Editing Involuntary commitment (section)

==Purpose==

For most jurisdictions, involuntary commitment is applied to individuals believed to be experiencing a mental illness that impairs their ability to reason to such an extent that the agents of the law, state, or courts determine that decisions will be made for the individual under a legal framework. In some jurisdictions, this is a proceeding distinct from being found [[Incompetence (law)|incompetent]]. Involuntary commitment is used in some degree for each of the following although different jurisdictions have different criteria. Some jurisdictions limit involuntary treatment to individuals who meet statutory criteria for presenting a danger to self or others. Other jurisdictions have broader criteria. The legal process by which commitment takes place varies between jurisdictions. Some jurisdictions have a formal court hearing where testimony and other evidence may also be submitted and the subject of the hearing is typically entitled to legal counsel and may challenge a commitment order through [[habeas corpus]].<ref>{{cite web | quote = The law provides a process known as Involuntary Commitment. Involuntary commitment is the use of legal means to commit a person to a mental hospital or psychiatric ward against their will or over their protests. |author=Texas Young Lawyers Association | title = Committed To Healing: Involuntary Commitment Procedures | publisher=State Bar of Texas |location=Austin, TX | date=January 2008 | url = https://www.texasbar.com/AM/Template.cfm?Section=Free_Legal_Information2&Template=/CM/ContentDisplay.cfm&ContentID=30801 |format=PDF |page=2 }}</ref> Other jurisdictions have delegated these power to physicians,<ref name="no-court-1"/> though may provide an appeal process that involves the judiciary but may also involve physicians.{{efn|name=tribunals| For a discussion of the role of physicians in mental health tribunals and its effects see <ref name="Thom Nakarada-Kordic pp. 112–126">{{cite journal | last1=Thom | first1=Katey | last2=Nakarada-Kordic | first2=Ivana | title=Mental Health Review Tribunals in Action: A Systematic Review of the Empirical Literature | journal=Psychiatry, Psychology and Law | publisher=Informa UK Limited | volume=21 | issue=1 | date=2013-05-22 | issn=1321-8719 | doi=10.1080/13218719.2013.790004 | pages=112–126| s2cid=143237902 }}</ref> }} For example, in the UK a mental health tribunal consists of a judge, a medical member, and a lay representative.{{efn|name=tribunal-members|"The  chair  of  each  Mental  Health  Tribunal  is  a  legal  member  who  is  known  as a tribunal judge. There are usually three tribunal members at a hearing, one legal  member,  one  medical  member,  and  one  other  member,  as  defined  above.  Any  three  or  more  such  members,  constituted  in  this  manner,  may  exercise  the  jurisdiction of a Mental Health Tribunal" <ref name="PuriBrown2017">{{cite book|author1=Basant Puri|author2=Robert Brown|author3=Heather McKee|author4=Ian Treasaden|title=Mental Health Law 2EA Practical Guide|url=https://books.google.com/books?id=pknOBQAAQBAJ|date=28 July 2017|publisher=CRC Press|isbn=978-1-4441-4975-3}}</ref> {{rp|99}} }}

===First aid===
Training is gradually becoming available in mental health first aid to equip community members such as teachers, school administrators, police officers, and medical workers with training in recognizing, and authority in managing, situations where involuntary evaluations of behavior are applicable under law.<ref>{{cite web |url=http://www.mentalhealthfirstaid.org/cs/background |title=About |website=Mental Health First Aid USA |publisher=National Council for Behavioral Health |date= 2013-10-10|access-date=2013-12-21}}</ref> The extension of first aid training to cover mental health problems and crises is a quite recent development.<ref>{{ cite journal |last1=Kitchener |first1=Betty A. |last2=Jorm |first2=Anthony F. | title = Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behaviour | journal = BMC Psychiatry |date=1 October 2002 | volume = 2 | page = 10 | pmid = 12359045 | pmc = 130043 | doi = 10.1186/1471-244X-2-10 |doi-access=free }}</ref><ref>{{cite book |last1=Kitchener |first1=Betty |last2=Jorm |first2=Anthony |last3=Kelly |first3=Claire | title = Mental Health First Aid Manual | edition = 2nd | location=Parkville, Victoria |publisher=ORYGEN Youth Health Resource Centre  | year = 2010 |isbn=978-0-9805541-3-7 |oclc=608074743 }}</ref> A mental health first aid training course was developed in Australia in 2001 and has been found to improve assistance provided to persons with an alleged mental illness or mental health crisis. This form of training has now spread to a number of other countries (Canada, Finland, Hong Kong, Ireland, Singapore, Scotland, England, Wales, and the United States).<ref>{{ cite journal |last1=Kitchener |first1=Betty A. |last2=Jorm |first2=Anthony F. |date=February 2008 | title = Mental health first aid: an international program for early intervention | journal = Early Intervention in Psychiatry | volume = 2 | issue = 1 | pages = 55–61 | pmid = 21352133 | doi = 10.1111/j.1751-7893.2007.00056.x |s2cid=11813019 }}</ref> [[Mental health triage]] may be used in an emergency room to make a determination about potential risk and apply treatment protocols.

===Observation===
{{Unreferenced section|date=October 2017}}
Observation is sometimes used to determine whether a person warrants involuntary commitment. It is not always clear on a relatively brief examination whether a person should be committed.

===Containment of danger===
{{See also|Obligatory Dangerousness Criterion}}
Austria, Belgium, Germany, Israel, the Netherlands, Northern Ireland, the Republic of Ireland, Russia, Taiwan, Ontario (Canada), and the United States have adopted [[Obligatory Dangerousness Criterion|commitment criteria]] based on the presumed danger of the defendant to self or to others.<ref>{{cite journal|title=Almost a Revolution: An International Perspective on the Law of Involuntary Commitment|journal=[[Journal of the American Academy of Psychiatry and the Law]] |date=June 1997|volume=25|issue=2|pages=135–147|pmid=9213286|url=http://jaapl.org/content/25/2/135 |last=Appelbaum |first=Paul S.}}</ref>

People with [[suicide|suicidal thoughts]] may act on these impulses and harm or kill themselves.

People with [[psychosis]] are occasionally driven by their [[delusion]]s or [[hallucination]]s to harm themselves or others. Research has found that those with schizophrenia are between 3.4 and 7.4 times more likely to engage in violent behaviour than members of the general public. 
<ref name="schizophrenia">{{cite journal | last1=Fazel | first1=Seena | last2=Gulati | first2=Gautam | last3=Linsell | first3=Louise | last4=Geddes | first4=John R. | last5=Grann | first5=Martin | editor-last=McGrath | editor-first=John | title=Schizophrenia and Violence: Systematic Review and Meta-Analysis | journal=PLOS Medicine | publisher=Public Library of Science (PLoS) | volume=6 | issue=8 | date=2009-08-11 | issn=1549-1676 | doi=10.1371/journal.pmed.1000120 | page=e1000120| pmid=19668362 | pmc=2718581 | doi-access=free }}</ref>  However, because other [[confounding factors]] such as childhood adversity and poverty are correlated with both schizophrenia and violence it can be difficult to determine whether this effect is due to schizophrenia or other factors. In an attempt to avoid these confounding factors, researchers have tried comparing the rates of violence amongst people diagnosed with schizophrenia to their siblings in a similar manner to [[twin studies]]. In these studies people with schizophrenia are found to be between 1.3 and 1.8 times more likely to engage in violent behaviour.<ref name="schizophrenia" />

People with certain types of [[personality disorder]]s can occasionally present a danger to themselves or others.<ref>{{cite journal|last1=Sansone|first1=Randy A.|last2=Sansone|first2=Lori|date=March 9, 2012|title=Borderline Personality and Externalized Aggression|journal=Innovations in Clinical Neuroscience|volume=9|issue=3|pages=23–26|pmid=22567607|pmc=3342993}}</ref>

This concern has found expression in the standards for involuntary commitment in every US state and in other countries as the danger to self or others standard, sometimes supplemented by the requirement that the danger be imminent. In some jurisdictions,{{which|date=October 2017}} the [[Obligatory Dangerousness Criterion|danger to self or others standard]] has been broadened in recent years to include need-for-treatment criteria such as "gravely disabled".<ref>{{cite book|title=State Standards for Civil Commitment |publisher=Treatment Advocacy Center |year=2018 |location=Arlington, Virginia}}</ref>