Involuntary Commitment

What is involuntary commitment?

Involuntary (civil) commitment is legally being admitted to a psychiatric unit for care of a severe mental health condition against your wishes.

Your clinical team and the local county probate court work with you to determine how long you need to stay and to determine treatment recommendations. You can’t be forced to take psychiatric medications unless the court approves that treatment.

You may meet the criteria for involuntary commitment if you have an underlying psychiatric condition that poses an immediate risk of danger to yourself (suicidal) or others (homicidal). It may also prevent you from taking care of your basic needs.

If someone is requesting involuntary commitment, it isn’t a personal attack. No one is trying to imprison you. The goal is to keep you safe and prevent life-threatening complications that may happen if you don’t receive treatment.

What conditions does involuntary commitment help?

Some of the most common mental health conditions that involuntary commitment may help you manage include, but aren’t limited to, the following:

• Mental health conditions like schizophrenia
• Mood disorders like major depression and bipolar disorder
• Drug-induced psychosis
• Suicidal ideation
• Dementia with associated psychiatric symptoms

These conditions don’t always require involuntary commitment. But they may if you’re in danger.

What are the criteria for involuntary commitment?

The criteria for civil commitment may look slightly different in each state. It sometimes varies depending on the county, too. It’s a civil legal process of the probate court. It’s guided by both state and federal law in the United States. The general criteria include:

• You have a mental health condition that has serious symptoms. These can significantly impact your perception, mood, judgment and behavior.
• Symptoms pose an immediate health and safety threat to yourself and/or others.
• Symptoms prevent you from completing basic personal needs like eating meals, wearing clothing and accessing shelter.
• You would benefit from treatment in a hospital for this mental health condition.

The legal system offers different criteria that vary by state and county, so care is as nonrestrictive as possible. For example, if outpatient services (going home after treatment) are available that meet your needs, you can receive that type of care rather than inpatient services (staying in a hospital).

How does involuntary commitment work

The process of involuntary commitment may look like this:

1. A concerned person contacts someone who can help get the civil commitment process started for you. This may be a healthcare or mental health provider, social worker, law enforcement officer or probate court.
2. Law enforcement might take you into custody to transport you to an emergency room to see a healthcare provider.
3. A healthcare provider will complete an evaluation to see whether you meet the criteria to be involuntarily committed.
4. If the healthcare provider agrees that you meet the criteria, you’ll be admitted to an inpatient psychiatric facility to receive treatment.
5. A court hearing is held to determine whether involuntary commitment is necessary for a longer amount of time (this varies by state).

Between steps three and four, you may be placed in a care setting for observation for up to 72 hours before a provider makes their official decision. This emergency hold may allow your symptoms time to stabilize. If you’re able to, you may have the option to choose whether you want to voluntarily admit yourself into treatment after 72 hours.

The process and timeline are slightly different for each person. It also varies based on the local civil code.

What are the consequences of involuntary commitment?

Involuntary commitment does have positive and negative aspects to it. For example, it may save your life and give you a second chance. But the process of forcibly getting you into care against your will might cause unnecessary trauma, fear and feeling helpless that may result in post-traumatic stress disorder.

Being involuntarily committed may:

• Disrupt your routine
• Make you feel betrayed
• Set you back financially
• Cause you to lose some personal independence while you’re hospitalized
• Make you lose trust in the healthcare system or law enforcement

You may not realize the severity of your symptoms before admission. Some studies show that people realize how important involuntary commitment is after they receive the treatment they need to stay healthy.

How long is involuntary commitment supposed to last?

The amount of time you need care varies based on your needs. As a legal process, the probate court will regularly hold hearings to check in and see how things are going. For example, you may have a hearing after seven days, 14 days, 30 days or 60 days. You may need to stay in treatment longer if you’re still meeting the criteria for civil commitment (for example, you’re at risk of harming yourself or others).

Studies show that the risk of suicide increases in the months after leaving treatment. It helps to build a support system and connect with local resources who can help you if you don’t feel well. You can also call or text 988 (U.S.). This is the Suicide & Crisis Lifeline. Someone is available to speak with you 24/7 if you’re in a rough spot.