Moran, M. (2025).
Psychiatric News, 60(10).
While rates of civil commitment vary widely across the country, nine states and the District of Columbia reported significant increases from 2010 to 2022, according to a survey study published recently by Psychiatric Services. No state showed a significant decrease.
However, civil commitment is governed by state laws, with substantial variation in how states collect and report civil commitment data. “This lack of standardization limits the ability to draw firm conclusions about national trends or about cross-state comparisons,” wrote Mustafa Karakus, Ph.D., of Westat, and colleagues.
Using systematic website searches and direct outreach to state mental health authorities (SMHAs) and court systems, the researchers obtained data on civil commitment rates between 2010 and 2022 for 32 states and D.C. Of the 18 states where no data was available, staff from seven SMHAs or state courts told the researchers that no state office was currently tracking the number of civil commitments in their state. For the remaining 11 states, the online search yielded no data, and the study team received no responses to outreach attempts.
The article is linked above.
Here are some thoughts:
The increasing use of civil commitment presents several critical challenges, focusing on trauma-informed care and policy reform. Clinically, mental health practitioners must recognize that the commitment process itself is often traumatizing—with patients reporting the experience, including transport in law enforcement vehicles, feels like an arrest—necessitating the use of trauma-informed principles to mitigate harm and rebuild trust. Ethically and legally, practitioners must master their specific state's law regarding the distinction between an initial hold and a final commitment, ensuring meticulous documentation and relying on rigorous, evidence-based risk assessment to justify any involuntary intervention. Systemically, mental health practitioners should advocate for immediate data standardization across states to move beyond "muddled" data, and champion policy changes, such as implementing non-law enforcement transport protocols, to minimize patient trauma and ensure civil commitment is used judiciously and with dignity.
