Patient diagnostic, behavioral and demographic variables associated with changes in civil commitment procedures

Examined diagnostic and demographic characteristics of six groups of voluntary and committed patients (N = 300) over a 3-year period in order to assess the impact of a change in civil commitment procedures in the state of Missouri. Committed and voluntary patients differed on the basis of several demographic and behavioral variables, including diagnosis, employment status, and instances of serious physical harm recorded on admission. No differences were found between patients committed under the old law (which stipulated that the presence of "mental illness" was a sufficient criterion) and patients committed under the new law (which requires the presence of serious physical harm as an essential criterion). These findings were interpreted to suggest that, in at least some settings, clinicians were restricting commitment to cases that gave evidence of physical harm prior to the enactment of new legislation.