Can We Force Help on the Mentally Ill Sooner?

At TNR online, William Galston asks an important question: is it time to change our laws on involuntary commitment of the extremely mentally ill?

William Galston makes the case for involuntary commitment of the extremely mentally ill. From the New Republic online:

Starting in the 1970s, civil libertarians worked to eliminate involuntary commitment or, that failing, to raise the standards and burden of proof so high that few individuals would meet it. Important decisions by the Supreme Court and subordinate courts gave individuals new protections, including a constitutional right to refuse psychotropic medication. A few states have tried to push back in constitutionally acceptable ways, but efforts such as California’s Laura’s Law, designed to make it easier to force patients to take medication, have been stymied by civil rights concerns and lack of funding.

We need legal reform to shift the balance in favor of protecting the community, especially against those who are armed and deranged. This means two changes in particular. First, those who acquire credible evidence of an individual’s mental disturbance should be required to report it to both law enforcement authorities and the courts, and the legal jeopardy for failing to do so should be tough enough to ensure compliance. Parents, school authorities, and other involved parties should be made to understand that they have responsibilities to the community as a whole, not just to family members or to their own student body. While embarrassment and reluctance to get involved are understandable sentiments, they should not be allowed to drive conduct when the public safety is at stake. We’re not necessarily cramming these measures down anyone’s throat: I’ve known many families who were desperate for laws that would help them do what they knew needed to be done for their adult children, and many college administrators who felt that their hands were tied.

Second, the law should no longer require, as a condition of involuntary incarceration, that seriously disturbed individuals constitute a danger to themselves or others, let alone a “substantial” or “imminent” danger, as many states do. A delusional loss of contact with reality should be enough to trigger a process that starts with multiple offers of voluntary assistance and ends with involuntary treatment, including commitment if necessary.