Academic journal article Law and Psychology Review

Dangerous Minds: Myths and Realities Behind the Violent Behavior of the Mentally Ill, Public Perceptions, and the Judicial Response through Involuntary Civil Commitment

Academic journal article Law and Psychology Review

Dangerous Minds: Myths and Realities Behind the Violent Behavior of the Mentally Ill, Public Perceptions, and the Judicial Response through Involuntary Civil Commitment

Article excerpt

TABLE OF CONTENTS  INTRODUCTION I. EXPLAINING DANGEROUS BEHAVIOR II. THE DANGEROUS ACT: MUST IT BE IMMINENT AND SHOULD COURTS        REQUIRE AN OVERT ACT? III. PREDICTING DANGEROUS BEHAVIOR IV. BACK TO REALITY: STATE EFFORTS TO CONFINE PEOPLE WITH        MENTAL ILLNESS AND JUDICIAL RESPONSE V. COURT INTERPRETATION OF DANGER STANDARD AND EXAMPLES OF        PROVING THE DANGER CRITERIA VI. CHALLENGES TO STATE CIVIL COMMITMENT STANDARDS: IS        DANGER TO SELF OR OTHERS STILL A REQUIREMENT IN        "GRAVELY DISABLED" STATUTES? VII. RISK FACTORS IN ASSESSING DANGEROUS BEHAVIOR AT THE        INVOLUNTARY CIVIL COMMITMENT HEARING VIII. PUBLIC PERCEPTION OF THE MENTALLY III AS DANGEROUS        CONTINUES TO BE A SERIOUS CHALLENGE IX. PSYCHOTROPIC MEDICATION IS NOT THE ANSWER X. RECOMMENDATIONS ON THE DANGER CRITERIA IN CIVIL COMMITMENT HEARINGS CONCLUSION 

INTRODUCTION

The public outcry about whether a person with a mental illness should be restrained and confined has grown in recent years as a result of misunderstanding the risk that these individuals pose to the safety of the community at large. Many questions accompany an inquiry into this misconception. Is there science behind how psychiatrists opine to judges in predicting future dangerous behavior? Why are jails filling up with criminal defendants carrying mental illness diagnoses? How are state legislatures addressing the dangerously mentally ill? Why does the public subscribe to the feeling that persons with mental illnesses are inherently dangerous? Taking into consideration these questions, it is time to understand and debunk the public perception that people with mental illnesses are risks to the community.

There is growing pressure from various coiners of society to address the presence of people with mental illness who are perceived as dangerous in the community. Certain segments of the public want to identify and remove such persons from neighborhoods before they do harm. These groups favor a preemptive strike to detain the mentally ill. Others in the mental health advocacy field worry that this knee-jerk reaction is based on the myth that people who are mentally ill pose a greater danger to the public than those persons without such a diagnosis. Complicating the picture is the lack of precise science on how to predict future dangerous behavior. Judges tasked with the responsibility of ordering involuntary confinement of people who are dangerously mentally ill often rely on carefully considered, but inherently limited, opinions about one's future danger behavior. This method of evaluating a person's future dangerous behavior and society's desire to intervene and confine leads one to ponder the serious risk this poses to an individual's freedom.

In the 1960s, there was a shift from the inhumane treatment of the mentally ill, which included a "significant curtailment of liberty interests," (2) to a more modern standard established by several landmark Supreme Court decisions. (3) This paved the way for state legislatures to enact stricter criterion for involuntary civil commitment laws, requiring a minimum showing of "dangerous behavior." (4)

Regrettably, the pendulum has swung in the opposite direction in recent decades." Legislatures, with the persuasive lobbying of some in the medical community, (6) have expanded the definition of "dangerousness" back to the less-enlightened times prior to the 1960s. (7) Professional opinion has followed suit. In a national survey completed by over 700 psychiatrists, 90% of respondents wanted grave disability to be at least one of the grounds for civil commitment. (8) In a late 1970s study, 48% of psychiatrists supported a commitment standard based on a mental illness alone, an increase from only 10% supporting such grounds in 1969. (9)

There are only eight states that define dangerousness as "danger to self or others." (10) Forty-two states utilize the standard of "grave disability" (11) or a "need for treatment" criteria. …

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