A person being mentally ill is not sufficient grounds for placing that person in a mental institution against his/her will. In the United States of America, the procedure for committing a person vary from state to state but certain conditions must be met.
The person must be judged to;
a) be dangerous to themselves or others and /or
b) incapable of providing for their basic physical needs and /or
c) unable to make responsible decisions about hospitalization and
d) in need of treatment or care in a hospital.
A concerned individual like a relative, physician, or mental health professional would normally make a petition to court for such a committal. The court would then appoint two examiners to evaluate the “proposed patient”.
If a person is committed to a mental hospital for treatment the hospital must report to court within 60 days on whether the person needs to be committed for a longer period or released. If the hospital does not make any report the person must be released forthwith.
If the hospital reports that the person needs further treatment, the person would then be held indefinite with regular reports to the court. If there is no time to get a court order for commitment or if there is imminent danger, the law allows emergency hospitalization without formal committal hearing. A physician must however sign a statement stating that an imminent danger exists.
Important Court decisions for Patient Rights
1) Right to Treatment: In the case of Wyatt v Stickney decided in 1972, the US District court in Alabama rendered a landmark decision to the effect that a mentally retarded persons has a right to receive treatment. This decision led to the state of Alabama increasing its budget for the treatment of mental illness and mental retardation by 300 per cent.
2) Freedom from Custodial Confinement: In Donaldson v O’Connor decided in 1975, the US Supreme court upheld the principle that patients have rights to freedom form custodial confinement if they are not dangerous to themselves or others and if they can safely survive outside custody.
3) Right to compensation for work: In the case of Souder v Brennan (the secretary of Labor) decided in 1973, the US District court ruled that a patient in a non-federal mental institution who performed work must be paid according to Fair Labor Standards Act.
4) Right to live in a Community: In Staff v Miller decided in 1974, a District court decided that released state mental health patients had a right to live in “adult homes” in the community.
5) Right to less Restrictive Treatment: A US District court in 1975 made a landmark decision establishing the right of individuals to receive treatment in less restrictive facilities than mental institutions. This was in the case of Dixon v Weinberger.
6) Right to legal counsel at commitment hearings: In the case of Memmel v Mundy decide in 1976, the state Supreme court of Wisconsin decided that an individual had the right to legal counsel during the commitment process.
7) Right to refuse treatment: The have been several court decisions as well as state legislation permitting patients the right to refuse certain treatment such as electroconvulsive therapy and psychosurgery.
Convincing evidence needed before confinement: The US supreme court in 1979 in the case of Addington v Texas ruled that a persons need to be confined to an institution must be based on demonstrable evidence.
9) Limits on Patients rights to refuse Psychotropic medication: The US Supreme court ruled in 1990 in the case of Washington v Harper that a state prison could override a disturbed prisoner’s right to refuse psychotropic medications.