State Involuntary Outpatient Commitment Laws

Involuntary outpatient commitment (IOC) is not a new idea. More than half the states have relatively longstanding provisions giving courts the authority to order a person with a mental illness—even when living in the community—to comply with a specified course of treatment. However, most of these states use IOC only rarely.

Recently, there has been renewed interest in IOC. State-based advocates and mental health consumers report a campaign to encourage states with IOC statutes to broaden their use and to promote enactment of such laws in states that do not already have them. In the past year, IOC legislation has been considered in a number of states, including California, Massachusetts and Connecticut, and enacted in New York. Advocates defeated an IOC proposal in Maryland and prevented proponents in Pennsylvania and Iowa from expanding the use of IOC.

Proponents of IOC cite isolated incidents of violence committed by people with mental illnesses to justify the need for statutes authorizing forced treatment. In these campaigns, IOC supporters tend to exaggerate the likelihood of such incidents and often mischaracterize the relatively few studies that have been conducted on the efficacy of IOC (see "Studies of Outpatient Commitment Are Misused.") Above all, IOC proponents blame violent incidents on the perpetrator's unwillingness to seek treatment, though they seldom offer any evidence that appropriate treatment was offered and rejected and ignore the glaring inadequacies of the mental health system. In New York, for example, IOC was proposed as protection against people like subway pusher Andrew Goldstein, in the face of evidence that Mr. Goldstein diligently and repeatedly sought treatment and was turned away or offered only inappropriate services.

The following chart provides a comprehensive side-by-side comparison of state IOC statutes as of June 2004. It does not include conditional release statutes—such as those found in Alaska, New Hampshire and Tennessee—which require a person to meet inpatient standards and be detained on an inpatient basis before a court can consider IOC. The landscape is changing rapidly but the Bazelon Center has been unable to update the chart.

As the chart indicates, a person with a mental illness can be committed in most of the 37 states that have IOC laws without any finding of imminent dangerousness to self or others. Even without any dangerousness requirement, a number of states explicitly allow police forcibly to pick up and detain people for mental evaluations if they have failed to comply with any provision in an IOC order. These concerns, among others, have led the Bazelon Center to oppose the use of outpatient commitment.

Go to the html version of the chart, or the PDF version of the chart*. (Requires Acrobat Reader)