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7 Law & Hum. Behav. 1 (1983)

handle is hein.journals/lwhmbv7 and id is 1 raw text is: Law and Human Behavior, Vol. 7, No. 1, 1983

The Structure of Civil Commitment
Patterns, Pressures, and Interactions in Mental Health
David B. Wexler*
The contents and provisions of civil commitment codes are shaped by a number of influences. This article
examines those influences and categorizes them as either falling within the civil commitment system itself or as
being external to that system. From an analysis of those internal and external influences, it is concluded that the
structure of civil commitment is very much dependent upon the environment in which such laws operate and upon
the intricate and integral relationship between civil commitment and other important forms of mental health
legislation (incompetence to stand trial, the insanity defense, etc.).
For the past decade and a half, the United States has witnessed a virtual explosion of
law relating to the mental health system.' Perhaps as an outgrowth of the civil rights
movement, U.S. courts began to accord rights to criminal suspects, then to prisoners,
and then to mental patients.
The initial thrust of mental health law activity involved the civil commitment
process as well as the rights of the institutionalized mentally ill. Civil commitment
reforms were of both a procedural and a substantive nature. Procedurally, due process
safeguards-such as the right to counsel2 and to a heightened standard of proof
regarding committability3-were grafted onto civil commitment hearings. Substan-
tively, mental health codes were rewritten to tighten and narrow the criteria for
*College of Law, University of Arizona, Tucson, Arizona 85721.
'Principal developments are discussed in D. Wexler, Mental Health Law: Major Issues (1981). A helpful article-
length overview, with an extensive bibliography, appears in Shah, Legal and Mental Health Interactions: Major
Developments and Research Needs, 4 Intl. J.L. & Psychiatry 219 (1981).
-State ex rel. Memmel v. Mundy, 75 Wis. 2d 276, 249 N.W.2d 573 (1977).
3Addington v. Texas, 441 U.S. 418 (1979) (committability must be established by clear and convincing
evidence rather than by a mere preponderance of the evidence).
0147-7307/83/0300-0001$03.00/0 © 1983 Plenum Publishing Corporation

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