Civil commitment reform: context and consequences

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Commitment of Mentally Ill; Community Mental Health Services; Deinstitutionalization; Hospitals, Psychiatric; Hospitals, State; Humans; Mental Disorders; United States


Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology


Laws and policies governing the care and treatment of the mentally ill are in part shaped by the sociopolitical climate in which they are formulated, and their outcomes are similarly shaped by the context in which they occur. Civil commitment laws were narrowed in a liberal era but later broadened in response both to the outcome of the initial reform and the trend toward social and fiscal conservatism which emerged in the late 1970s and 1980s. This study, which reports on the evolution of commitment law in the state of Washington, indicates that while recent changes in these laws mandate greater use of state hospitals, the retention of the procedural safeguards set in place by the initial reform coupled with limitations on resources available to state mental health systems will prevent a return to the state hospital as it appeared prior to the deinstitutionalization movement. These factors may promote the search for non-institutional alternatives, such as efforts underway in Washington and elsewhere to implement civil commitment of community-based services.


Psychiatr Q. 1985 Fall-Winter;57(3-4):217-29.

Journal/Book/Conference Title

The Psychiatric quarterly

Related Resources

Link to Article in PubMed

PubMed ID