Commitment, civil

As early as 1874, Connecticut passed a law providing for treatment of narcotics addicts. New York established civil commitment procedures for narcotics addicts in 1909 but did not provide treatment facilities. Although California authorized a state hospital for narcotics addicts in 1927, states in general were slow to provide facilities even when authorized by law. 

United States Narcotic Addiction Rehabilitation Act authorizes the civil commitment of narcotic addicts, and gives federal financial assistance to states and local authorities to develop a local system of drug treatment programs. Methadone clinic treatment programs begin to dramatically rise. 

If the subject is an involuntary patient, the direct or primary goal of treatment (civil commitment and some other intervention) is to make others feel better (about the patient or about being reUeved of him). The sole criterion for assessing the efficacy of the intervention is the opinion of others (judges, psychiatrists, relatives). The patients opinion is irrelevant. 

The authors of DSM-IV further assert that a common misconception is that a classification of mental disorders classifies people, when actually what are being classified are disorders that people have. Then, perhaps in an attempt to forestall the criticism that the psychiatrist s paradigmatic interventions are forensic—civil commitment and the insanity defense—the authors add this disingenuous disclaimer DSM-IV is a classification of mental disorders that was developed for use in clinical, educational, and research settings.. . . When the categories, criteria, and textual descriptions are... 

What psychiatrists do conflicts glaringly with such claims. Pathologists examine cadavers, biopsy specimens, and body fluids. Surgeons operate on patients and repair or remove diseased parts of the body. Psychiatrists do not even perform physical examinations they listen and talk to patients, ask psychologists to administer pencil-and-paper tests to them, give patients diagnoses and drugs, and certify them as fit for civil commitment or unfit to stand trial. Their claim that they treat brain diseases is manifestly absurd.22... 

If the policy on civil commitment of the American Civil Liberties Union is ill conceived, its recommendations for further improvements are nothing less than terrifying "Anyone hospitalized for mental illness, the statement asserts, is entitled to medical and psychiatric care, appropriate to his particular case. In making this declaration, the American Civil Liberties Union not only supports commitment on the basis of an undefined concept of mental illness and as a legitimate medical function, but also advocates psychiatric treatment, regardless of whether or not the patient consents to it or of how dangerous or destructive such "treatment might be. Does the American Civil Liberties Union really believe... 

American Civil Liberties Union, The Policy Guide of the American Civil Liberties Union (Policy No. 225 The Mentally 111—Civil Commitment), June, 1966. 

---