services that aims to assess and categorize the urgency of mental health related problems. Mental health triage services may be located in the Emerg ...
may be used in an emergency room to make a determination about potential risk and apply treatment protocols.


Observation

Observation is sometimes used to determine whether a person warrants involuntary commitment. It is not always clear on a relatively brief examination whether a person should be committed.


Containment of danger

Austria, Belgium, Germany, Israel, the Netherlands, Northern Ireland, Russia, Taiwan, Ontario (Canada), and the United States have adopted commitment criteria based on the presumed danger of the defendant to self or to others. People with
suicidal thoughts Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
may act on these impulses and harm or kill themselves. People with
psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...
are occasionally driven by their
delusion A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some o ...
s or
hallucination A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combinatio ...
s to harm themselves or others. Research has found that those with schizophrenia are between 3.4 and 7.4 times more likely to engage in violent behaviour than members of the general public. However, because other
confounding factors In statistics, a confounder (also confounding variable, confounding factor, extraneous determinant or lurking variable) is a variable that influences both the dependent variable and independent variable, causing a spurious association. Con ...
such as childhood adversity and poverty are correlated with both schizophrenia and violence it can be difficult to determine whether this effect is due to schizophrenia or other factors. In an attempt to avoid these confounding factors, researchers have tried comparing the rates of violence amongst people diagnosed with schizophrenia to their siblings in a similar manner to
twin studies Twin studies are studies conducted on identical or fraternal twins. They aim to reveal the importance of environmental and genetic influences for traits, phenotypes, and disorders. Twin research is considered a key tool in behavioral genetics a ...
. In these studies people with schizophrenia are found to be between 1.3 and 1.8 times more likely to engage in violent behaviour. People with certain types of
personality disorder Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture ...
s can occasionally present a danger to themselves or others. This concern has found expression in the standards for involuntary commitment in every US state and in other countries as the danger to self or others standard, sometimes supplemented by the requirement that the danger be imminent. In some jurisdictions, the danger to self or others standard has been broadened in recent years to include need-for-treatment criteria such as "gravely disabled".


Deinstitutionalization

Starting in the 1960s, there has been a worldwide trend toward moving psychiatric patients from hospital settings to less restricting settings in the community, a shift known as "deinstitutionalization". Because the shift was typically not accompanied by a commensurate development of community-based services, critics say that deinstitutionalization has led to large numbers of people who would once have been inpatients as instead being incarcerated or becoming homeless. In some jurisdictions, laws authorizing court-ordered outpatient treatment have been passed in an effort to compel individuals with chronic, untreated severe mental illness to take
psychiatric medication A psychiatric or psychotropic medication is a psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat mental illnesses. These medications are typically made o ...
while living outside the hospital (e.g.
Laura's Law Laura's Law is a California state law that allows for court-ordered assisted outpatient treatment. To qualify for the program, the person must have a serious mental illness plus a recent history of psychiatric hospitalizations, jailings or acts, ...
,
Kendra's Law Kendra's Law, effective since November 1999, is a New York State law concerning involuntary outpatient commitment also known as assisted outpatient treatment. It grants judges the authority to issue orders that require people who meet certain cri ...
). Before the 1960s deinstitutionalization there were earlier efforts to free psychiatric patients.
Philippe Pinel Philippe Pinel (; 20 April 1745 – 25 October 1826) was a French physician, precursor of psychiatry and incidentally a zoologist. He was instrumental in the development of a more humane psychological approach to the custody and care of ps ...
(1745–1826) ordered the removal of chains from patients. In a study of 269 patients from
Vermont State Hospital Vermont State Hospital, alternately known as the Vermont State Asylum for the Insane and the Waterbury Asylum, was a mental institution built in 1890 in Waterbury, Vermont to help relieve overcrowding at the privately run Vermont Asylum for the In ...
done by Courtenay M. Harding and associates, about two-thirds of the ex-patients did well after deinstitutionalization.


Around the world


France

In 1838, France enacted a law to regulate both the admissions into asylums and asylum services across the country.
Édouard Séguin Édouard Séguin (January 20, 1812 – October 28, 1880) was a French physician and educationist born in Clamecy, Nièvre. He is remembered for his work with children having cognitive impairments in France and the United States. Background and c ...
developed a systematic approach for training individuals with mental deficiencies, and, in 1839, he opened the first school for intellectually disabled people. His method of treatment was based on the idea that intellectually disabled people did not suffer from disease.


United Kingdom

In the United Kingdom, provision for the care of the
mentally ill A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitt ...
began in the early 19th century with a state-led effort. Public mental asylums were established in Britain after the passing of the 1808 County Asylums Act. This empowered
magistrate The term magistrate is used in a variety of systems of governments and laws to refer to a civilian officer who administers the law. In ancient Rome, a '' magistratus'' was one of the highest ranking government officers, and possessed both judici ...
s to build rate-supported asylums in every
county A county is a geographic region of a country used for administrative or other purposesChambers Dictionary, L. Brookes (ed.), 2005, Chambers Harrap Publishers Ltd, Edinburgh in certain modern nations. The term is derived from the Old French ...
to house the many "pauper lunatics". Nine counties first applied, and the first public asylum opened in 1812 in
Nottinghamshire Nottinghamshire (; abbreviated Notts.) is a landlocked county in the East Midlands region of England, bordering South Yorkshire to the north-west, Lincolnshire to the east, Leicestershire to the south, and Derbyshire to the west. The traditi ...
. Parliamentary Committees were established to investigate abuses at private madhouses like
Bethlem Hospital Bethlem Royal Hospital, also known as St Mary Bethlehem, Bethlehem Hospital and Bedlam, is a psychiatric hospital in London. Its famous history has inspired several horror books, films and TV series, most notably ''Bedlam'', a 1946 film with Bo ...
- its officers were eventually dismissed and national attention was focused on the routine use of bars, chains and handcuffs and the filthy conditions in which the inmates lived. However, it was not until 1828 that the newly appointed
Commissioners in Lunacy The Commissioners in Lunacy or Lunacy Commission were a public body established by the Lunacy Act 1845 to oversee asylums and the welfare of mentally ill people in England and Wales. It succeeded the Metropolitan Commissioners in Lunacy. Previ ...
were empowered to license and supervise private asylums. The
Lunacy Act 1845 The Lunacy/Lunatics Act 1845 (8 & 9 Vict., c. 100) and the County Asylums Act 1845 (8 & 9 Vict., c. 126) formed mental health law in England and Wales from 1845 to 1890. The Lunacy Act's most important provision was a change in the status of menta ...
was a landmark in the treatment of the mentally ill, as it explicitly changed the status of mentally ill people to
patients A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...
who required treatment. The Act created the
Lunacy Commission The Commissioners in Lunacy or Lunacy Commission were a public body established by the Lunacy Act 1845 to oversee asylums and the welfare of mentally ill people in England and Wales. It succeeded the Metropolitan Commissioners in Lunacy. Previ ...
, headed by
Lord Shaftesbury Earl of Shaftesbury is a title in the Peerage of England. It was created in 1672 for Anthony Ashley-Cooper, 1st Baron Ashley, a prominent politician in the Cabal then dominating the policies of King Charles II. He had already succeeded his f ...
, focusing on reform of the legislation concerning lunacy. The commission consisted of eleven Metropolitan Commissioners who were required to carry out the provisions of the Act; Wright, David: "Mental Health Timeline", 1999 the compulsory construction of asylums in every county, with regular inspections on behalf of the
Home Secretary The secretary of state for the Home Department, otherwise known as the home secretary, is a senior minister of the Crown in the Government of the United Kingdom. The home secretary leads the Home Office, and is responsible for all national ...
. All asylums were required to have written regulations and to have a resident qualified
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
. A national body for asylum superintendents - the ''Medico-Psychological Association'' - was established in 1866 under the Presidency of
William A. F. Browne Dr William Alexander Francis Browne (1805–1885) was one of the most significant British asylum doctors of the nineteenth century. At Montrose Asylum (1834–1838) in Angus and at the Crichton Royal in Dumfries (1838–1857), Browne introduc ...
, although the body appeared in an earlier form in 1841. At the turn of the century, England and France combined had only a few hundred individuals in asylums.Shorter, E. (1997), p. 34 By the late 1890s and early 1900s, those so detained had risen to the hundreds of thousands. However, the idea that mental illness could be ameliorated through institutionalization was soon disappointed.Shorter, E. (1997), p. 46 Psychiatrists were pressured by an ever-increasing patient population. The average number of patients in asylums kept increasing. Asylums were quickly becoming almost indistinguishable from custodial institutions,Rothman, D.J. (1990). ''The Discovery of the Asylum: Social Order and Disorder in the New Republic''. Boston: Little Brown, p. 239. and the reputation of psychiatry in the medical world had hit an extreme low.Shorter, E. (1997), p. 65


United States

In the United States, the erection of state asylums began with the first law for the creation of one in New York, passed in 1842. The
Utica State Hospital Utica may refer to: Places *Utica, Tunisia, ancient city founded by Phoenicians * Útica, a village in Cundinamarca, Colombia * Port Perry/Utica Field Aerodrome, Canada United States *Utica, New York * Utica Mansion, in Angels Camp, California *N ...
was opened approximately in 1850. The creation of this hospital, as of many others, was largely the work of Dorothea Lynde Dix, whose philanthropic efforts extended over many states, and in Europe as far as
Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (Old Norse), Tsargrad ( Slavic), Qustantiniya (Arabic), Basileuousa ("Queen of Cities"), Megalopolis (" ...
. Many state hospitals in the United States were built in the 1850s and 1860s on the
Kirkbride Plan The Kirkbride Plan was a system of mental asylum design advocated by American psychiatrist Thomas Story Kirkbride (1809–1883) in the mid-19th century. The asylums built in the Kirkbride design, often referred to as Kirkbride Buildings (or si ...
, an architectural style meant to have curative effect. In the United States and most other developed societies, severe restrictions have been placed on the circumstances under which a person may be committed or treated against their will as such actions have been ruled by the
United States Supreme Court The Supreme Court of the United States (SCOTUS) is the highest court in the federal judiciary of the United States. It has ultimate appellate jurisdiction over all U.S. federal court cases, and over state court cases that involve a point o ...
and other national legislative bodies as a violation of
civil rights Civil and political rights are a class of rights that protect individuals' freedom from infringement by governments, social organizations, and private individuals. They ensure one's entitlement to participate in the civil and political life of ...
and/or
human rights Human rights are Morality, moral principles or Social norm, normsJames Nickel, with assistance from Thomas Pogge, M.B.E. Smith, and Leif Wenar, 13 December 2013, Stanford Encyclopedia of PhilosophyHuman Rights Retrieved 14 August 2014 for ce ...
. The Supreme Court case O'Connor v. Donaldson established that the mere presence of mental illness and the necessity for treatment are not sufficient by themselves to justify involuntary commitment, if the patient is capable of surviving in freedom and does not present a danger of harm to themselves or others. Criteria for involuntary commitment are generally set by the individual states, and often have both short- and long-term types of commitment. Short-term commitment tends to be a few days or less, requiring an examination by a medical professional, while longer-term commitment typically requires a court hearing, or sentencing as part of a criminal trial. Indefinite commitment is rare and is usually reserved for individuals who are violent or present an ongoing danger to themselves and others. Kansas v. Hendricks established the procedures for indefinite commitment of sex offenders.


United Nations

United Nations The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and international security, security, develop friendly relations among nations, achieve international cooperation, and be ...
General Assembly A general assembly or general meeting is a meeting of all the members of an organization or shareholders of a company. Specific examples of general assembly include: Churches * General Assembly (presbyterian church), the highest court of presb ...
Resolution 46/119, " Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care", is a non-binding resolution advocating certain broadly drawn procedures for the carrying out of involuntary commitment. These principles have been used in many countries where local laws have been revised or new ones implemented. The UN runs programs in some countries to assist in this process.


Criticism

The potential dangers of institutions have been noted and criticized by reformers/
activists Activism (or Advocacy) consists of efforts to promote, impede, direct or intervene in social, political, economic or environmental reform with the desire to make changes in society toward a perceived greater good. Forms of activism range fro ...
almost since their foundation.
Charles Dickens Charles John Huffam Dickens (; 7 February 1812 – 9 June 1870) was an English writer and social critic. He created some of the world's best-known fictional characters and is regarded by many as the greatest novelist of the Victorian e ...
was an outspoken and high-profile early critic, and several of his novels, in particular '' Oliver Twist'' and '' Hard Times'' demonstrate his insight into the damage that institutions can do to human beings.
Enoch Powell John Enoch Powell, (16 June 1912 – 8 February 1998) was a British politician, classical scholar, author, linguist, soldier, philologist, and poet. He served as a Conservative Member of Parliament (1950–1974) and was Minister of Health (1 ...
, when Minister for Health in the early 1960s, was a later opponent who was appalled by what he witnessed on his visits to the asylums, and his famous "water tower" speech in 1961 called for the closure of all NHS asylums and their replacement by wards in general hospitals: Scandal after scandal followed, with many high-profile public inquiries. These involved the exposure of abuses such as unscientific surgical techniques such as
lobotomy A lobotomy, or leucotomy, is a form of neurosurgical treatment for psychiatric disorder or neurological disorder (e.g. epilepsy) that involves severing connections in the brain's prefrontal cortex. The surgery causes most of the connections t ...
and the widespread neglect and abuse of vulnerable patients in the US and Europe. The growing
anti-psychiatry Anti-psychiatry is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionabl ...
movement in the 1960s and 1970s led in Italy to the first successful legislative challenge to the authority of the mental institutions, culminating in their closure. During the 1970s and 1990s the hospital population started to fall rapidly, mainly because of the deaths of long-term inmates. Significant efforts were made to re-house large numbers of former residents in a variety of suitable or otherwise alternative accommodation. The first 1,000+ bed hospital to close was
Darenth Park Hospital Darenth Park Hospital was a healthcare facility in Darenth near Dartford in Kent, originally founded as Darenth School. History The hospital was founded by the Metropolitan Asylums Board in Darenth near Dartford in Kent as Darenth School for 500 ...
in
Kent Kent is a county in South East England and one of the home counties. It borders Greater London to the north-west, Surrey to the west and East Sussex to the south-west, and Essex to the north across the estuary of the River Thames; it faces ...
, swiftly followed by many more across the UK. The haste of these closures, driven by the
Conservative Conservatism is a cultural, social, and political philosophy that seeks to promote and to preserve traditional institutions, practices, and values. The central tenets of conservatism may vary in relation to the culture and civilization i ...
governments led by
Margaret Thatcher Margaret Hilda Thatcher, Baroness Thatcher (; 13 October 19258 April 2013) was Prime Minister of the United Kingdom from 1979 to 1990 and Leader of the Conservative Party (UK), Leader of the Conservative Party from 1975 to 1990. S ...
and
John Major Sir John Major (born 29 March 1943) is a British former politician who served as Prime Minister of the United Kingdom and Leader of the Conservative Party (UK), Leader of the Conservative Party from 1990 to 1997, and as Member of Parliament ...
, led to considerable criticism in the press, as some individuals slipped through the net into homelessness or were discharged to poor quality private sector mini-institutions.


Wrongful involuntary commitment

There are a few rare instances in which mental health professionals have wrongfully deemed individuals to have been displaying the symptoms of a
mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
, and committed the individual for treatment in a
psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative ...
upon such grounds. Involuntary commitment is undertaken when the information provided to the doctor during the period of evaluation appears to show that the patient is a danger to themselves or others. This can be challenging in some scenarios, when there isn't enough collateral information to disprove the claims erratic or dangerous behaviors. Therefore, claims of wrongful commitment are a common theme in the anti-psychiatry movement. In 1860, the case of
Elizabeth Packard Elizabeth Parsons Ware Packard (28 December 1816 – 25 July 1897), also known as E.P.W. Packard, was an American advocate for the rights of women and people accused of insanity. She was wrongfully confined by her husband who claimed that she ...
, who was wrongfully committed that year and filed a lawsuit and won thereafter, highlighted the issue of wrongful involuntary commitment. In 1887, investigative journalist
Nellie Bly Elizabeth Cochran Seaman (born Elizabeth Jane Cochran; May 5, 1864 – January 27, 1922), better known by her pen name Nellie Bly, was an American journalist, industrialist, inventor, and charity worker who was widely known for her record-breaki ...
went undercover at an asylum in
New York City New York, often called New York City or NYC, is the List of United States cities by population, most populous city in the United States. With a 2020 population of 8,804,190 distributed over , New York City is also the L ...
to expose the terrible conditions that mental patients at the time had to deal with. She published her findings and experiences as articles in ''
New York World The ''New York World'' was a newspaper published in New York City from 1860 until 1931. The paper played a major role in the history of American newspapers. It was a leading national voice of the Democratic Party. From 1883 to 1911 under publi ...
'', and later made the articles into one book called ''
Ten Days in a Mad-House ''Ten Days in a Mad-House'' is a book by American journalist Nellie Bly. It was initially published as a series of articles for the ''New York World''. Bly later compiled the articles into a book, being published by Ian L. Munro in New York City ...
''. In the first half of the twentieth century there were a few high-profile cases of wrongful commitment based on racism or punishment for
political dissent Political dissent is a dissatisfaction with or opposition to the policies of a governing body. Expressions of dissent may take forms from vocal disagreement to civil disobedience to the use of violence.Soviet Union The Soviet Union,. officially the Union of Soviet Socialist Republics. (USSR),. was a transcontinental country that spanned much of Eurasia from 1922 to 1991. A flagship communist state, it was nominally a federal union of fifteen national ...
, psychiatric hospitals were used as prisons to isolate
political prisoner A political prisoner is someone imprisoned for their political activity. The political offense is not always the official reason for the prisoner's detention. There is no internationally recognized legal definition of the concept, although n ...
s from the rest of society. British playwright
Tom Stoppard Sir Tom Stoppard (born , 3 July 1937) is a Czech born British playwright and screenwriter. He has written for film, radio, stage, and television, finding prominence with plays. His work covers the themes of human rights, censorship, and politi ...
wrote '' Every Good Boy Deserves Favour'' about the relationship between a patient and his doctor in one of these hospitals. Stoppard was inspired by a meeting with a Russian exile. In 1927, after the execution of
Sacco and Vanzetti Nicola Sacco (; April 22, 1891 – August 23, 1927) and Bartolomeo Vanzetti (; June 11, 1888 – August 23, 1927) were Italian immigrant anarchists who were controversially accused of murdering Alessandro Berardelli and Frederick Parmenter, a ...
in the United States, demonstrator Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in a rally in support of the anarchists. Throughout the 1940s and 1950s in
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
, 20,000 Canadian children, called the
Duplessis orphans The Duplessis Orphans (french: link=no, les Orphelins de Duplessis) were a population of Canadian children wrongly certified as mentally ill by the provincial government of Quebec and confined to psychiatric institutions in the 1940s and 1950s ...
, were wrongfully certified as being mentally ill and as a result were committed to psychiatric institutions where they were allegedly forced to take psychiatric medication that they did not need and were abused. They were named after
Maurice Duplessis Maurice Le Noblet Duplessis (; April 20, 1890 – September 7, 1959), was a Canadian lawyer and politician who served as the 16th premier of Quebec. A conservative, nationalist, anti-Communist, anti-unionist and fervent Catholic, he and hi ...
, the premier of
Quebec Quebec ( ; )According to the Canadian government, ''Québec'' (with the acute accent) is the official name in Canadian French and ''Quebec'' (without the accent) is the province's official name in Canadian English is one of the thirtee ...
at the time, who deliberately committed these children to misappropriate additional
subsidies A subsidy or government incentive is a form of financial aid or support extended to an economic sector (business, or individual) generally with the aim of promoting economic and social policy. Although commonly extended from the government, the ter ...
from the federal government. Decades later in the 1990s, several of the orphans sued Quebec and the
Catholic Church The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptized Catholics worldwide . It is among the world's oldest and largest international institutions, and has played a ...
for the abuse and wrongdoing. In 1958, black pastor and activist
Clennon Washington King Jr. Clennon Washington King Jr. (July 18, 1920 – February 12, 2000) was the second African-American man to run for the office of President of the United States after George Edwin Taylor, and whose attempts at civil rights actions and running fo ...
tried enrolling at the
University of Mississippi The University of Mississippi (byname Ole Miss) is a public research university that is located adjacent to Oxford, Mississippi, and has a medical center in Jackson. It is Mississippi's oldest public university and its largest by enrollment. ...
, which at the time was white, for summer classes; the local police secretly arrested and involuntarily committed him to a mental hospital for 12 days."Negro Pastor Pronounced Sane; Demands Mississippi Apologize".
UPI. '' Sarasota Journal'' 20 June 1958: 3.
Patients are able to sue if they believe that they have been wrongfully committed. In one instance, Junius Wilson, an African American man, was committed to Cherry Hospital in Goldsboro, North Carolina in 1925 for an alleged crime without a trial or conviction. He was castrated. He continued to be held at Cherry Hospital for the next 67 years of his life. It turned out he was deaf rather than mentally ill. In many American states sex offenders who have completed a period of incarceration can be civilly committed to a mental institution based on a finding of dangerousness due to a mental disorder. Although the United States Supreme Court determined that this practice does not constitute
double jeopardy In jurisprudence, double jeopardy is a procedural defence (primarily in common law jurisdictions) that prevents an accused person from being tried again on the same (or similar) charges following an acquittal or conviction and in rare case ...
, organizations such as the
American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 37,000 members are involve ...
(APA) strongly oppose the practice. The Task Force on Sexually Dangerous Offenders, a component of APA's Council on Psychiatry and Law, reported that "in the opinion of the task force, sexual predator commitment laws represent a serious assault on the integrity of psychiatry, particularly with regard to defining mental illness and the clinical conditions for compulsory treatment. Moreover, by bending civil commitment to serve essentially non-medical purposes, statutes threaten to undermine the legitimacy of the medical model of commitment."


See also


In the creative arts

*
One Flew Over the Cuckoo's Nest (novel) ''One Flew Over the Cuckoo's Nest'' is a novel by Ken Kesey published in 1962. Set in an Oregon psychiatric hospital, the narrative serves as a study of institutional processes and the human mind, including a critique of psychiatry and a tribute ...
, (
One Flew Over the Cuckoo's Nest (film) ''One Flew Over the Cuckoo's Nest'' is a 1975 American psychological comedy drama film directed by Miloš Forman, based on the 1962 novel of the same name by Ken Kesey. The film stars Jack Nicholson who plays a new patient at a mental insti ...
), (
One Flew Over the Cuckoo's Nest (play) ''One Flew Over the Cuckoo's Nest'' (1963) is a play based on Ken Kesey's 1962 novel of the same name. Productions Dale Wasserman's stage adaptation, with music by Teiji Ito, made its Broadway preview on November 12, 1963, its premiere on Novemb ...
) * '' if....'' * Forrest Gump
novel A novel is a relatively long work of narrative fiction, typically written in prose and published as a book. The present English word for a long work of prose fiction derives from the for "new", "news", or "short story of something new", itsel ...
and film based on the novel *
Cool Hand Luke ''Cool Hand Luke'' is a 1967 American prison drama film directed by Stuart Rosenberg, starring Paul Newman and featuring George Kennedy in an Oscar-winning performance. Newman stars in the title role as Luke, a prisoner in a Florida prison cam ...
*
Rebel without a Cause ''Rebel Without a Cause'' is a 1955 American coming-of-age drama film about emotionally confused suburban, middle-class teenagers. Filmed in the then recently introduced CinemaScope format and directed by Nicholas Ray, it offered both social co ...


Notes


References


Further reading

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* Report of the Committee of Inquiry into allegations of ill-treatment of patients and other irregularities at the Ely Hospital, Cardiff, HMSO 196

* Extracts of the Report of the Committee of Inquiry into Normansfield Hospital - British Medical Journal, 1978, 2, 1560-156

*
Erving Goffman Erving Goffman (11 June 1922 – 19 November 1982) was a Canadian-born sociology, sociologist, Social psychology (sociology), social psychologist, and writer, considered by some "the most influential American sociologist of the twentieth ...
Asylums * Whyte, William H., ''The Organization Man'', Doubleday Publishing, 1956.
excerpts from Whyte's book
* The Production and Reproduction of Scandals in Chronic Sector Hospitals Amy Munson- Barkshire 198


External links


National Resource Center on Psychiatric Advance Directives
(United States) * Provides information related to
Florida Florida is a state located in the Southeastern region of the United States. Florida is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Bahamas and Atlantic Ocean, and to ...
's Civil Commitment Statute.
National Alliance on Mental Illness
(United States) {{DEFAULTSORT:Involuntary Commitment Ethically disputed medical practices Mental health law