Amicus curiae brief in the Donaldson case

Civil commitment reform: context and consequences

Laws and policies governing the care and treatment of the mentally ill are in part shaped by the sociopolitical climate in which they are formulated, and their outcomes are similarly shaped by the context in which they occur. Civil commitment laws were narrowed in a liberal era but later broadened in response both to the outcome of the initial reform and the trend toward social and fiscal conservatism which emerged in the late 1970s and 1980s. This study, which reports on the evolution of commitment law in the state of Washington, indicates that while recent changes in these laws mandate greater use of state hospitals, the retention of the procedural safeguards set in place by the initial reform coupled with limitations on resources available to state mental health systems will prevent a return to the state hospital as it appeared prior to the deinstitutionalization movement. These factors may promote the search for non-institutional alternatives, such as efforts underway in Washington and elsewhere to implement civil commitment of community-based services.

The association between psychosis and violent crime: a study of offenders evaluated at a court psychiatric clinic

Examination of 2100 psychiatric evaluations conducted by a court psychiatric clinic to determine competency or for a presentence evaluation indicated no association between a diagnosis of psychosis and commission of a crime of violence. However, offenders referred for a pretrial competency examination were more likely to have committed a crime of violence than were defendants seen for a presentence evaluation. The implications of these results are discussed.

When schizophrenia comes marching home

Deinstitutionalization of the chronically mentally ill has only recently been recognized as a phenomenon which may not be in the best interests of the patients involved. The reasons for this include the lack of adequate community-based resources for domiciliary, treatment, and rehabilitative services, plus the response of society to deviant behavior. However, the most fundamental problem is likely to be the severity of the illnesses with which we are concerned, so that the solution cannot be as simple as the sending "home" of the long-term patients. Prevention of institutionalization is seen as a more feasible goal than its cure. This requires a comprehensive program incorporating, among other things, a recognition of the necessary role of the mental hospital, and the need to improve the quality of care provided therein.