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Emergency Detention and Involuntary Hospitalization: Assessing the Front End of the Civil Commitment Process


The allocation of treatment resources in the behavioral health system in the United States has shifted dramatically over the past fifty years. Most people who require mental health care, including patients who have severe mental illnesses, now receive treatment in outpatient set-tings. Inpatient care is often limited to brief stays of a week or less. Some jurisdictions have adjusted the statutes governing the initiation of involuntary hospitalization to reflect these clinical changes. These states may require some form of judicial oversight within the first hours or days of an individual’s detention, and some also seek to connect patients in distress to community-based screening mechanisms to facilitate the diversion of eligible individuals to suitable alternatives to hospitalization and the civil commitment process. Other jurisdictions, however, have not made the sort of fundamental adjustments necessary to reflect the changed role of psychiatric hospitalization. In jurisdictions that have not adjusted their procedural timelines, it is possible for statutorily mandated adjudication to be pushed well beyond the seven- to ten-day average of most psychiatric hospitalizations, thereby rendering these formal legal protections ineffective.