Thirty-five years of working with civil commitment statutes

This commentary reflects my 35 years of working with civil commitment statutes, first in Alaska, then in Oregon, and on various committees on the national level. Coming from a background in community and public psychiatry, I have always considered civil commitment to be the most important forensic mental health statute, as the commitment process in any state greatly influences the lives of many severely mentally ill individuals. Over the course of the past 35 years, many changes have occurred in civil commitment law, resulting in the gradual de-emphasis of the importance of these statutes. The ability of clinicians to use these statutes effectively has diminished. Herein, I review some of the areas of conceptual and practical problems related to the use of these statutes and, in effect, make a plea for a re-examination of the importance of civil commitment and for an attempt to fix some of the problems that have led to the loss of effective and rational civil commitment laws.