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Wednesday, September 14, 2011

Essay on Involuntary Commitment of Mentally Ill Persons

The beauty of democracy lies in its ability to maintain a delicate balance between the powers of the government and the civil rights and liberties of the people.  Democracy still guarantees the exercise by the government of its fundamental powers such as the police power, power of taxation and the power of eminent domain.  It recognizes that these powers of the government must subsist otherwise no government will be able to survive without them.  However, democracy also guarantees civil and political rights to the people.  A democratic government is considered a government for the people, by the people and of the people.  A government which does not protect the rights of the people to due process, to free speech, to religious freedom is not a democracy.

One of the duties of the government is to protect its people from harm.  In order to perform its duty, the government is given the power to arrest persons who have committed a crime and to detain them so that the society will be protected against them. The government also has the power to require the commitment and confinement of persons who are mentally ill for the protection of the society even against his will.  This is otherwise known as involuntary confinement which is defined as “the practice of using legal means to commit a person to a mental hospital, insane asylum or psychiatric ward against the will or over the protests of that person.”  In this case the government’s objective is to separate those who are mentally ill from those who are not so that they will receive treatment from institution and to protect those who are not mentally ill from them. 

Some sectors of the society however consider that the involuntary confinement of mentally-ill individuals is constitutionally infirm as it violates the right to due process of the mentally ill individual.  The Fifth Amendment provides that “No person shall be deprived of life, liberty and property without due process of law.”  Depriving a person of his liberty by detention and commitment to an institution against his will is a violation of his due process rights. 

This essay seeks to discuss the arguments in favor and against the involuntary commitment of individuals pending the determination of their fitness for trial.  Scholarly articles were used as basis for the opinions written in this essay. 

Arguments in favor of Involuntary Commitment
Michael Kennedy, an 18 year old boy, had just escaped from a mental clinic. He thought that there were aliens from outer space who were after him.  The assessment of the social worker is that he was not an “imminent danger to himself or to others.”  Subsequently, he was released.  Three days later, Michael Kennedy took some guns from his home and shot veteran police officers.  He was killed.   This incident highlights the importance of the issue of involuntary commitment of mentally ill individuals. 

As a result, states have passed laws providing for the involuntary confinement of individuals who are mentally ill.  These statutes allow the confinement of individuals who are suffering from sickness such as mental retardation, epilepsy, developmental disabilities and even drug or alcohol addiction. 

On the other hand, there are those states which require the commitment of individuals who pose danger to himself and to others (Bruce Bower, 1988, p.1).  Bruce A. Arrigo (1999), citing Lev and Rubenstein (1996), states that the concept of dangerousness is one of the most elusive doctrines in mental disability law (p.11).  Dangerousness test means that the individual must pose a substantial threat of serous harm to oneself or to others (Arrigo, 1999, p.12).  It has also been interpreted to mean a real and present threat of harm.  It has also been interpreted to mean not only violence to oneself or to others, but also severe neglect where one is unable to survive in the community, that is, where n is gravely disabled (Arrigo, 1999, p12).   

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The present trend however among states is to deviate from the dangerous test as a requirement prior to commitment.  Thus, in Arizona, a person can be involuntarily committed to an institution if he is "persistently or acutely disabled" because of mental illness may be subject to commitment (Ariz. Rev. Stat. Ann. § 36-540 (A) [1995]).  Also, in Delaware, an individual can be involuntarily committed to an institution if he cannot make "responsible decisions" about inpatient care and treatment may be committed (Del. Code Ann. tit. 16, § 5001 [1995]). Iowa also allows the commitment of individuals to an institution if he is likely to inflict serious emotional injury on family or others who "lack reasonable opportunity" to avoid contact with that person (Iowa Code Ann. § 229.1 [West 1995]).

The basis for the involuntary commitment of mentally ill individuals is based on the inherent right of police power.  This power allows the state to deprive individuals of their right to liberty for the purpose of protecting the society against them.  The idea is to separate them from non-mentally ill individuals so that they do not pose danger to themselves.  It bears stressing that mentally ill individuals do not only pose a serious threat to their own safety but to others as well.  As such, it would be in the interest of the society to keep mentally ill individuals inside institutions for treatment and for the protection of the society. 

It is not denied that even if the person is mentally ill, he is entitled to his fundamental rights.  It is however also true that a person who is mentally ill is a serious danger to his society.  In this case, the state will be doing the society grave injustice if it will allow these individuals to roam around without adequate supervision. 
It is true that one of the common criticisms against involuntary commitment is the lack of uniform standard for purpose of defining who are mentally-ill individuals.  They argue that the lack of standard has resulted in differences in the application of the statute such that in some states mentally-ill individuals are freed because of laxity in standard while there are some mentally-ill individuals who are involuntarily committed because of strict standards. This does not however mean that the whole system should be abolished.  If there are imperfections in the system, the solution is not to abolish the whole system but to improve it.

Arguments against Involuntary Confinement
The opponents of Involuntary Confinement, on the other hand, argue that freedom of movement and liberty are fundamental rights of individuals.  Without freedom an individual cannot be considered a living person and is better of dead.  Right to health on the other hand is also important but it is merely secondary to freedom. To say that a person should be deprived of his freedom so that he can be cured of his illness is utterly without any sense. 

No person should be deprived of his liberty except upon commission of a crime.  When society tolerates the involuntary commitment of individuals just because some person arbitrarily declare them to be mentally ill we open the door to the possibility that in the future more people will be deprived of their liberty for any flimsy and baseless reason.  Also, when society tolerates the involuntary commitment of individuals, there are certain sectors of our society that are placed in grave danger from the state.  These are the old, the homeless and the young.  There is the possibility that old people will be placed in mental institutions simply because their family no longer wants to take care of them.  It is possible that homeless persons will also be placed in mental institutions just so they could be removed from the street.  Though it is better that these individuals are placed in the mental institutions where they will be taken cared of, but the point is that persons who may not be mentally ill may be placed inside mental institutions while those who are mentally ill are outside these institutions. 

They also argue that the determination of individuals who are mentally ill and those who are not rests on unconstitutional ground.  Until now there is no uniform standard as to who are mentally ill individuals.  The absence of a uniform standard has resulted in the differences in the approach among psychiatrists and psychologists and even judges.  As a result in some states mentally ill individuals are allowed to roam around because of the laxity in the standard while in some state the even non-mentally ill individuals are placed in confinement because of the strict standards.  When some states grants privileges to certain group of individuals while denying the same to others, the act constitute a violation of the Equal Process Clause of the Constitution which states that: “No person shall be denied the equal protection of the law.” 

The commitment of persons to mental hospitals and other institutions against his will is indeed an extraordinary measure because it involves the deprivation of one of our most fundamental rights – liberty.  Time however has changed.  In the light of the extraordinary time, the situation demands for extraordinary action on the part of the state. 

Involuntary confinement should not be viewed by the society not an arbitrary and unconstitutional act of the state.  It is an act which is authorized by state laws.  It is also an act that is given legality by the order of the court.  In this age and time, peace and security comes at a price. 

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