9.7 Summary
- Several forms of commitment, or court-ordered involuntary mental health treatment, exist to serve various purposes in or adjacent to the criminal justice system.
- Civil commitment provides a non-criminal process for a court to order a person to receive treatment for a mental illness, including possible confinement to a treatment facility.
- Civil commitment requires a complex set of processes with multiple layers of review to ensure that a person’s rights are not violated. A person cannot be committed simply because they experience mental illness; rather there must be clear and convincing evidence that they pose a danger due to a mental disorder.
- There are several forms of commitment that relate directly to criminal proceedings. These include commitment for competency restoration and commitment to a hospital or other facility for treatment upon successful assertion of the insanity defense.
- Another criminal-system commitment, specific to Oregon, is the Extremely Dangerous and Resistant to Treatment commitment for people who, usually, have been found “never able” to aid and assist in their own defense.
- Some states, including Washington, have provisions in law that allow for the post-conviction commitment of sex offenders who remain dangerous to the community even after serving a sentence on the underlying offense.
9.7.1 Key Terms
- Beyond a reasonable doubt: The legal standard of proof in criminal cases. Proof at this level includes overwhelming evidence that leaves no significant doubt in the minds of decision makers.
- Burden of proof: the amount or level of evidence required to prevail in a particular legal case. The burden of proof in a criminal case is “beyond a reasonable doubt,” and in most civil cases it is “by a preponderance of the evidence.”
- Civil commitment: A court order requiring involuntary treatment, and sometimes confinement, for a person who has become unsafe due to a mental disorder.
- Clear and convincing evidence: A legal standard of proof more demanding than the “preponderance of the evidence” standard, but less stringent than proof “beyond a reasonable doubt.” This standard is used in civil commitment cases, where serious liberty interests are at stake.
- Commitment hearing: A hearing where a judge or hearings officer considers the evidence and decides whether to order a civil commitment.
- Competency restoration: The process where a person determined by the court to be mentally unfit to resolve their criminal case receives treatment to become competent, or be restored.
- Conditional release: Release of a person from an institutional setting (prison or hospital, for example) into the community, often in a group setting, with requirements to abide by a set of rules and safeguards. If those conditions of release are violated, the person may be returned to confinement.
- Criminal commitment: Term used to describe commitments (involuntary treatment and/or confinement) by operation of law in the context of a criminal case. A commitment is not a conviction or a punishment.
- Emergency hold (hospital hold): A process allowing a doctor to order that a person be kept under medical supervision so their mental health can be assessed and stabilized. A hold can be a first step in involuntary commitment proceedings.
- Grave disability: a legal status defined by state laws indicating that a person is unable to safely care for themself, or likely to harm themself. Grave disability can be a basis for civil commitment in some states.
- Imminent danger: Threat of harm that is immediate rather than in the future.
- Notice of Mental Illness (NMI): In Oregon, the paperwork that triggers a court’s involvement in a civil commitment. Each state and the federal system has developed their own procedures for initiating and completing civil commitments.
- Pre-commitment investigation: An evaluation by mental health professionals to determine what, if any, mental disorder a person is experiencing, and how that mental disorder is currently impacting the person facing commitment.
- Preponderance of the evidence: The legal standard of proof in civil cases. Evidence at this level makes something more likely than not to be true, and may be characterized as “just enough” to tip the scales, or 51%.
- Psychiatric Security Review Board: In Oregon, an multi-disciplinary oversight board charged with ensuring proper management and community safety with respect to all GEI (guilty except for insanity) patients. Each jurisdiction that allows the insanity defense has their own methods of overseeing this population.
- Public petition for civil commitment: In Oregon, a specific procedure for initiating civil commitment proceedings that allows any two people acting together to initiate the commitment process.
- Section 1983: A common name for the federal law, 42 U.S.C. Sec. 1983, originally enacted in 1871 and known as the Ku Klux Klan Act. Section 1983 allows individuals to bring lawsuits in federal court to address violation of their federal civil rights by state officials.
9.7.2 Discussion Questions
- How is a civil commitment under modern statutes different from the routine institutionalization of people with mental disorders that occurred up through the mid-to-late 1900s?
- Explain the “imminent danger” standard that is generally required for civil commitment. Why does this standard exist? Should this be the requirement, or would you choose a different standard for civil commitment?
- What is the basis for the post-prison commitment of sex offenders in states like Washington? What are the pros and cons of this type of commitment? Would you prefer to see restriction or expansion of these commitments?