The impact of public policy and publicity on admissions to state mental health hospitals
Department of Psychiatry
Medical Subject Headings
Commitment of Mentally Ill; Health Policy; Homicide; Humans; Mental Disorders; Patient Admission; *Public Opinion; *Public Policy; Research; United States
Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology
This paper examines the impact of broadened Washington state civil commitment standards on utilization of the state's mental hospitals. Included in the analysis is an assessment of the impact of a public event (a well-publicized murder case) which was in all likelihood a precursor to the law's revision. We also examine the different ways Washington's two state hospitals managed the dramatic increase in civilly committed patients that occurred after the revision took effect. The findings indicate that the murder case, in which the defendant had been denied voluntary admission to a state hospital prior to the killing, resulted in an increase in involuntary admissions in the county where it occurred a full year before the standards were revised. The law itself had the effect of increasing commitments throughout the state, reducing the levels of voluntary admissions, and increasing the likelihood of involuntary admission for individuals previously admitted voluntarily, thus transforming a principally voluntary system into one which was primarily involuntary. Finally, it was found that the increased demand for services mandated by the broadened commitment standards was managed differently in the two state hospitals: one imposed a cap on admissions; the other phased out voluntary admissions at a rate roughly equal to the increase in commitments. These findings illustrate both the substantive impact of broadened civil commitment law and the importance, when assessing the impact of laws, of examining public events and administrative interventions which may have significant causal links with legal interventions.
Rights and Permissions
Citation: J Health Polit Policy Law. 1986 Spring;11(1):41-66.
Pierce, Glenn L.; Durham, Mary L.; and Fisher, William H., "The impact of public policy and publicity on admissions to state mental health hospitals" (1986). Systems and Psychosocial Advances Research Center Publications and Presentations. 257.