For example, a person with depression may see him- or herself as worthless and, in his or her despair, make efforts to end his or her life. The perceptual distortions caused by disorders of mood, thought, and cognition can interfere with a person's functioning to such a severe degree that treatment is critical to the safety of the affected individual and of others. Many people with psychiatric illnesses spend much of their lives struggling with disorders that affect the most fundamental aspects of the human experience-their perceptions of themselves and the world in which they live. By reading this article, one will learn the history of involuntary psychiatric hospitalization in the United States and gain an understanding of the ethical issues that make civil commitment one of the most controversial practices in modern psychiatry. Finally, an overview of outpatient commitment is provided. Involuntary hospitalization of patient populations that present unique challenges for psychiatry (e.g., not guilty by reason of insanity acquittees, sex offenders, and individuals with eating disorders, substance use disorders, and personality disorders) is discussed. The evolution of the United States commitment standards, from being based on a right to treatment for patients with mental illness to being based on dangerousness, as well as the implications that the changes in commitment criteria has had on patients and society, are discussed. ![]() The ethical conflict that the practice of involuntary hospitalization presents for providers, namely the conflict between the ethical duties of beneficence and respect for patient autonomy, is presented. ![]() It provides an overview of the history of involuntary psychiatric hospitalization in the United States-from the creation of the first asylum and the era of institutionalization to the movement of deinstitutionalization. ![]() This article reviews the academic literature on the psychiatric practice of civil commitment.
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