Involuntary commitment is the ability of the State to institutionalize mentally ill people against their will. Perhaps the most well-known law providing for involuntary commitment is Florida’s “Baker Act” of 1971, which allows for the involuntary commitment of a person who (a) may possibly have a mental illness, and (b) may be harm to themselves, a harm to others, or self-neglectful. The experience of being institutionalized is largely traumatic, and many who have been committed claim it was of no help at all. Rather than help people in need, the State arrests them and forces them to serve time for the crime of simply existing. The State’s resounding message is this: mentally ill people are not people at all.
Involuntary hospitalization is commonly used as a means to prevent someone from committing suicide. However, no states in the U.S. have laws against attempted suicide, and have not had such laws since the 1990s. Suicide is a human right. Just as people have the right to live as they choose so long as they do not harm others, they have the right to die so long as they do not harm others. Despite the lack of laws against suicide itself, many states have laws in place to support the involuntary commitment of people who are suicidal.
Instead of treating suicide as a public health issue, the State treats those who are suicidal as criminals. I spoke with Alexis*, of New York, who was involuntarily committed when she expressed suicidal thoughts to her therapist. Her therapist deceivingly informed Alexis’* family members that she was voluntarily committing herself. Alexis was taken to the hospital in an ambulance, which she and her family had to pay for. During her stay, Alexis, a transgender woman, was kept at the hospital, deprived of her hormonal medication, referred to with the wrong pronouns, and asked invasive questions about her genitalia. Despite telling Alexis she could leave when she wanted to, hospital staff threatened her with keeping her for another month if they disagreed with her reasons for leaving and forced her to take debilitating medications. Alexis found the experience to be traumatizing and utterly unhelpful, hospital bills aside.
The State treats even those who hospitalize themselves voluntarily as criminals. I spoke with Carla*, from Mississippi, who voluntarily presented herself at her school psychologist’s office to ask about hospitalization, but then was not allowed to leave. She was forced to go directly to the hospital, and made to take (and pay for) an ambulance, even though she had friends who were willing to drive her. Her school’s counseling services was surrounded by dorm buildings, and when the ambulance arrived it drew a crowd or observers, making what should have been a private experience public and humiliating. While hospitalized, Carla felt isolated and trapped, and had no idea how long she would be held. What began as a voluntary step toward recovery turned into a traumatizing imprisonment.
Other cases begin even worse. Generally those who are involuntarily committed out of their homes arrive at the hospital in handcuffs, after experiencing the humiliation of arrest in front of family members and neighbors. Such was the case of Ben* from Florida. Police arrived at Ben’s house while he was still sleeping. He was forced into a police care in his pajamas, not to return for five days. After spending the night in the hospital due to injuries from a suicide attempt, Alex*, of Arizona, was threatened with more time if she did not “voluntarily” check in to the hospital’s psych ward. Despite the fact that she felt better, hospital staff told her she would have police on her tail if she didn’t comply. Alex described her time in the psych ward as being a fish in a fish bowl — completely alone but constantly watched. Hospital staff took her phone away and refused her permission to stay with her mother. Alex said her involuntary commitment was the “worst days of [her] life.”
Of those who are involuntarily committed, an overwhelming majority says they would never do it again, even if they were in need of help. An anonymous poster in an online forum on the subject said:
I am one who would rather die than be forced into the psych hospital again. Forced treatment was a re-creation of sexual assault for me, which was not life saving, it was destroying. To be forced to take my clothes off in front of people, to try and hide my body with my arms, to be put in a room with a metal door, to be reduced to pleading and begging, to know my voice meant nothing. It was the same story only with different perpetrators. I would not ever, for a second, turn to a mental health professional who would do that to me again. I didn’t commit a crime and I didn’t deserve to be terrorized like that. I already had those memories. I didn’t need any more.
Involuntary commitment serves to victimize those who have already been victims. It often causes the committed to relive personal trauma, and reduces them to criminals, without the rights all human beings deserve. Involuntary commitment transforms doctor and patient to guard and prisoner, punishing those who have done no wrong.
Involuntary commitment lends itself to heinous abuses of power, as little evidence is required for a patient to be committed. In the United States in 1927, Aurora D’Angelo was involuntarily committed after participating in a demonstration in defense of anarchists Sacco and Vanzetti, who had been sentenced to death. Authorities in Mississippi in 1958 arrested and committed black pastor and activist Clennon W. King, Jr. on the grounds of insanity for trying to enroll in the all-white University of Mississippi. In the 2010 case of whistleblower Adrian Schoolcraft, when the former NYPD officer asserted that the police force was faking crime statistics, the police sent him to a mental hospital rather than investigate his claim. Involuntary hospitalization has been used, and can continue to be used, by the State as a means of speech suppression.
Abuse of power within mental hospitals is all too common. A senior member of hospital staff in England raped a woman patient sixty times, sneaking in Valium to render her unable to fight back. A psychiatric unit in Brooklyn recently came under investigation for being run more like a prison than a hospital, as staff subdued patients with physical restraints and drugs rather than offering individualized treatment. Patients of varying states of health commonly abuse each other with little intervention from hospital staff. Hospital staff isolates and traumatizes schizophrenics, treating them as violent criminals, despite a lack of any criminal history.
Part of the reason for involuntary commitment is the association between mental illness and violence. However, much of these fears are unfounded. Mental illness has become the new scapegoat for violent crimes committed by evil people, and the main people affected are the mentally ill. However, mental illness is not a crime; it is a medical condition and should be treated as such. Most people suffering from depression, anxiety, bipolar disorder, schizophrenia, or any other number of mental illnesses are capable, functioning adults. The notion of mental illness itself is largely socially constructed. By feeding off of social stigma, the State is able to imprison mass amounts of people despite them never having committed a crime.
Involuntary commitment is traumatizing and unhelpful to sufferers of mental illness and easily lends itself to abuse. What seems like a dystopian practice out of a science fiction novel, the imprisonment of people who think differently is all too real. By stripping the mentally ill of their rights as human beings, and treating them as government property, the State perpetuates the idea that the mentally ill are less than people. I cannot believe I have to say this, but mentally ill people are people too.
*Names have been changed to protect the subject’s identity.
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