Commitment: the consistency of clinicians and the use of legal standards

UMMS Affiliation

Department of Psychiatry



Document Type


Medical Subject Headings

Commitment of Mentally Ill; Dangerous Behavior; Decision Making; Emergency Services, Psychiatric; Forensic Psychiatry; Hospitalization; Humans; Mental Disorders; *Mentally Ill Persons; United States


Law | Psychiatry | Psychiatry and Psychology


The reliability and validity of the application of legal criteria for commitment were investigated as part of a larger study. Evaluations of 411 patients by 96 different clinicians showed good interrater reliability for assessment of dangerousness and committability. A strong relationship between ratings of committability and ratings of dangerousness suggests that clinicians were conforming to the logic of the commitment law. Discrepant cases involved patients who desired voluntary admission or whose commitment was completed elsewhere. Results suggest fair application of commitment standards but that two issues of statutory interpretation confused participating clinicians.

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Citation: Am J Psychiatry. 1989 Feb;146(2):176-81.

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