Risk Assessment and Involuntary Commitment

Prior to the 1970s, there was little concern about the rights of individuals who were committed to mental institutions; it was seen as a benevolent act, to assist an individual in taking care of themselves. In 1972, a case from Wisconsin, Lessard v. Schmidt, proposed that since commitment represented a loss of liberty, it could only be done if an individual were dangerous to self or others. Most, but not all states adopted this line of reasoning, though some maintained that a need for treatment needed to be at the center of the rationale for involuntary hospitalization. Closely related to these laws, were several requiring treatment within the institution as a step toward eventually leaving the hospital. Other concepts such as the least restrictive alternative, and gravely disabled followed. Beginning in the 1980s several lawsuits also dealt with the right to refuse treatment, and the conditions under which this right could be overridden. Most recently, there has been a great deal of controversy surrounding the involuntary commitment of those individuals deemed to be sexually violent predators. One of the recurring issues is our inability to predict accurately future violent behavior.