Implications of need-for-treatment laws: a study of Washington State's Involuntary Treatment Act

In 1979 the State of Washington revised its civil commitment law to make it easier to hospitalize patients in need of care but not imminently dangerous to themselves or others. To assess the impact of the law, the author studied commitment patterns in Washington for two-year periods before and after the revised law went into effect. Results indicate that the number of involuntary commitments increased substantially after the law was revised, and the commitments were more likely to be based on grave disability rather than on dangerousness even if patients had engaged in violent behavior. However, the mental health system did not expand sufficiently to meet the needs of the increased patient population. Implications of Washington's experience for states considering passage of need-for-treatment legislation are discussed.