A study of mandatory review of civil commitment.

The California Civil Commitment Statute provides for prolonged (14-day) involuntary hospitalization of the mentally ill on the basis of grave disability (GD), danger to self, and danger to others. Recently the procedure has been modified to provide mandatory review of all 14-day certificates for GD. Comparison of 47 patients certified before the law change with 58 subjects certified after the change found that correlations between certification category and criterion measures were significant but low. Although the change was directed toward GD, no significant improvement was seen in the specificity of application of the GD category after the legal change. Because of these limited effects, the value of time-consuming mandatory judicial review is questionable. The attempt may have been doomed from the start because of unquantifiable commitment criteria. Before additional judicial burdens are imposed on the psychiatrist, careful assessment of the rationale for such procedures should be made.