Author: Aidyn Carlson

For their own good: Involuntary commitment and patient’s rights in Washington D.C.

As we approach the holidays, we are encouraged to consider what we are grateful for. Walking around the WCL campus and seeing the posterboards, I am struck by how many people express open gratitude for therapy and psychiatric medication. Over the last week, I’ve seen notes that say: “I’m grateful for my meds” and “I am grateful for Celexa” (An antidepressant). In past years, I’ve seen: “I’m grateful for Prozac” and “I’m grateful for Lexapro.” These are also antidepressants. These notes indicate to me that there is not only less shame in disclosing mental health conditions and treatments, but more desire to speak openly about how we live with these conditions. Considering the stressful, highly competitive nature of law school, students on psychiatric medications should be aware their conditions can become unmanageable and require treatment in a psychiatric hospital ward. This raises the question: Are they aware of their rights once they have voluntarily accepted or have been forced into treatment? It is important to understand the basic rights of involuntarily committed patients because these patients are often vulnerable to misuse of their information and arrive at the hospital in a state not conducive to self-advocacy. Even in the midst of a mental health crisis, patients have a right to privacy and humane treatment.

What follows is a summary of rights of mental health patients in the D.C. metropolitan area. A person can be involuntarily committed for psychiatric treatment in Washington D.C. when a psychiatrist, qualified physician, or qualified psychologist has examined the person and has determined that the person has a mental illness which makes them a danger to themself or others, and that hospitalization is the least restrictive setting that meets the person’s needs. If the patient is a minor (under 18), their parent or legal guardian must be served notice of the patient’s admission to the hospital no more than 24 hours after admission. If the patient is an adult, the patient must authorize the Department to serve notice to their spouse, domestic partner, or legal guardian as long as the notice is consistent with the District of Columbia Mental Health Information Act of 1978 D.C. Code §7-1201-0.1. Patients cannot be detained for more than 48 hours, unless the chief officer of the department files a written petition with the court for emergency observation and diagnosis of the patient, in which case, the patient’s detention cannot exceed seven days from the time the order is entered. Patients are entitled to a complete record of their treatment as a patient. Not all mental health conditions qualify for involuntary commitment. A national survey of psychiatrists in the United States revealed that most believe simply having a mental illness that is diagnosable using the DSM should not be grounds for involuntary commitment, but being a danger to one’s self or others should be grounds for involuntary commitment. Most psychiatrists that were surveyed believed conditions that included a psychotic component should be grounds for involuntary commitment. Fifty-one percent of psychiatrists believed that having depression should be grounds for commitment.

We fear what we do not understand. Mental health commitment is not something to be feared. Psychiatric wards offer a place to rest and disconnect from the stresses of daily life until we are ready to face them again.  The goal of involuntary commitment is to prepare patients for a successful re-entry into society. Commitment may seem frightening at first, but it will likely be an experience you are grateful you had.