Needed changes in law and procedure for the chronically mentally ill.

Three areas of legal change have had major effects on the chronic mentally ill: substantive and procedural alterations in civil commitment laws, the limited implementation of a constitutionally based right to treatment, and the partial recognition of a right to refuse treatment. After discussing these changes, the authors make recommendations they believe would be beneficial. Revised civil commitment laws should allow greater access to both emergency and ongoing involuntary treatment, including reintroduction of a need-for-treatment standard and use of informal rules of evidence. The right to treatment should be implemented beginning with established constitutional minimums of providing reasonable care and safety, reasonably nonrestrictive confinement, and treatment to prevent clinical deterioration. Legislation should permit medication of involuntarily committed patients without their consent.