State Legislation on Involuntary Psychiatric Interventions and Rights Restrictions, 2011-2022

The authors sought to identify trends in state legislation concerning involuntary psychiatric interventions and rights restrictions.

The authors identified and reviewed bills pertaining to involuntary interventions and rights restrictions (II/RR) introduced in each U.S. state legislature from 2011 to 2022. Each bill was coded according to its anticipated impact on rates of involuntary treatment or rights restrictions, the specific subject matter themes addressed, and the party affiliation of the bills' sponsors.

During the study period, the number of bills introduced and passed (N=1,903) nearly doubled. States varied widely in the proportion of overall legislative activity dealing with II/RR. Most bills sought to increase II/RR, but the proportion of bills with components that were anticipated to reduce such interventions grew over time. Short-term interventions predominated and became more common during the period examined. II/RR bills addressing funding or discharge procedures were comparatively rare. A significant number of bills sought to decrease criminal legal contact by diverting individuals into involuntary treatment programs.

In the United States, involuntary mental health interventions have received increased attention in response to public health crises such as homelessness, opioid addiction, gun violence, and suicide, but legislative trends were found not to be unidirectional and to be unevenly distributed across states. Further research could help identify determinants of the observed variation among states and examine how policy change is connected to actual use of interventions, individual outcomes, and community impacts.