Psychology: PROCEDURES TO A PSYCHOLOGICAL COMMITMENT
Psychology: PROCEDURES & Commitment Requirements: States differ enormously in the procedures that are used to commit people, and in the safeguards those procedures provide. All states require that the individual be suffering from a psychological disability, variously termed "mental illness," "mental disease," or "mental disability." But often these phrases are not specifically defined, leaving unclear which disabilities qualify and which do not. In addition to psychological disability, all states stipulate that the individual must meet additional requirements. While these requirements vary from state to state, they require that one or more of the following "incapacitating conditions" must arise from the psychological disability: impaired judgments, need for treatment, behavioral disability, dangerousness, and danger to self. We will examine each in turn.
IMPAIRED JUDGMENT The person is so distressed that he does not recognize the need for hospitalization. Mayock could well have qualified for commitment under such a requirement since in the view of his psychiatrists, he was blind to his need for hospitalization.
NEED FOR TREATMENT The need for treatment often serves to qualify what is meant by mental disability. Thus, the state of Virginia defines a committable person as one who is "afflicted with mental disease to an extent that ... he requires care and treatment.* But however humane the "need for treatment" statute may seem, experience with it has demonstrated that this approach can have some surprisingly untoward consequences, as the case of Emily Bronson reveals. Emily Bronson, a widow, suffered two delusions: The first, that the restaurant at which she frequently ate, poisoned her food; and the second, that men were constantly planning sexual assaults upon her. These delusions were mild and harmless, and she continued to eat at the same restaurant, and her behavior with men seemed unaffected by these concerns. Her friends knew of her delusions, but they seemed to cause them or her no difficulty. One day Mrs. Bronson fell and injured her hip. She was brought to the emergency ward of a nearby hospital where she remained for several days during which time she spoke of her delusions. In this wholly fortuitous manner she was perceived as a paranoid schizophrenic who needed treatment and was transferred to a psychiatric hospital just as soon as her hip improved.
Subsequently, she was involuntarily committed to a county facility where she remained for five years before she saw an attorney. During that time, the hospital ordered her estate to pay for her psychiatric hospitalization. (Brooks, 1994, p. 655)
BEHAVIORAL DISABILITY An increasing number of states require evidence that the individual's psychological disability results in serious behavioral disability. California, for example, defines such disability as "a condition in which a person, as a result of a mental disorder, is unable to provide for his basic personal needs for food, clothing or shelter."* Many involuntary hospitalizations occur when an individual is judged to be dangerous to himself or others. Would this man be a candidate for involuntary commitment?
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