A comparison of commitment and recommitment hearings: legal and policy implications.

The changes in civil commitment law that took place in the late 1960s and early 1970s stimulated much empirical research. The resulting studies have provided a detailed description of respondents in commitment hearings and of the commitment process itself. With few exceptions (Hiday, 1981a; Peters, Miller, Schmidt, & Meeter, 1987), this research has demonstrated that the procedural and statutory requirements of state civil commitment laws are rarely met in practice. Studies have reported that attorneys have limited experience in mental health law and are inadequately prepared for hearings (Hiday, 1982; Koch, Mann, & Vogel, 1987). Furthermore, many defer to the opinions and recommendations of mental health professionals and function as guardians ad litem or as mere bystanders (Ehrenreich, Roddy, & Baxa, 1982; Hiday, 1982, 1983). Attorneys rarely call witnesses, object to evidence, cross-examine clinicians, or explore the use of less restrictive alternatives (LRAs) to involuntary hospitalization (Hiday, 1982; Lelos, 1981; Lipsitt & Lelos, 1981). The performance of judges in commitment hearings has also been found to be deficient. Judges often conduct commitment hearings in an informal manner and routinely neglect to inform respondents of many of their rights (Ehrenreich et al., 1982; Koch et al., 1987). Judges sometimes discourage attorneys from actively representing their clients and may usurp attorneys’ role by questioning respondents and witnesses (Hiday, 198 la, 1982; Shar, 198 1). In addition, judges fail to fulfill the statutory requirement to consider treatment in the least restrictive environment in as many as 55% of hearings (Ehrenreich et al., 1982; Grouse, Avellar, & Biskin, 1982). When LRAs are considered they are used infrequently (Hiday, 1981b; Hiday & Goodman, 1982).