With the trend towards deinstitutionalization, this situation is becoming increasingly frequent, and hospital admission is restricted to people with severe mental illnesses.
[3] A person may be committed if they are an imminent danger or at the request of either a third party, usually a family member, one or two physicians or a representative of the state.
In Italy the physician Giorgio Antonucci, in his work at the hospitals of Gorizia, Cividale del Friuli and Imola since the late 1960s, has avoided involuntary hospitalisation and any kind of coercion, rejecting the diagnosis as psychiatric prejudice.
In Dutch criminal law, a convict can be sentenced to involuntary psychiatric treatment in a special institute called a ''TBS'' clinic [nl].
[citation needed] Every convict detained in a TBS clinic may get temporary leave after serving a certain time or after some progress in treatment.
The first level of controversy resulted from the media increasingly reporting cases of convicts committing crimes while still in, or after, treatment in a TBS clinic.
Numerous articles in newspapers, magazines, television and radio programs and a revealing book written by an ex-convict (which for the first time openly questioned the effectiveness of the TBS-system) boosted discussion.
Concern rose about claims of unprofessional behavior by staff working in TBS clinics, and the Dr. S. Van Mesdagkliniek developed a poor reputation over these problems.
During that year, the clinic came under investigation by Dutch police after rumors about female staffmembers committing sexual offenses against convicts emerged.
[6] At least one psychiatrist, employed as such by the clinic, proved to be not qualified[clarification needed],[7] and treatment of convicts was in many cases simply non-existent.
In 2005, a staff member working in the Dr. S. Van Mesdagkliniek was caught smuggling liquor to convicts suffering from alcohol-related problems.
That same year, investigation proved convicts still had ample access to illicit drugs[14] and four inmates from the Dr. S. Van Mesdagkliniek were arrested for possession of child pornography.
(MHA 1969 s28(2)) Despite the deinstitutionalization that began in New Zealand during the 1960s, as in many other Western countries, many patients stayed at the psychiatric hospital for years, as the original reception order remained in force.
Section 8B requires that the person be seen by a doctor, preferably their own General Practitioner, to give their opinion as to whether the applicant is correct in their statements about the proposed patient's behaviour.
[citation needed] Under s10 they are formally interviewed by the psychiatrist, and if they are to be admitted, a s11 is issued that detains the patient for assessment and treatment at an inpatient mental health unit, for up to five days.
The current system is not set up for people who require long term closely supervised mental health care.
The process involves an application for admission submitted to a mental health review board or a magistrate's court.
[18][19] Switzerland has a high proportion of involuntary commitments (German: Zwangzulassung, French: placement forcé) compared to other European countries.
A police officer, doctor, nurse or licensed mental health professional may initiate an involuntary examination that lasts for up to 72 hours.
This matter has been the subject of a number of cases before the Supreme Court, most notably Kansas v. Hendricks and United States v. Comstock[29] in regard to the Adam Walsh Child Protection and Safety Act, which does not require a conviction on sex offenses, but only that the person be in federal custody and be deemed a "sexually dangerous person".
Virtually anyone who suspects that someone has mental problems and needs help could file an application to a state-licensed healthcare agency for a court-ordered evaluation.
"Gravely disabled" has usually been interpreted to mean that the person is unable on their own to obtain adequate food, shelter and clothing.
The Michigan Mental Health Code provides that a person "whose judgment is so impaired that he or she is unable to understand his or her need for treatment and whose continued behavior as the result of this mental illness can reasonably be expected, on the basis of competent clinical opinion, to result in significant physical harm to himself or herself or others" may be subjected to involuntary commitment, a provision paralleled in the laws of many other jurisdictions.
In Oregon, the standard that the allegedly mentally ill person "Peter [h]as been committed and hospitalized twice in the last three years, is showing symptoms or behavior similar to those that preceded and led to a prior hospitalization and, unless treated, will continue, to a reasonable medical probability, to deteriorate to become a danger to self or others or unable to provide for basic needs" may be substituted for the danger to self or others standard.
Other individuals have opposed involuntary commitment on the basis that they claim (despite the amendment generally being held to apply only to criminal cases) it violates the Fifth Amendment in a number of ways, particularly its privilege against self-incrimination, as the psychiatrically examined individual may not be free to remain silent, and such silence may actually be used as "proof" of his "mental illness".
Court reviews usually are heavily weighted toward the hospital staff, with the patient input during such hearings minimal.
[43] Accompanying deinstitutionalization was the development of laws expanding the power of courts to order people to take psychiatric medication on an outpatient basis.
The intent of conservatorship or guardianship is to protect those not mentally able to handle their affairs from the effects of their bad decisions, particularly with respect to financial dealings.
A family member or concerned citizen can also petition the Department of Mental Health, but the claim will be evaluated prior to the police acting upon it.
But after the Virginia Tech Massacre, there was significant political consensus to strengthen the protections for society and allow more leniency in determining that an individual needed to be committed against their will.