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It seems obvious sometimes, obvious to everyone but the addict that they are placing their life in danger through their abuse, neglecting their basic needs for food and shelter and badly in need of help.

Sometimes, despite our most determined efforts, we just can’t get them to see reason and can’t get them to concede to a need for treatment. Surely when things get as bad as this we can have them temporarily committed for their own safety and wellbeing?

Unfortunately, the State is very unwilling to intervene except in real emergencies, unwilling for a couple of basic reasons.

Why the State Won't Often Intervene...

Civil Rights

Firstly and historically, it used to be quite easy to have a relative committed  for mental health or substance abuse needs, and in retrospect, civil rights advocates argue that it was far too easy to have someone committed against their will and consent, and for an indefinite length of time as well.

In response to many real abuses of individual rights on cases of questionable merit, the state in the second half of the last century moved progressively away from easy familial commitment of people in need of mental health or substance abuse treatment. The state would intervene only when there was a clear and imminent danger to self or others, and the standard of proof required to meet these criteria was quite high.

In retrospect, and in the guise of civil liberty, the state moved too far away from involuntary commitments and a great many people in real need of temporary psychiatric or substance abuse care were not compelled to get it, and a great many tragedies ensued as a direct result.

The state in recent years has moved back slightly towards making it easier for people in real danger to be treated without their consent, but the requirements for involuntary commitment remain very high, and most addicts, even those who are most certainly harming themselves as a consequence of their abuse, will not meet the stringent guidelines for involuntary commitment.

The regulations vary by state, but in general, to be involuntarily committed a person needs to present with an imminent (and provable based on recent actions) danger to themselves or others, or through their neglect of basic necessities (that cannot or are not being met by family) be placing themselves in immediate and direct harms way.

It can be very tough to prove that an addict or alcoholic is placing themselves imminent danger, chronic and long term danger is easy, but imminent danger is tough, and as a result few people with substance abuse problems will meet the minimum standards for involuntary commitment.

Limited Resources

The second fundamental problem state agencies face when dealing with requests for involuntary treatment is a real lack of resources to treat all people in society in need of mental health and substance abuse care, within their budgetary and personnel constraints. Essentially, unless these agencies are given greater funding they cannot meet the treatment needs of all those people who would benefit from involuntary care.

The regulations do vary by state though, and to get more information about the requirements for involuntary temporary commitment in your area you should visit or call the state court mental health department to learn more. It is worth looking into, and in some cases you may find that the state will do what you cannot, and compel needed treatment on an otherwise unwilling participant.

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Page last updated Jan 21, 2013

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