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Civil Commitment (Involuntary Psychiatric Hospitalisation)

The state-law process by which a person can be held and treated in a psychiatric facility against their will - the emergency hold, the court hearing, the standard of dangerousness, and the constitutional limits on all three.

Informational only - this is not legal advice. These definitions explain general legal vocabulary in plain English. They are not advice about your situation, reading them creates no attorney-client relationship, and the law differs from state to state and changes over time. For advice you can rely on, speak to a lawyer licensed in your state.

What it means

Civil commitment is the involuntary hospitalisation of a person for mental illness. It is a civil proceeding, not a criminal one, and it has two typical stages. An emergency hold allows a physician, a mental-health professional, or in some states a police officer, to detain a person for a short period set by statute for evaluation, on a finding that the person appears to be mentally ill and, because of it, a danger to themselves or others or unable to meet their basic needs. Holding the person beyond that period requires a petition to a court, a hearing at which the person is entitled to notice, to be present and to counsel, and a judicial finding that the statutory standard is met.

The standard is set by each state within constitutional limits. The Supreme Court has held that a state cannot confine a person who is not dangerous and is capable of living safely in the community, and that the facts justifying commitment must be proved by at least clear and convincing evidence - a higher standard than the ordinary civil one. Most states require a recent act or threat as evidence of danger; a growing number also allow commitment on a "grave disability" standard for a person who cannot provide for their own food, shelter or safety, and many now have outpatient commitment, under which a court orders treatment in the community rather than confinement.

Being committed is not the same as being found incompetent to make treatment decisions, and in most states a committed patient retains the right to refuse medication except in an emergency or after a separate determination. Commitment also carries collateral consequences the statute does not mention: a federal prohibition on possessing firearms after a formal commitment (not an emergency hold), and effects on professional licensing and some employment. A person subject to a hold or a petition has the right to a lawyer and, in most states, to an appointed one if they cannot afford counsel.

Where this comes from

Civil commitment is state law: the grounds, the length of an emergency hold, the hearing procedure and the availability of outpatient commitment are set by each state's mental-health code. The constitutional floor comes from O'Connor v. Donaldson, 422 U.S. 563 (1975) (no confinement of a non-dangerous person capable of surviving safely in freedom) and Addington v. Texas, 441 U.S. 418 (1979) (clear and convincing evidence). The federal firearms consequence is 18 U.S.C. § 922(g)(4). Federal protection and advocacy systems in every state, created by 42 U.S.C. § 10801 and following, investigate abuse and neglect of people in psychiatric facilities.

When people hire a lawyer for this

A person facing a commitment petition should have a lawyer at the hearing, and the state will usually appoint one; a family member who wants to help should ask the facility for the hearing date and the name of counsel rather than trying to argue the case. For families on the other side - trying to get treatment for someone who refuses it - a lawyer or the county mental-health authority can explain what the state's standard actually requires and what evidence a petition needs, which is very often the reason a first petition fails.

Find a lawyer for this in your state

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Part of the LawyerLand plain-English legal glossary. Definitions are written from primary sources - statutes and court rules - and each entry states the authority it rests on, or says plainly when the doctrine is state law with no national rule.

If you cannot afford a lawyer, civil legal aid programmes provide free help with many of these problems: civil legal aid programmes by state.

Related free reference tools: statute of limitations for a personal-injury claim, by state, quoted from each state's official text - part of LawyerLand's legal reference tools.