NEWS: Texas Supreme Court clarifies what constitutes an "overt act." Click here to learn more.

Texas, like every state, has its own civil commitment laws that establish criteria for determining when court-ordered treatment is appropriate for individuals with severe mental illness who are too ill to seek care voluntarily. The state authorizes both inpatient (hospital) and outpatient (community) treatment, which is known in Texas as "court-ordered outpatient mental health services." It is one of the 27 states whose involuntary treatment standard is based on a person’s “need for treatment” rather than only the person’s likelihood of being dangerous to self or others.



For “temporary” (90-day) inpatient commitment, a person must be mentally ill and EITHER:

  • likely to cause serious harm to self or others; OR
  • suffering ALL of the following:
  • severe and abnormal mental, emotional, or physical distress;
  • substantial deterioration of ability to function independently; AND
  • (iii) inability to make rational and informed treatment decisions.

For “temporary” (90-day) outpatient commitment, a person must be ALL of the following:

  • severely and persistently mentally ill;
  • if untreated, destined to continue to suffer BOTH:
  • severe and abnormal mental, emotional, or physical distress; AND
  • deterioration of the ability to function independently, leading to an inability to live 
  • safely in community; 
  • unable to voluntarily and effectively participate in outpatient treatment.


New clarity on acts that are “overt”

On July 2, 2010, the Texas Supreme Court provided some much-needed clarity on what constitutes an “overt act” for purposes of civil commitment.

Texas is one of several states that requires someone petitioning for commitment of a mentally ill person to identify a specific “overt act or pattern of behavior” by the person that tends to confirm that he or she meets the commitment criteria. Not surprisingly, questions of interpretation sometimes arise: Just how far down the road of dangerous behavior must a mentally ill person walk to convince a judge that an “overt act” has occurred?

The case of Texas v. KEW is illustrative. KEW was an occasional visitor to a mental health center, where he received outpatient services for his schizophrenia. One day, he came to the center for a scheduled appointment and informed staff that he had been instructed by aliens to populate a new race by impregnating multiple women, including his adult step-daughter and a particular staff member of the center. He repeatedly asked to see this woman and became agitated when not permitted to do so. However, he denied any intent to force himself upon the women. (Presumably, he expected them to willingly comply once he made them understand the urgency of his mission.)

KEW was committed on grounds of dangerousness, with his statement identified as the requisite “overt act.” To the uninitiated, this may seem like common sense. Given KEW’s impaired judgment and his determination to impregnate multiple women, why wait to find out how far he was willing to go after the women inevitably rebuffed him?

A Texas appellate court didn’t see it that way. The court overturned the commitment, finding that KEW took no steps in furtherance of any dangerous plan and holding that his mere words – absent a specific threat of violence – are insufficient to constitute an "overt act." The court found that evidence of "possible" or "potential" serious harm was insufficient.

Happily, the Texas Supreme Court rejected this analysis and reinstated the commitment. The majority held that even if not a direct threat, a statement is a sufficient overt act so long as it “is to some degree probative of a finding that serious harm is probable.”

Two justices submitted a concurring opinion, agreeing with the result but not the majority’s reasoning. The concurring judges agreed with the court below that a verbal statement is not an "overt act" unless it amounts to a violent threat. But they also found that the issue need not have been reached in light of the discovery of a list of the targeted women's names in KEW's pocket, the making of which did, in their view, constitute a sufficient overt act.

To read the majority opinion, click here. The oral arguments presented to the court are also available to view on this site.


State standards for emergency hospitalization for evaluation and state-by-state information on initiating emergency hospitalization and assisted inpatient or outpatient treatment can be found from our Civil Commitment Laws and Standards page. 


Visit Get Helpfor tools and information about preparing for and handling a psychiatric crisis.

Visit Get Involved for information about how you can help bring down barriers to the timely and effective treatment of severe mental illness.


Visit Your State

How to Help

Sign up for updates
Become an advocate
Recruit others to help
Follow us on Facebook